Rare TEVAR procedure performed at NH MMI Narayana Hospital

NH MMI Narayana Super speciality Hospital claims to have performed probably first Thoracic Endovascular Aortic Repair (TEVAR) procedure in Chhattisgarh successfully.

 

(L to R) Dr Alok Swain, Dr Sunil Gouniyal, Vineet Saini and Dr Sumanta Shekhar Padhi.

 

Dr Sunil Gouniyal, DM, Interventional Cardiologist at NH MMI Narayana Hospital informed mediapersons that TEVAR is a minimally invasive procedure to repair the major blood vessel Aorta.

 

Dr Gouniyal explained that a 60-year-old male patient suffering from hypertension was admitted to hospital with recent onset severe chest pain. Through CT Scan and CT Aortogram Type B Aortic dissection was detected. It is an uncommon, but extremely dangerous medical emergency. If not detected and treated promptly, aortic dissection can be deadly. Aortic dissection is one of the most challenging vascular disease, with an in-patient fatality rate as high as 30 per cent and 30 day and five year

 

fatality rates of just over 50 and 60 per cent respectively. Management of patients with aortic dissection is challenging and its treatment is an area of development and innovation.

 

Before the procedure, meticulous planning was done by the team which includes interventional cardiologist, cardiac surgeon, radiologist, cardiac anaesthetist and cath lab team. Initially artery of leg is accessed through

which tube is placed across the Aorta. Through the tube, a calculated size stent graft was deployed inside the Aorta at its proximal ruptured part. Procedure was done under short duration general anesthesia successfully without any complication. Patient was discharged after three days with no pain and well controlled blood pressure. Now he is stable and already resume his routine work.

 

Dr Gouniyal further explained that Aortic dissection is a tear that develops along the inner layer of the Aorta. Blood spills through the inner layer tear into the middle layers of the Aorta, causing them to separate (dissect). If the blood breaks through the outer layer of the Aorta the condition can be fatal. To fix the Aorta doctors placed a stent graft made of fabric covered metal mesh which is fully opened under X-ray. The device repairs the diseased Aorta and helps to keep it open and allow blood to flow properly. Facility Director Vineet Saini informed that there is a need to raise awareness about these conditions and understanding the risk factors. Multiple reasons are associated with these conditions but most of them are associated with uncontrolled blood pressure and atherosclerosis disease.