Aortic Dissection Treatment in India
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What is an Aortic Dissection?
An aortic dissection occurs when a tear in the aorta's inner lining lets blood into the wall and separates its layers, creating a false lumen. The dissection may involve the ascending aorta, descending thoracic aorta, abdominal aorta, or multiple segments.
Aortic dissections are commonly classified as:
- Type A: Involves the ascending aorta and may extend into the aortic root, arch, coronary arteries, or other branches.
- Type B: Does not involve the ascending aorta and usually begins in the descending aorta.
A dissection can interfere with blood flow to the heart, brain, kidneys, intestines, spinal cord, or limbs and may cause complications such as rupture, cardiac tamponade, aortic valve leakage, stroke, or organ ischemia.
What is the Importance of Timely Treatment?
Aortic dissection can rapidly become life-threatening. A tear involving the ascending aorta can lead to rupture, cardiac tamponade, aortic regurgitation, coronary artery obstruction, stroke, or reduced blood flow to other organs.
Acute Type A aortic dissection requires immediate evaluation by an experienced aortic or cardiac surgical team, with emergency operative repair generally recommended. Patients who are stable enough for transfer may be transferred to a high-volume aortic centre with appropriate expertise.
What are the Common Symptoms of an Aortic Dissection?
- Sudden, severe chest pain
- Severe upper-back pain
- Pain that may spread to the neck, jaw, abdomen, or back
- Shortness of breath
- Fainting or loss of consciousness
- Sweating, weakness, or a feeling of impending illness
- Stroke-like symptoms such as weakness, numbness, confusion, or difficulty speaking
- Abdominal pain
- Reduced blood flow to an arm or leg, which may cause pain, weakness, numbness, or a cold limb
- Unequal blood pressure or pulses between limbs
Causes and Risk Factors of Aortic Dissection
Causes
- Long-standing or severe hypertension
- Aortic aneurysm
- Genetic connective-tissue disorders
- Marfan syndrome
- Loeys-Dietz syndrome
- Vascular Ehlers-Danlos syndrome
- Bicuspid aortic valve and associated aortic disease
- Previous aortic surgery or procedures
- Significant chest trauma
- Certain inflammatory or vascular conditions
- Pregnancy-related aortic disease in susceptible individuals
Risk Factors
- Uncontrolled high blood pressure
- Personal or family history of aortic disease
- Thoracic aortic aneurysm
- Inherited aortic disorders
- Bicuspid aortic valve
- Increasing age
- Smoking
- Previous aortic surgery
Latest Research and Technologies in the Treatment of Aortic Dissection in India
- Modern management of aortic dissection focuses on rapid diagnosis, accurate anatomical assessment, specialised surgical or endovascular treatment, and intensive postoperative monitoring. CT angiography, echocardiography, and MRI are used when appropriate to define the location and extent of disease. Treatment may include open ascending aortic or arch repair, valve or aortic-root procedures, hybrid approaches, and endovascular techniques for selected descending-aorta dissections.
Treatment options for Aortic Dissection
Open Surgical Repair: Acute Type A aortic dissection generally requires emergency open surgery. The procedure may involve replacement of the ascending aorta, hemiarch or arch reconstruction, and repair of associated complications such as aortic regurgitation or coronary involvement.
Bentall Procedure : A Bentall procedure may be performed when the aortic root and aortic valve are significantly affected. It involves replacement of the aortic root and ascending aorta with a composite graft containing an artificial valve, with reimplantation of the coronary arteries into the graft.
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Valve-Sparing Aortic Root Repair: In selected Type A dissections involving the aortic root, the native aortic valve may be preserved when appropriate. The dilated or dissected root is replaced or reconstructed while retaining the patient's own valve, when clinically appropriate.
Endovascular Repair (TEVAR): Thoracic endovascular aortic repair (TEVAR) may be considered for Type B dissection when complications such as rupture, malperfusion, persistent pain, uncontrolled hypertension, or other high-risk features are present and the anatomy is suitable.
- Clinical assessment:
- Symptom assessment: Sudden chest or back pain, pain radiation, shortness of breath, fainting, or neurological symptoms.
- Blood pressure: Measurement in both arms to identify significant differences that may indicate impaired blood flow.
- Pulse examination: Checking pulses in the arms and legs for differences or reduced blood flow.
- Cardiovascular examination: Assessment for abnormal heart sounds, aortic regurgitation, or signs of cardiac complications.
