SURGERY FOR THE ANEURYSM OF THE AORTIC ARCH AT SJICR

Surgery for the aneurysm of the aortic arch is the most challenging operation in the field of heart surgery. Sometimes this is associated with a leaking aortic valve compounding the challenge to the surgeon who dares to operate on such patients. In this disease the main vessel coming out of the heart,called aorta , becomes abnormally enlarged and causes 'SUDDEN DEATH' due to rupture. Operation is the only option to prevent this complication.

The operation for this disease is a complicated one as the blood supply to the braincomes from this portion of the main artery. Replacement of the aorta requires reconstruction of the brain vessels also.Otherwise there can be a situation of 'brain dead'patient after a " successful operation'. Worldwide the mortality rate of this operation is 25-30%. Recently a team led by Dr P.S.Seetharama Bhat did this operation successfully, for the first time,in Sri Jayadeva Institute of Cardiovascular Sciences and Research.

33 year old Veerendra Patil,an agriculturist from Davangere had breathlessness since the past 2 years.His problem in the heart was diagnosed at Davangere and he was advised surgery at carporate hospitals in Bangalore,.He preferred not to undergo surgery as the cost of the surgery was very high and he was told that the surgery carried a very high risk. Under the 'Hridaya Sanjeevini' scheme of the Govt of Karnataka he presented to the Jayadeva Institute of Cardiology for surgical treatment. On 25th November he underwent this highly complicated 14hours surgery by Dr Seetharama Bhat and his team.In medical parlance this operation is called BENTALL OPERATION WITH COMPLETE AORTIC ARCH RECONSTRUCTION.

Dr C N Manjunath, Director of the institute says the whole problem with this operation is not only the difficult aspect of reconstruction of the aorta (major artery coming out of the heart) including the arteries to the brain but the preservation of the brain function throughout the procedure.Dr Bhat and his team accomplished this by cooling the brain down to 18degreeC from the normal temperature of 37degreeC and maintaining blood supply to the brain through a separately created artificial artery. This manouvere gave the team just enough time to reconstruct brain vessels. Otherwise the brain would be dead within 4-5 minutes on stopping its blood supply.Incidentally amphibians like frogs preserve their body functions by cooling themselves to 4degreeC during hibernation.

Mr Patil has made complete recovery and is ready to get discharged from the hospital.The team of doctors who made this possible for him comprised of Dr P.S.Seetharama Bhat,Dr Arul Furtado,Dr Syed Murfad,Dr Shilpa,Dr Ramesh,Dr A.M.Jagadish,and Mr Krishnaprasad.Dr Manjunath Director of the institute has congratulated the team which has achieved this rare feat for the first time in the hospital and made the hospital proud.He added what would have costed 7-8 lakhs in a corporate hospital was done free of cost to the poor agriculturist under the'Hrudaya Sanjeevani'scheme of Government of Karnataka

Dr.C.N.Manjunath
Professor & HOD of Cardiology
Director, Sri Jayadeva Institute of Cardiovascular sciences and Research, Bangalore