07/12/2025
A 65-year-old retired personnel was undergoing routine work up for psoriasis , and a chest xray was performed. The XRay aroused doubts of SOl. On close observation it was observed to be continuous with the aortic shadow. That is when a CT Angiogram was done . This picked up a huge , more than 7 cm Distal arch Aortic Aneurysm.
This size of aneurysm was prone to rupture, subjecting him to risk of almost instant death due to internal bleeding on one hand , on the contrary the patient was asymptomatic. The location just distal to major arteries supplying upper limbs and close proximity to the arteries supplying brain meant his critical organs were at risk while a treatment was planned
A hybrid approach was planned
Two small cuts on either side of the wind pipe on the neck was used to connect the two main arteries supplying the brain, so that one keeps the other going in case our stent graft would decrease brain flow. A small groin cut was made and a Thoracic aortic stent graft device was used to exclude this aneurysm and cover it totally, at the same time keeping the blood flow to the brain and upper limbs maintained. He recovered within 3 days and discharge in walking condition by day 3.
This case highlights the value of hybrid surgery in modern thoraco vascular surgery which incorporates open surgery and blends it with endovascular modalities of stent graft to deal with life threatening thoracic aneurysms. This ensures precise repair, early ambulation, lesser morbidity and mortality from the dreaded disease and also overcomes shortcomings of open morbid extensive surgeries and limitations of only catheter based endovascular procedure.
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Dr. Kaushik Mukherjee
Dr. Kaushik Mukherjee is the chief Consultant cardiac surgeon and head of the department of cardiac surgery in Manipal hospitals ,Dhakuria in Kolkata.
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Dr. Kaushik Mukherjee
Mch Cardiothoracic & Vascular Surgery
MS (PGIMER, Chandigrah)
MBBS (Kolkata)
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Manipal hospital, Dhakuria, Kolkata.
Call for Appointment: 091630 74726
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Medica Superspecialty Hospital
Call for Appointment: 6290 458 470
Every Thursday (9am-2pm) other days by appointment
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https://drkaushikmukherjee.com/
