Mumbai: At 43, Srikala was too young to suffer an extensive aortic dissection , a severe cardiac complication in which the inner layer of the aorta—the body's largest artery—develops tears that affect blood flow to several organs, including the brain. But the farmer's wife from a village near Aurangabad carried on for three months with severe stomach ache, dizziness, and poor appetite. When her haemoglobin count dropped to 6 and she had lost considerable weight, her family brought her to civic-run KEM Hospital , Parel, in July.
Srikala required a complex procedure called TEVAR (thoracic endovascular aortic repair), which is typically performed in private hospitals with advanced infrastructure. However, the team at KEM Hospital successfully carried out the procedure at a much lower cost. "Our team did the complex procedure successfully, and that too at a fraction of the cost in other hospitals," said KEM Hospital dean Dr Sangeeta Ravat.
Professors Dr Balaji Aironi and Dr Charan Lanjewar said that it was the first time TEVAR had been performed in such an extensive aortic dissection with a hybrid approach in a public hospital in Maharashtra. Srikala's husband was given an estimate of Rs 30 lakh by a private hospital , but the procedure cost barely one-fifth of the sum at KEM. "We also raised funds through donors to help her," said Dr Lanjewar.
The repair was challenging due to Srikala's narrow blood vessels at the groin, measuring only 4mm in diameter instead of the usual 7mm. "When she came to us, she was in cardiogenic shock. We couldn't have done an open-heart surgery for a complete repair as it carries high mortality," said Dr Airona from the cardiothoracic surgery department.
The KEM team decided to opt for a hybrid operation involving both cardiac surgeons and cardiologists to ensure the patient's safety and quick recovery. On Aug 5, in the first step, cardiac surgeons led by Dr Airona created an alternative bypass (connecting the openings of the main arteries to the brain and hands) using a dacron graft, which is a polyester material used to replace or repair blood vessels. Dr Prafulla Kerkar, former head of KEM Hospital 's cardiology department who now consults at Asian Heart Hospital, said, "TEVAR is not frequently performed.
It is commendable that university hospital performed it," he said..
