Laparoscopic surgery to repair a rare thoracic aortic aneurysm case

When the doctor said there was a bulge of 82mm in thoracic aortic, patient Le Viet Hai (62, Can Tho) was so surprised. He did not believe that a very healthy person like him has carried a “slow bomb” in his body.

Complicated surgery with small incision

Dr. Luong Ngoc Trung – Vascular Surgery at FV Hospital, who directly treated patient Le Viet Hai, said: “Aortic aneurysm is a disease that accounts for 10-15% of cardiovascular diseases but the case of patient Le Viet Hai with size of aneurysm up to 82mm is very rare.

This case is more special because the bulge was not only three times bigger than normal but also being folded 90 degree. The danger is that the patient was not aware of this, so he was still playing badminton. “Just jump up half a meter to hit the badminton, but when he fell down, he would never wake up again,” Dr. Trung said.

The only way to repair the aortic aneurysm is to place a stent graft. Due to the size of the patient’s bulge is too large, doctors must send order for stent graft to the United States. In the meantime, Dr Trung coordinated with the Imaging department to determine the exact size of the bulge, position of the artery to put the stent, worked with the anesthesiologists to examine and evaluate the patient’s health status, anticipate of the situation that could happen, and check all the necessary tools. Dr Trung said a lot of sugeries to repair horacic aortic aneurysm had been done in Vietnam but he was still very careful becasue this was a complicated case, just a minor error can make the bulge burst immediately.

Thanks to the careful preparation of Dr. Trung and ekip of doctors with modern equipment and machines meeting JCI standards at FVH, the surgery was successful. Patient were operated with the most modern method with the incision was just about 3cm in the thigh to insert the instrument, skillfully crossed the “90 degree” bend and placed the stent at the two ends of the arteries which had not been stretched. Compared with traditional surgery which may take a whole day with high level of risk, laparoscopic surgery can help reduce the surgery time to 3 hours, less pain, faster recovery time and avoid many dangerous complications such as lower limb or infection … Afterwithdrawing the breathing tube, patient can walk immediately.

Do not underestimate aortic aneurysm

Speaking about his case, Mr. Le Viet Hai still remembers his surprise feeling: “My health condition is very good, periodic examinations did not detect anything even the high blood pressure. I also play badminton and drink beer with friends”. He did not feel anything unusual until the doctor told him that he was carrying an aortic aneurysm.

Dr. Trung explained that the aneurysm had developed over the years, the cause of which could be attributed to the smoking habit in the past of the patient. This is common for people in the age of 50. The result is high blood pressure or atherosclerosis. Aortic aneurysms have confusing symptoms which similar to back pain, abdominal pain, shortness of breath, voice effection due to blockage on the vocal cords … In the case of Mr. Le Viet Hai, there was no clear symptoms. Therefore, the way to detect it early is to regularly check for aortic aneurysm to have timely intervention.

What made him happy with this surgery was that the patient had recovered very quickly. During examination after the surgery, the patient asked Dr Trung: “Doctor, can I play badminton without worry now?” He advised the patient it should be wait for a year to fixed stent and abstain from alcohol, cigarettes. However, the patient can do exercise and other activities.

He shared his hope: “FV Hospital will put Cathlab into operation soon. Thus, more and more cases of aortic intervention will be performed conveniently, safely in shorter time.”

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