First-Ever TEVAR Successfully Performed at SUM Cardiology in a Life-Threatening Emergency

A 50-year-old male presented to the Pulmonary Medicine Department with complaints of hemoptysis. Initial evaluation with chest X-ray revealed mediastinal widening, prompting immediate advanced imaging. A CT thorax identified a massive pseudoaneurysm of the descending thoracic aorta with fissuring and signs of impending rupture. Subsequent CT angiography confirmed the presence of two large saccular aneurysms, the largest measuring approximately 12 cm in diameter.

The clinical situation was extremely high risk. Any episode of coughing could have resulted in catastrophic aortic rupture and sudden death. The case was further complicated by severe time constraints, logistical and financial limitations, and the fact that this would be the first TEVAR procedure undertaken by the Cardiology Department at SUM.

Given the life-threatening nature of the condition, a multidisciplinary Heart Team discussion was urgently convened, involving Pulmonary Medicine, Radiology, Cardiothoracic and Vascular Surgery (CTVS), and Cardiology. Two treatment options were considered: open surgical repair and endovascular intervention. Considering the significantly high mortality risk associated with open surgery in this emergency setting, the team unanimously decided to proceed with TEVAR.

The procedure was performed via a percutaneous femoral approach. A thoracic stent graft was successfully deployed, effectively excluding the aneurysms and stabilising the aorta. The intervention was completed without procedural complications. The patient showed steady clinical improvement post-procedure and was subsequently discharged in stable condition.

This successful outcome was the result of close coordination and teamwork across multiple departments. The Pulmonary Medicine Department played a crucial role in early recognition and prompt referral. The Radiology Department ensured expedited CT angiography and rapid reporting, which was critical for decision-making. The CTVS team provided valuable intra-procedural and post-procedural support, while the Cardiology team led the endovascular intervention with meticulous planning and execution. The cath lab team, OT staff, and residents contributed significantly to procedural efficiency and patient care.

Special acknowledgment is extended to the hospital leadership for addressing major logistical challenges and enabling timely access to life-saving treatment.

Reflecting on the case, Dr. Gyana Ranjan Nayak (https://drgyana.com/) described it as one of the most challenging yet deeply fulfilling interventions of 2025, given the urgency, complexity, and collaborative effort involved. The successful completion of this first TEVAR at SUM marks an important step forward in advanced endovascular cardiac care at the institution.

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In a significant medical milestone, the Cardiology Department at SUM successfully performed its first-ever Thoracic Endovascular Aortic Repair (TEVAR) to save the life of a patient with a critically unstable thoracic aortic condition.

This release was published on openPR.