- Neurological assessment: Checking for weakness, numbness, confusion, speech difficulties, or other signs of stroke or reduced blood flow to the brain.
- Organ and limb perfusion: Assessment for signs of reduced blood supply to the kidneys, intestines, spinal cord, or limbs.
- Medical history: Review of hypertension, aortic aneurysm, previous aortic procedures, or known cardiovascular disease.
- Family history: Assessment for a family history of aortic disease or inherited connective-tissue disorders.
- Underlying conditions: Evaluation for conditions such as Marfan syndrome, other connective-tissue disorders, or bicuspid aortic valve.
- Imaging Tests:
- CT Angiography (CTA): Provides rapid, detailed images of the aorta and can identify the location and extent of the dissection and involvement of major branches.
- Transesophageal Echocardiography (TEE): Provides detailed assessment of the ascending aorta, aortic root, valves, heart function, and complications such as pericardial effusion.
- Transthoracic Echocardiography (TTE): Helps evaluate heart function, aortic valve regurgitation, and pericardial effusion, although it does not fully visualise the entire aorta.
- MRI/MRA: Provides detailed aortic imaging and can be useful for selected patients, particularly during longer-term surveillance.
MediRehab (a chain of Rehab centres, part of MediGence) provides comprehensive rehabilitation services designed to support Aortic Dissection patients in India. These services include:
- Rehabilitation after aortic dissection or surgical repair is gradual and should be guided by the treating cardiovascular team.
- It may include supervised physical activity, gradual walking, breathing exercises, strength and mobility work, blood-pressure monitoring, medication education, nutritional guidance, and strategies to support cardiovascular health.
- Patients may need restrictions on heavy lifting and high-intensity activities. Rehabilitation timing and intensity depend on the type of dissection, treatment performed, complications, cardiovascular status, and follow-up imaging.
- Medicines reduce stress on the aortic wall, control blood pressure and heart rate, relieve pain, and manage associated cardiovascular risks. Treatment may include beta-blockers, intravenous antihypertensive medicines, other blood-pressure-lowering medicines, and analgesics. Clinicians may use diuretics or other medicines when indicated.
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Hospitals for Aortic Dissection in India
Clear Medi Hospital, Karkardooma
Delhi, India
Clear Medi Hospital, Karkardooma located in New Delhi, India is accredited by ISO. Also listed below are some of the most prominent infrastructural details:
- There are 12 Linear Accelerators in all hospitals of Clear Medi Hospital, Delhi, India and more in the development stage.
- Over 25 surgical and medical specialties across all Clear Medi Hospitals
- Care Medi is one of the biggest Oncology care organisations in India.
- Hospital management solutions provided to over 15 partner healthcare organisations managing more than 300 beds.
- The organisation consists of offerings such as clinical manpower management and equipment management.
- Advanced radiology and nuclear medicine centres
- Professionally managed international patient care
- Clear Medi Hospital, Delhi has a capacity of 100 beds.
- Clear Medi is a multispecialty hospital.
- It is a NABH (National Accreditation Board for Hospitals & Healthcare providers) certified hospital.
- It has Oncology and Cardiac departments with an Intensive Care Unit.
- It also has fully equipped Operation Theatres.
- Clear Medi Hospital ensures coordination with patients and International Patient assistance
- It has an online Tumor Board with a number of Medical, Surgical and Radiation Oncologists.
VPS Rockland Hospital
Gurgaon, India
VPS Rockland Hospital located in Gurugram, India is accredited by NABH, NABL. Also listed below are some of the most prominent infrastructural details:
- Well-designed compact 103-bed hospital expanding over120,000 square feet
- Well equipped modular operation theatres, intensive care unit, interventional Cath lab, and in-patient rooms ranging from economy to luxury
- Offers a bouquet of services like Internal Medicine, Obstetrics & Gynaecology, Surgery, Pediatrics
- High-end diagnostic services like 1.5 T MRI and 128 slice CT Scan
- Advanced non-invasive assessment with echo & TMT machines
- State of the art cardiac Cath-Lab
- Appointment Scheduling
- Treatment packages
- Accommodation arrangement for the accompanying attendant
- Customized diet for patient and attendant
- Laundry services
- Prayer room
- Visa assistance
- Pick and drop facility from/to the Airport
- Foreign exchange facility
- Registration with the Foreigners Regional Registration Office
- Dedicated Neuro-Intensive care unit managed by expert intensivists
- Accommodation arrangements post discharge
- Highly advanced instruments for deep brain stimulation, stereotaxy, micro-neurosurgery, pediatric neurosurgery & neurophysiology
- Most advanced dialysis machines and advanced diagnostic and therapeutic facilities
- Renal replacement therapy for hemo-dynamically unstable patient
- Technologically advanced endoscopy suite
- Wi-Fi/internet service in the room
- Travel arrangement for patient & attendant post discharge
- Tele-consults post discharge
- Dialysis beds
- 24x7 ‘Trauma & Emergency Center
- Dedicated blood bank
- 24x7 comprehensive patient care.
