A team of vascular surgeon and cardiac anaesthetist from Fortis Malar Hospital recently performed a challenging endo vascular aneurysm repair on a 69 yrs. -old man from Bangladesh. The timely treatment and meticulous procedure saved Mr Ananta Kumar Saha who was in critical condition as his abdominal aorta was in high risk of rupture. This challenging procedure was successfully executed by Dr Balakumar S, Senior Vascular Surgeon, Fortis Malar Hospital.
Mr Saha, a hardware sales man from Bangladesh, has been experiencing pulsating mass in his abdomen for the past 20 years, and the intensity had increased over the last two months. The patient was admitted at Fortis Malar and diagnosed with abdominal aortic aneurysm. His ballooned abdominal aorta was 9 cm (normal 1.6cm) with 90 degree turns and twists at three levels, resulting in a very high chance of rupture and instant death.
Following an evaluation, the patient was taken for Endovascular Aneurysm Repair (EVAR). EVAR is a minimally invasive procedure wherein both the femoral arteries in the thighs are opened with a very small incision and a stent graft is inserted, excluding the aneurysm thereby preventing rupture. Due to multiple angulations which were along the course of the blood vessels from the heart to the legs, the exact and precise placement of the stent graft had to be meticulously executed by the doctors to prevent leak and clot migration.
Speaking on the surgery, Dr Balakumar S said, “Abdominal Aortic Aneurysm cases could be very risky as once the aorta ruptures, it could lead to instant death. Prevalence of Abdominal Aortic Aneurysm is about 5 to 16% in men older than 65 years. But the dilatation of blood vessels occurs earlier and will be asymptomatic in most patients. The rupture rate is 20% for 5years if size is above 5.5cms causing instantaneous death. Therefore, screening by simple Ultrasound Abdomen becomes essential in men over 50 years with risk factors such as diabetes, elevated blood pressure, increased cholesterol values, obese individuals and patients with known coronary artery disease. Failure of early screening would result in detection of aortic aneurysms with complications like contained rupture and at times rupture leading to inevitable loss of precious life.”
“I am very happy that we came to Fortis Malar. Our hope increased after we met Dr Balakumar. I no more feel the pulsating mass in my abdomen and I am very thankful to the team of doctors who performed this surgery successfully.”said Mr Saha.
An abdominal aortic aneurysm is an enlarged area in the lower part of the aorta, the major blood vessel that supplies blood to the body. Because the aorta is the body’s main supplier of blood, a ruptured abdominal aortic aneurysm can cause life-threatening bleeding. The likelihood that an aneurysm will rupture is influenced by the size, expansion rate, continued smoking and persistent hypertension.