High-Risk Hybrid Cardiac Procedure Gives New Life to 29-Year-Old Patient

Gurugram: Doctors at Fortis Memorial Research Institute (FMRI), Gurugram successfully carried out an extremely rare and highly complex life-saving hybrid cardiac procedure on a 29-year-old man suffering from a ruptured and severely enlarged thoracoabdominal aorta — a condition known to carry a very high risk of death. Medical literature suggests this is the first reported case of its kind in South-East Asia.

The patient, Saif Alam from Palamau district in Bihar, reached Fortis Gurugram in a critical state with a ruptured aorta, the main artery that supplies blood to the entire body. Earlier, his condition had been mistaken for fluid buildup in the chest at multiple hospitals in Bihar, where a chest tube was inserted. This led to worsening complications and uncontrolled internal bleeding.

Over the following months, his health deteriorated rapidly. His heart function dropped to nearly 15%, leaving him bedridden for almost a month due to the constant risk of sudden, fatal bleeding. After being turned away by several hospitals in Bihar, Kolkata, and Bengaluru because of the extremely high surgical risk, he was eventually referred to Fortis Gurugram as a last option.

A detailed evaluation by the Cardio Thoracic Vascular team at Fortis Gurugram, led by Dr. Udgeath Dhir, Principal Director – Cardio Thoracic Vascular Surgery, revealed that the patient’s entire thoracoabdominal aorta was dangerously dilated and filled with extensive clots.

This severely compromised blood flow to vital organs such as the kidneys, liver, and intestines. Conventional open surgery was ruled out due to the high risk of paralysis, organ failure, and death.

Explaining the procedure, Dr. Udgeath Dhir said that with the patient’s heart functioning at only 15%, urgent intervention was essential. The team opted for a hybrid approach, combining open bypass surgery with minimally invasive endovascular repair.

The procedure began with placing a stent graft to seal the rupture and control bleeding, followed by a complex aortic debranching technique. This approach helped maintain continuous blood flow to vital organs while protecting the spinal cord and reducing the risk of paralysis.

Spinal cord pressure was closely monitored throughout the surgery. Despite an estimated mortality risk of nearly 50%, the patient recovered well and was discharged within six days. He is currently stable and undergoing medical management for low heart function, with plans for further cardiac treatment once fully recovered.

Dr. Anand Kumar, Senior Director – Cardiac Anaesthesia, highlighted that managing such patients requires precise anesthetic planning and continuous monitoring due to unstable blood pressure, reduced cardiac function, and high neurological risk.

Expressing his gratitude, Saif Alam said he had lost hope after months of suffering and multiple hospital visits before receiving appropriate treatment at Fortis Gurugram.

Yash Rawat, Facility Director and Senior Vice-President, FMRI Gurugram, stated that the case reflects the institute’s expertise in handling complex and high-risk cardiovascular conditions using advanced surgical techniques.