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COMPLEX HEART SURGERY FOR 40 YEARS OLD FEMALE PATIENT
40 yrs old female came with complaints of chest pain for 20 days. CT aortogram done showed large aneurysm extending from subclavian artery to abdominal aorta up to visceral vessels. Echocardiogram showed normal heart function. Coronary angiogram was normal.
She underwent Open Thoraco Abdominal Aortic Aneurysm (TAAA) repair which involves surgical removal of a section of the aorta and replacing it with an artificial graft. This is an extremely extensive and complicated operation. Usually, a large incision extending from the upper back on the left side, curving around under the shoulder-blade, around to the front of the abdomen, down to the umbilicus. The most serious risks associated with TAAA repair are death, stroke, and damage to the spinal cord resulting in paraplegia. She recovered well and was discharged in 1 week.
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An aortic aneurysm is localized abnormal dilatation or widening of a blood vessel, at least 50% more than its normal size. The aorta is the largest blood vessel in the body, extending from the heart down through the thorax and abdomen until it divides to form the major arteries of the legs. Thoracoabdominal aortic aneurysm (TAAA) refers to an abnormal widening of the aorta involving both its thoracic and abdominal segments. Although atherosclerosis and TAAA share common risk factors and frequently co-exist, these aneurysms are primarily the result of age-related degeneration and weakening of the aortic wall. Connective tissue disorders, dissections (separation of the wall layers), infections, and inflammations are the other causes.
Without surgical treatment, patients with thoracoabdominal aortic aneurysms (TAAAs) have dismal survival. A thoracoabdominal aortic aneurysm can burst, which can cause life-threatening, uncontrolled bleeding.
The most serious risks associated with TAAA repair are death, stroke, and damage to the spinal cord resulting in paraplegia Repair of the thoracoabdominal aorta represents a formidable challenge for surgeons, anesthesiologists, and patients alike. Operative repair is generally carried out only in specialized institutions.
Dr. Pramod Reddy Kandakure
FRCS(CTH-England);FIACS; M.CH(CVTS), DNB(CVTS);MS(GEN SURG), DNB(GEN SURG); MBBS