Dubai: The life of a tourist to Dubai was saved by skilled cardiac surgeons from the Dubai Hospital who successfully performed a 12-hour complex emergency cardiac surgery on him.
The patient, a 56-year-old American citizen of Pakistani origin, was brought to Rashid Hospital’s Trauma Centre after he complained of acute chest pain. A diagnosis revealed that the patient had a Type A Aortic Dissection, a life-threatening condition that needs immediate surgical intervention.
Elaborating on the condition, Dr Obaid Al Jasem, cardiac surgeon and head of cardiothoracic surgery at Dubai Health Authority, said: “Aortic dissection is a serious life-threatening condition in which the inner layer of the aorta [the large blood vessel branching off the heart] tears. Blood surges through the tear, causing the inner and middle layers of the aorta to separate. Therefore, emergency surgery is needed to stop the bleeding, replace the torn blood vessels and ensure the functioning of the heart. With each hour’s delay in surgery, there is a five per cent increase in the mortality risk.”
A multi-disciplinary team from Dubai Hospital headed by Dr Jasem conducted the surgery. The team included Dr Fawzi Al Safadi and Dr Tarek Abdul Aziz who performed the surgery assisted by Dr Nayeer Seddiqi, cardiac anaesthetist, as well as nurses, cardiovascular perfusionists, and technicians.
Dubai Hospital’s Blood Bank was contacted and sufficient units of blood and blood products were stocked up as this surgery usually causes massive loss of blood. All other preparations were made and the patient was shifted by ambulance to Dubai Hospital.
Explaining the procedure, Dr Al Jasem said the surgery required elaborate preparation. The patient was put on a heart-lung machine [a device used in open heart surgery to support the body during the surgical procedure while the heart is stopped]. “We then lowered the body temperature to 18 degrees to protect the patient’s brain and conducted some procedures to ensure the brain received oxygenated blood during surgery. This patient’s condition was the most complicated aortic dissection we have seen because the dissection extended right up to the arch of the aorta [where the main arteries of the brain arise],” he said.
Working to a plan, the surgeons first repaired the arch using a tube graft, then the patient’s aortic valve was replaced with a valve tube and then both the tubes were connected so that the aorta could function optimally. Medical therapy was also administered to the patient pre-operatively, intraoperatively, and post-operatively to prevent progression or recurrence of aortic dissection.
It took the team close to 12 hours to complete these procedures and control the bleeding.
In the last two years, the cardiac team at Dubai Hospital has performed 12 aortic dissection surgeries but this was by far the most complicated. Of the 12 surgeries performed earlier, ten patients were saved. After the surgery, the patient was critical and was shifted to a surgical Intensive Care Unit for round-the-clock monitoring. He was shifted to the ward after eight days and subsequently discharged. After a few follow-ups, the patient is expected to return home.