Aortic dissection is a condition caused by a tear in the inner lining of the aorta  Aortic dissection is a potentially life threatening condition in which there is bleeding into and along the wall of the aorta  the major artery carrying blood out of the heart  The pain experienced by the patient is the first symptom of the condition  And this pain is unique  The pain starts suddenly  It is usually described by the patient as  tearing  ripping or stabbing   This is in contrast to the pain normally associated with heart attacks
Aortic dissection is the commonest catastrophe of the aorta  When left untreated  33  patients die within 24 hours  50  in 48hours  It is a medical emergency that is potentially fatal  Best of medical care and treatment may not save patients  Aortic dissections resulting in rupture has 80  mortality rate  50  of patients die before they even reach the hospital
Hence  lot of attention and importance is attached to it  In an unusal effort  Cardiac and Vascular Surgeons at Star Hospitals performed a unique and highly risky Hybrid Surgical Stent Procedure for the first time in the state of Andhra Pradesh on a forty years old patient from Kukatpally in the city  This new procedure is a combination of surgery cum stent one  It requires good technical expertise and team work
Addressing a Press Conference at its premises today Dr  M  Gopichand Chief Cardiothoracic Surgeon and Managing Director of Star Hospitals informed that Aortic dissection is a rare  but potentially fatal condition in which blood passes through the inner lining and between the layers of the aorta  The dissecting aorta usually does not burst  but has an abnormal second channel within it  The aorta is the large blood vessel that leads from the heart and carries blood to the rest of the body  The aorta has a thick wall  with three layers of muscle that allow the blood vessel to withstand the high pressure that is generated when the heart pumps blood to the body
The three layers are the tunica intima  tunica media  and the tunic adventitia  In an aortic dissection  a small tear occurs in the tunica intima  the inside layer of the aortic wall in contact with blood   Blood can enter this tear and cause the intima layer to strip away from the media layer  in effect dividing the muscle layers of the aortic wall and forming a false channel  or lumen  a new blood channel  This channel may be short or may extend the full length of the aorta  A distal  further along the course of the aorta  tear in the intima layer can let blood re enter the true lumen of the aorta  This can lead to heart attack  strokes  abdominal pain  and nerve damage  Blood may leak from the dissection and collect in the chest and around the heart  Aortic dissections require immediate surgery to repair the aorta  he informed
Aortic dissection is a medical emergency and can quickly lead to death  even with optimal treatment  If the dissection tears the aorta completely open  through all three layers   massive and rapid blood loss occurs  If the dissection reaches 6 cm  it calls for an emergency surgery
The incidence of aortic dissection is not very common  Middle aged men in the late forties and fifties are victims of the aortic dissection  Aortic dissection occurs in approximately 2 out of every 10 000 people  It can affect anyone  but is most often seen in men aged 40 to 70  Approximately 2 000 cases of aortic dissection occur yearly in the United States added Dr  P C  Gupta
Stating further Dr  P C  Gupta added that there are many reasons for this condition  Aortic dissection is associated with hypertension  high blood pressure  and many connective tissue disorders  Most cases  over 70   are associated with high blood pressure  hypertension   Vasculitis  inflammation of an artery  is rarely associated with aortic dissection  It can also be the result of chest trauma  72 to 80  of individuals who present with an aortic dissection have a previous history of hypertension
The highest incidence of aortic dissection is in individuals who are 50 to 70 years old  The incidence is twice as high in males as in females  male to female ratio is 2:1   Half of dissections in females before age 40 occur during pregnancy
Under this new procedure the risk of life is minimised  It is a safe and established but not routine procedure  It is now established procedure abroad  but  not many tried in India  Only few cases have been treated in India with this technique  It has less mortality  The cost of the procedure may range anywhere between Rs 13 lakh to Rs 15 lakh depending on the condition of the patient  About ten patients with similar conditions are reported at Star Hospital annually  But the number is rapidly increasing  If the number goes up  the costs may come down  informed Dr  Gopichand
This disease was first described long ago almost 200 years back  But new challenges have arisen since the advent of advanced diagnostic and therapeutic modalities  The clinical manifestations are diverse  making the diagnosis difficult  Utmost skilled surgeons can only handle such surgeries