Max Lucknow Surgeons Successfully Treat Rare 8 cm Aortic Tear in Young Patient with 'Frozen Elephant Trunk' Surgery

Lucknow : In a remarkable medical feat, doctors at Max Super Speciality Hospital, Lucknow, successfully performed a complex "Frozen Elephant Trunk" procedure on a 27-year-old man from Prayagraj who was suffering from a life-threatening 8 cm aortic dissection.

The massive tear extended from the Aortic Root to the Abdominal Aorta, posing an imminent risk of rupture and instant death.The young patient, Alok, had been experiencing chest pain and breathlessness for five months, which he mistakenly dismissed as acidity or chest congestion.

Upon his family bringing him to Max Hospital due to worsening symptoms, a CT Aortogram revealed the critical condition, prompting doctors to also suspect Marfan Syndrome, a congenital connective tissue disorder that can predispose individuals to such vascular issues.The marathon 7-hour surgery was led by Dr. Vijayant Devenraj, Director and Head of Department, Cardio-Thoracic and Vascular Surgery (CTVS). 

The highly challenging hybrid procedure involved a complete replacement of the ascending aorta and aortic arch, debranching of the brain arteries, and the implantation of an aortic-stented hybrid graft for the descending thoracic aorta.A key challenge was the necessity to halt the blood circulation of the entire body—including the heart, brain, kidneys, and liver—to operate safely on the heart and major arteries.

This was achieved using Deep Hypothermic Total Circulatory Arrest (DHCA), cooling the patient's body temperature to a deep low of $18^\circ\text{C}$ for about 35-40 minutes.Dr. Devenraj noted that the surgery successfully replaced the damaged section of the aorta and reconnected the brain arteries. Following the extensive operation, the patient was shifted to the ICU and kept on ventilator support for two days. Despite the complexity, blood loss was minimal, and the recovery was straightforward. Alok was discharged in a healthy condition just ten days after the surgery.

(Report by R. L.Pandey)