Mr. C. was hospitalized at a medical facility near his home for treatment with a diagnosis of progressive pulmonary tuberculosis and descending thoracic aortic aneurysm. Afterward, The patient was admitted to the Emergency Department of Gia Dinh People's Hospital with left back pain radiating to the chest.
On October 19, Dr. Tieu Chi Duc, Deputy Head of the Department of Thoracic and Vascular Surgery, Gia Dinh People's Hospital, said that after examining the patient, doctors assessed that the patient was in extremely dangerous condition due to the possibility of a ruptured aneurysm in the thoracic aorta, in addition to the very bad condition of Mr. C's lungs due to tuberculosis, with the risk of death at any time.
Doctors from the Department of Thoracic Vascular Surgery - Goiter, Department of Respiratory Medicine, and Interventional Radiology urgently consulted to find appropriate treatment solutions.
Two aortic aneurysms at the same time
"The patient's condition is extremely dangerous because the CT scan results show two thoracic aortic aneurysms. The first aneurysm has ruptured. Choosing a treatment method at this time is also very difficult because the patient's lungs are very bad due to progressive tuberculosis, so surgery requiring anesthesia is almost impossible to be successful," said Dr. Duc.
After consultation and consultation with experts, the doctors decided on the appropriate treatment plan, which was stent graft intervention.
The surgeon will proceed through the femoral artery in the groin up to the aneurysm and fix it in the artery. This is a minimally invasive technique that helps reduce mortality and complications compared to open surgery.
Blood vessel images before and after (right) intervention
High blood pressure can also cause death.
Doctor Duc said that the patient had a ruptured aortic aneurysm but was held back by surrounding structures such as the spine and lungs, although quite fragile. Thanks to that, the patient's life was preserved, just a slight impact such as increased blood pressure or shock could cause the hematoma to rupture, threatening his life. Furthermore, the patient's lungs were damaged. These were challenges that required the team to have experience with proficient techniques and a firm grasp of anatomy to intervene successfully.
"We had to 'hold our breath' from the time we received the patient until we were able to pop the graft across the two ends of the blood vessel and isolate the ruptured aneurysm before we could breathe a sigh of relief knowing we were able to save the patient's life," Dr. Duc shared.
Doctor examines patient
The patient was then transferred to the Department of Thoracic and Vascular Surgery for further monitoring and treatment. The postoperative process was also closely monitored to prevent possible complications. The re-examination of the CT scan showed that the thoracic aorta at the previous rupture site had recovered stably. After 2 weeks of treatment, the patient was discharged from the hospital.
Doctor Duc said that aortic aneurysm is a common disease nowadays, the disease often occurs in the elderly with accompanying diseases such as high blood pressure, diabetes, dyslipidemia, smoking habits..., when the aneurysm progresses to rupture, the possibility of causing death for the patient is very high. Patients with risk factors should go to a medical facility for screening to detect the disease early for treatment.
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