- Deployed high-end technologies & smart digital system
- Robust Hospital Information Systems to meet complex medical needs of patients
- Robotic-assisted surgeries
- International Patients Lounge
The Madras Institute of Orthopedics and Traumatology
Chennai, India
MIOT started its journey with only 70 beds and focusing on Orthopedics and Trauma care. However, we grew into a multi-specialty hospital with time. MIOT is now a 1000-bedded hospital and can offer an extensive range of services across 63 specialties. The state of art laboratory of our hospital is ranked 8th internationally. We have 21 super-specialty operation theaters equipped with cutting-edge technology to help our doctors with complex procedures.
We take great care to make our patient rooms comfortable enough. The patient rooms get plenty of fresh air as well as natural light. The soothing views from the rooms do not let the patients feel cut off from the outside world. We use separate entrances for emergency patients, out-patients, in-patients, and their attendants. We put our patients’ safety first which is why we use a superior air system to ensure a near-zero infection healthy environment.
Apart from that, MIOT’s 24 hours blood bank provides all kinds of blood work related services which include blood collection to component separation. This state-of-art blood bank alone handles more than 30,000 units of blood over the course of a year. Every month around 600 blood transfusions are managed by this blood bank.
MIOT’s SIGNA Pioneer 3T MRI machine is made with noise reduction technology. This silent MRI machine can deliver superior quality neuroimages without wasting any time. The department of Radiology and Imaging Sciences can give tough competition to any international hospital with its advanced technology and accuracy.
The PET CT service at MIOT International is the first of its kind in South India enabling better and more accurate diagnosis than earlier. The superior diagnosis is also possible for the two digital cath labs at MIOT Heart Revive center.
We also have a physiotherapy team where a team of highly efficient physiotherapists deals with the mobility and functional disability issues of our patients. They listen to the patients carefully to identify the root of the pain and use therapeutic exercises to reduce their pain.
The CCU of MIOT is something to be proud of. The specially-trained staff of this unit is dedicated to ensuring top-quality medical support to serious patients. This unit along with the MIOT International Laboratory is the backbone of our facility.
Furthermore, what makes MIOT unique is our Telemedicine service. In the new normal, we are trying everything to reach our patients. Our one of its kind Telemedicine service connects our patients to our 250 full-time doctors over email, phone, chat and video consultations.
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Why Choose India for Aortic Dissection Treatment?
- World-Class Healthcare Infrastructure: India is home to numerous JCI (Joint Commission International) accredited hospitals equipped with state-of-the-art cardiothoracic surgical suites, specialized aortic intensive care units (ICUs), and advanced hybrid operating theaters designed for complex vascular repairs.
- Highly Skilled Cardiothoracic Surgeons: Vascular and cardiothoracic surgeons are globally renowned for their expertise, often having trained or worked in top medical institutions in the US, UK, and Europe. They routinely manage high volumes of complex aortic emergencies, including Bentall procedures and Frozen Elephant Trunk (FET) reconstructions.
- Cost Advantage: Emergency or elective aortic reconstruction in India costs a fraction of what it does in other nations, without compromising clinical quality.
- Cutting-Edge Diagnostic and Surgical Technology: Indian cardiac centres use the latest medical advancements, including intra-operative fusion imaging, Intravascular Ultrasound (IVUS), and specialised hybrid prostheses, ensuring precise stent deployment and surgical accuracy.
- Minimal Wait Times: Unlike public healthcare systems in some countries where waiting lists can delay complex vascular care, private cardiac centres in India offer immediate admission and rapid surgical deployment, which is vital for a life-threatening condition like an aortic dissection.
- Dedicated Cardiac Teams and Comprehensive Care: Leading Indian hospitals employ multidisciplinary Aortic Teams, including cardiac surgeons, interventional radiologists, cardiologists, and intensive care specialists, to deliver coordinated emergency care and structured post-operative rehabilitation.