detection and swift intervention can prevent
strokes, kidney failure and heart disease.
When Mr. Dayal began experiencing back pain
and breathlessness at the age of 50, he
thought it was a consequence of aging. As
none of the conventional balms and muscle
relaxants helped, he finally approached our
hospital for investigation. And, just as
well. Out tests revealed that
actually had an aneurysm of his aorta
involving the entire chest. He also had
chronic pulmonary disease in his lungs,
which caused the breathlessness.
What are aneurysms?
are abnormal dilatations (bulges) of the
aortic blood vessel, which carry blood to
the body. The bulge can occur either in the
chest or in the abdomen. As the aneurysm
expands in size they cause discomfort to the
patient in the form of vague chest
/abdominal/back pain. Aneurysms can be
critical if they burst. This results in
heavy bleeding into the chest and abdomen.
In fact patients with a ruptured aneurysm
have a poor chance of survival. Many of them
die before they reach the hospital!
Aneurysms can be fatal
aneurysms are treated by open surgery where
the cardiothoracic surgeon opens the chest
or abdomen and replaces the diseased aorta
with a new graft. Open surgeries have their
own problems and require a long hospital
stay and may not be possible in very old
patients or high-risk patients. In Mr. Dayal’s case major surgery was ruled out
because of his bad lung disease.
Now, an option to open surgery
Instead, Mr. Dayal
benefited from a new procedure. Instead of
an open surgery of the chest, a
pinhole-sized incision was made in the groin
and through it, an endovascular graft was
placed within the aneurysm. This graft
prevents any blood flow into the aneurysm
and it becomes thrombosed. Mr. Dayal
recovered immediately and was discharged
without any problems in 4 days.
Stents - the new lifesavers
Stent grafts like
the one used on Mr. Dayal are now
commercially available for treatment of
aneurysm in the chest and abdomen. Stenting
through a pinhole procedure involves
teamwork between the Interventional
Radiologist, Cardiovascular Surgeon,
Anaesthetist and Cardiologists. The
procedure is done under anaesthesia in the
Cath Lab. Once the graft is successfully
deployed, check angiograms are done. The
incisions are closed and patient is
monitored in intensive care unit for 24
Because it is a very minimally invasive
procedure, patients recover fast and are fit
for discharge and are back to routine
activities within one week.