Surgeons at Hospital México have reconstructed the aorta of a patient. The job was in two steps 12 months apart, said the Caja Costarricense de Seguro Social, which operates the nation’s public hospitals.
The aorta is the main blood vessel of the body. In the case of the patient, the aorta was malformed. There was a possibility of rupture without surgery, said the Caja.
The thoracic surgeon in charge was Edgar Méndez Jiménez. The Caja gave this explanation:
The patient also had a heart valve that was not working correctly. That was the first effort, and the valve was replaced with a Dacron tube with an artificial valve incorporated within.
To do that, the Caja said the patient was cooled to 16 degrees
C for 30 minutes to slow the flow of blood. That’s 56 degrees F, far lower than normal body temperature of 98.6 degrees F or 37 degrees C. In addition the blood flow was diverted from the heart mechanically while the surgical team worked.
The second procedure 12 months later was more complicated, said the Caja. It involved replacing part of the aorta. To do that the patient again was cooled, this time for an hour and 15 minutes. External blood flow also was provided. The surgeons also used retrograde perfusion in which oxygenated blood was forced through the veins to keep the patient’s brain alive during the surgery.
Then the surgeons used what is known as the elephant trunk procedure to put a 10-centimeter (about 4-inch) tube of Dacron around the aorta.
The Caja praised the work and said that this type of surgery can only be done at the better hospitals in the hemisphere.