HYDERABAD: Dr L R Sajja survey stresses timely surgery for aortic dissection

HYDERABAD: A nationwide survey of cardiac surgeons has revealed wide variations in the treatment of acute Type A aortic dissection across India, underlining the importance of urgent surgery at specialised centres. The survey, led by Dr Lokeswara Rao Sajja, Senior Consultant Cardiothoracic Surgeon at Star Hospitals and Chairman of the Sajja Heart Foundation, was published in the October 2025 issue of the Indian Journal of Thoracic and Cardiovascular Surgery.

Fatal if untreated

Aortic dissection is a rare but life-threatening condition in which the aorta, the main blood vessel carrying blood from the heart, develops a tear. Without treatment, it can be fatal within hours, with the risk of death increasing by 1–2% every hour.

Global incidence is estimated at 3–6 cases per 1,00,000 annually, while Indian data suggests 5–6. Given India’s population, thousands are at risk each year. Many cases are misdiagnosed as heart attacks or strokes, with patients often dying before reaching hospital.

Risk factors and treatment

High blood pressure is the main risk factor. Men over 50 and those with conditions such as Marfan syndrome or bicuspid aortic valve are especially vulnerable. Warning signs include sudden chest pain, severe back pain or fainting. For acute Type A cases, surgery is the only proven treatment. Emergency procedures replace the torn section of the aorta with an artificial graft. Newer approaches, including the Frozen Elephant Trunk technique, combine open surgery with a stent graft, offering better long-term outcomes.

“Aortic dissection may not be as widely known as a heart attack or stroke, but it is equally dangerous. Awareness, timely recognition and immediate referral can save lives,” said Dr Sajja. The study stressed the need for greater awareness, faster diagnosis and wider use of advanced surgical methods to improve survival in India.