Karnataka's first, rare hybrid surgery for aortic aneurysm performed at Indiana Hospital

Media Release

Mangaluru, Jan 31: In yet another medical milestone for Indiana Hospital, one of city's leading hospital, a 64-year patient from Hassan underwent a successful rare hybrid surgery for aortic aneurysm.

A team of specialist doctors at Indiana Hospital & Heart Institute performed a rare, risky surgical procedure tor the thirst time in Karnataka. This successful surgery, done rarely in India gave a new lease of life to the patient. The patient with severe abdominal pain was presented with large aortic aneurysm of the abdominal aorta and in the chest (thoracic aorta) and on evaluation was advised for a high risk surgery at a few hospitals in Bengaluru. However, in view of the technical complications, the hospitals were not willing to do the surgery because of the uncertain outcome. It was at this stage, the patient party approached Indiana Hospital, Mangaluru, a name to reckon with in heart care in the entire state and under whose credit there are several milestone treatments performed. The patient discharged from Bengaluru Hospital and approached Dr Yusuf A Kumble at Mangaluru.

Accepting the challenge, Indiana Hospital Mangaluru formed a cardio-vascular team which included Dr Yusuf A Kumble, chief interventional cardiologist and chairman of the Indiana Hospital, Dr Prashanth Vaijyanath, cardiovascular surgeon and Dr Shyam K Ashok, cardio-thoracic and vascular surgeon at Indiana Hospital to perform a hybrid antegrade aortic vessel de-branching thoraco abdominal endovascular aneurysm repair. The team also included physician and intensivist Dr Aditya Bharadwaj, consultant cardiac anaesthesiologist Dr Sukhen N Shetty, senior nephrologist Dr Pradeepa K J, cardiologists Dr Sandhya Rani, Dr Syed Mohammad and Dr Latha.

The risks involved included de-branching all the natural arteries of the liver, kidney, spleen and the gut and then re-implanting these arteries into artificially made vascular structure directly from aorta. Explains Dr Yusuf A Kumble, Karnataka's eminent cardiologist, "This surgery is rarely done in India and Indiana Hospital Mangaluru is a pioneering centre for heart diseases. De-branching procedures are clearly advantageous compared not only with conventional open surgery, but, also with limited complications. This procedure is called antegrade aortic de-branching of the gut and renal arteries and hepatic arteries and then connection is given to the artificially made synthetic aortic graft.”

The surgical procedure was followed by the successful thoracic aortic stent implantation and abdominal aortic stent implantation by Dr Yusuf A Kumble. The patient which was hospitalized for a week was closely monitored for renal failure, liver failure and grotischemia. The patient is now stabilized and ready for discharge.

"These type of rare, complicated and highly skilled interventions are normally done at Indiana Hospital Mangaluru. I am very proud that many of Karnataka's first complicated medical surgeries and interventional procedure are done at Indiana Hospital Mangaluru. Indiana Hospital has been a place which explores different techniques and we use ultra-modern treatment. We have achieved many successes including using innovative techniques. We have handled an extraordinary and unusual case here. The patient came to us from Bengaluru and was diagnosed with problems in his heart iota and up to lower limb. The iota pipe has branches which usually carry blood to vital organs such as lungs, brain, kidney, liver, gut, intestine etc. The iota pipe is very fragile and causes breakage, with patients losing life in a few days. The treatment for such cases are limited and there is 50% mortality rate. When the patient reached out to the local doctors at Bengaluru, they denied treatment saying it would risk the patient’ss life. The patients later approached Indiana Hospital and after inspecting and understanding the problems, we understood the case and we installed a second pipe and made an artificial Iota to supply blood to liver, gut and kidneys. Anti-grade de-branching technique is unique and it is not a new technique, but it is complicated. The chances of death is also high and a group of doctors did a wonderful job and have bypassed the iota to all the vessels of the organs and put stent up to lower limbs. It is more than 10 days now and the patient is about to be discharged,” said Dr Yusuf A Kumble.

The patient, Shivshekhar along with his son Mahadevaiah, residents of Bengaluru, expressed their experience and how the hospital provided the best treatment and the progress of the patient.

On a query from the media regarding how many years the surgery helps patients and the cost, the doctors said, “These patients do very well up to 5-10 years. The expenses of the stent itself is up to Rs 15 lac, and we have performed a similar surgery, but not to this extent.”

Dr Apoorva, medical director; Dr Shyam K Ashok, cardio-thoracic and vascular surgeon; Dr Sandhya and Dr Latha were present.





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Title: Karnataka's first, rare hybrid surgery for aortic aneurysm performed at Indiana Hospital

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