Hybrid Approach (Combined surgery and Stenting)
For some patients, surgery or stenting alone are not complete treatment. Hybrid surgeries ensure complete treatment for complex aortic disease. Hybrid surgery offers good long term results in this disease with the least invasive and safe approach. In contrast to open surgeries which could take long duration and lead to many complication, hybrid surgeries take less time and are overall safer to the patient.
Marfan’s Aortic surgery
The set of Marfan’s syndrome patients have a difficult disease wherein, the aortic tissue is prone to diseases like aortic dissection and aneurysms. Their management requires expertise and experience as they can present with multiple problems.
STAGED HYBRID AND ENDOVASCULAR STENTING FOR A COMPLEX TYPE B AORTIC DISSECTION WITH INFRA RENAL AND RIGHT COMMON ILIAC ARTERY ANEURYSM
65 year old gentleman was investigated in August 2015 following history of vague abdominal pain and was detected to have Type B Aortic dissection in a local hospital. His 64 slice CT scan done at MIOT Hospitals revealed acute intimal tear with intramural hematoma of proximal descending thoracic aorta extending up to the renal segment of abdominal aorta, focal saccular aneurysm in the distal descending thoracic aorta, infrarenal abdominal aortic aneurysm and saccular aneurysm in the proximal right common iliac artery. Hence it was decided to do Hybrid procedure for Type B Aortic dissection in 2 stages. He underwent Stage I – Left Carotid to left Subclavian bypass followed by Stage ll Endovascular stenting of Type B Aortic dissection on 11.08.2015 and 12.08.2019 respectively. Post operatively patient made an uneventful recovery. It was decided to conservatively manage the infra renal and right common iliac artery aneurysm with regular follow-up. In 2017, patient underwent Aortogram which revealed enlarged size of the infra renal abdominal aortic aneurysm and right common iliac artery aneurysm. Hence, patient underwent endovascular stenting of abdominal aorta and right common iliac artery aneurysm. His follow-up Aortogram done in May 2019 showed excellent results.