Kolkata, 13th June 2024: Fortis Hospital Anandapur successfully treated a 77-year-old woman from Bhutan suffering from a complex cardiac condition – a large leaking Abdominal Aortic Aneurysm (AAA). This condition is characterised by a bulge in the aorta, the body’s largest blood vessel, located in the abdomen. Due to the patient’s deteriorating health, she was airlifted from a local hospital in Thimphu, Bhutan to Fortis Hospital, Anandapur.

The patient was experiencing continuous stomach and back pain due to the bulge in the blood vessel. After a thorough diagnosis, Dr K.M. Mandana, Director, Cardio Thoracic Vascular Surgery, Fortis Hospital, Anandapur and his team opted for a less invasive approach of EVAR (Endovascular Aneurysm Repair). In simple terms, EVAR involves using special stents to repair a damaged aorta from the inside, which is safe and has minimal complications as compared to a traditional open surgery. This approach was particularly crucial for this patient, who also suffered from obesity—a condition that increases the risks associated with open surgery as fatty tissues can restrict blood flow and slow the healing process. Furthermore, because the patient had blockages in the ilio-femoral arteries, which run from the pelvis to the thighs, a combined approach was necessary. She was first put under anaesthesia in the operation theater, where both femoral arteries were exposed. Subsequently, she was moved to the Cath lab for the insertion of stents and completion of the EVAR procedure.

Explaining the complexity of the case, Dr Mandana said, “Abdominal aortic aneurysms usually happen as people get older, often linked to conditions like atherosclerosis (a buildup of fatty deposits in the arteries), which can block blood flow. Risk factors such as high cholesterol and blood pressure also contribute to the development of heart disease. It’s crucial to get the diagnosis right and treat it early, especially for those in their 70s and 80s. Preventive and regular check-ups are key to getting the best outcome in such cases. The patient’s aneurysm was about 6.5 centimeters wide with clots surrounding the aorta, showing why it’s so important to act quickly.”

Dr. Shuvanan Ray, Director, Cardiology, Fortis Hospital, Anandapur, said, “Our team created custom-made coverings for this patient’s damaged blood vessel. With the help of the cardiac anesthesia team, they successfully placed a complex ‘Y’-shaped graft using both leg arteries in two steps. They made sure to protect the renal arteries. It was a complex case, and we are glad we could provide for the patient.”

Following the procedure, the patient recovered well and experienced resolution of her stomach and back pain issues. She was discharged from the hospital within a few days, which highlights the success of the treatment.