On 20th October Sivakumar (38) a resident of Rathinapuri, Coimbatore, developed sudden severe pain from his neck radiating to his legs. “It was the worst pain I had experienced in my lifetime it was like lightning struck through my body.” Sivakumar said. Before he knew what was happening he had collapsed to the ground and was helped on his feet by his co-workers. However, he could not stand as his right limb had gone limp. “I could see my friends around trying to help me, but I was confused and it was like a trance state. Though I tried to stand I could not feel my legs. My back hurt and I felt it was my end.” Sivakumar says.
In this state he was rushed to Sri Ramakrishna Hospital, Coimbatore Emergency Room. His right leg was cold and he was not able to move or feel his leg. There was no pulse in the leg. His blood pressure was 200/100 mm Hg. An urgent CT Angiogram was done and he was diagnosed with Type A Aortic Dissection with occlusion of the right leg arteries. It is a rare condition where there is a tear in the inner layer of aorta, the main artery that carries blood from the heart to the rest of the body. The tear extended from his heart to both the legs arteries. Aortic dissection is a surgical emergency and more than 75% of patients die when left untreated said Dr. Nandhakumar, Interventional Cardiologist.
He was taken up for emergency surgery by Dr. E. Krishnan and his associate Dr. U. Arunkumar and Dr. Sujith, Cardiovascular and cardio thoracic surgeons. The surgical correction of aortic dissection is a complex procedure and caries a high risk to life. Under anaesthesia a trans-oesophageal ECHO cardiogram performed by anaesthesiologist Dr. Muthukumar and Dr. Narendra Menon, showed the tear extended to the right coronary ostium which supplies blood to the heart (further complicating the situation).
Median sternotomy was performed and frank blood around his heart was evacuated. He was put on Cardiopulmonary bypass and core temperature was cooled to 18ºC. His blood circulation was stopped for a brief period and part of damaged aorta was excised and replaced with artificial conduit. Since the tear was extending to his coronary artery, a bypass graft was performed to supply blood to the right coronary artery. The aorta was badly damaged and it was like performing surgery on a thin paper said Dr. Arunkumar. The surgery lasted for four and half hours and he was shifted to high dependency unit for monitoring at around 12 midnight.
Sivakumar’s family heaved the first sign of relief on hearing the surgery went on well and Sivakumar’s vital organs were stable. He is a fighter and he made good recovery in the post-operative period. The patient was able to walk, climb stairs and take care of himself on the fifth post-operative day. He walked out of the hospital a new man with new responsibilities to educate people about this deadly condition and how keeping the blood pressures normal with regular checkups could save you from a life-threatening complication.
“I remember those dark moments when I thought, I would not live to see another day and sincerely thank the team of doctors, nurses, physiotherapist and all the people who helped me get me back to my life.” Sivakumar said.