The patient is Mr. T.V. S. (78 years old, residing in Lam Dong), with many underlying diseases such as high blood pressure, diabetes, gout and ischemic heart disease.
About 3 days before being admitted to the hospital, the patient suddenly experienced severe left chest pain spreading to the back, accompanied by shortness of breath. At a local hospital, CT scan results recorded many dangerous lesions in the aorta. On June 16, the patient was transferred to Thong Nhat Hospital for emergency treatment in a state of severe chest pain, respiratory failure, low blood pressure, signs of shock and had to use vasopressors to maintain blood pressure.
The emergency CT scan results at Thong Nhat Hospital showed that the patient had a ruptured thoracic aortic wall ulcer, causing bleeding into the mediastinum and bilateral pleural effusion in large quantities. This is a particularly dangerous condition, threatening life every minute.
After emergency consultation, doctors decided to perform Hybrid surgery (surgery combining open surgery and endovascular intervention). The team proceeded to relocate the branch arteries feeding the brain and upper extremities, and at the same time placed a stent graft to cover the ruptured aorta to prevent bleeding. At the same time, the patient was drawn more than 2 liters of blood in the bilateral pleural cavity.
Throughout the surgery and intensive resuscitation process, the patient was transfused with a large amount of blood products to compensate for the lost blood, including 6 units of depositioned red blood cells, 6 units of fresh frozen plasma and 1 unit of platelets, contributing to maintaining hemodynamics and helping the surgery take place safely.
Dr. Nguyen Duy Tan - Head of Cardiovascular - Thoracic Surgery Department, Thong Nhat Hospital said that after surgery, the patient's condition improved significantly. Brain and upper extremity artery branches were well preserved, the location of aortic damage was completely treated. The patient's breathing tube was removed on the 3rd day after surgery. Up to now, the patient is awake, breathing well on his own, and vital signs are stable. X-ray results show that the lungs are dilated well, and there is no longer pleural effusion.
Aortic diseases include: aneurysm, dissection, peripheral ulcers, blood clots that are common in the elderly, especially in people with high blood pressure, diabetes, cardiovascular disease or atherosclerosis. Symptoms such as severe chest pain, pain spreading to the back, sudden shortness of breath should be taken to a medical facility immediately because they may be signs of dangerous life-threatening complications" - Dr. Nguyen Duy Tan recommends.
