Nationwide Survey Highlights Urgent Need for Timely Surgery in Aortic Dissection Cases

By Dr. Lokeswara Rao Sajja, Senior Consultant Cardiothoracic Surgeon, Star Hospitals & Chairman, Sajja Heart Foundation Hyderabad, 1st October, 2025: A recent nationwide survey of Indian cardiac surgeons, conducted by Dr. Lokeswara Rao Sajja and published in the October 2025 issue of the Indian Journal of Thoracic and Cardiovascular Surgery, has revealed significant variation in how acute Type A aortic dissection cases are treated across India.

While some centers adopt advanced surgical techniques, others continue to face challenges, including limited infrastructure, delayed patient presentation, and late diagnosis. The key takeaway, however, is clear: timely surgery at specialized cardiac centers can save lives.

Aortic Dissection: A Silent but Deadly Emergency Aortic dissection is a rare yet life-threatening condition where the aorta, the main blood vessel carrying blood from the heart, develops a tear. This tear spreads rapidly, and without treatment, it can be fatal within hours. Research shows the risk of death increases by 1–2% every hour if left untreated.

How Common Is It in India? • Globally, the incidence is about 3–6 cases per 100,000 people annually.

• In India, recent data suggests 5–6 cases per 100,000 people each year.

• With a population of over 1.4 billion, this translates into thousands of Indians at risk every year.

• Sadly, many cases go unrecognized or misdiagnosed as a heart attack or stroke, and patients often die before reaching a hospital.

Who Is at Risk? • High blood pressure is the biggest risk factor.

• Men over 50 years are more commonly affected.

• People with genetic conditions like Marfan syndrome or bicuspid aortic valve face a higher risk.

• Sudden chest pain, severe back pain, or fainting are critical warning signs.

• Public awareness and timely recognition by doctors are essential for saving lives.

Surgery: The Only Lifesaving Treatment For acute Type A aortic dissection, surgery is the only proven treatment. Emergency surgery replaces the torn part of the aorta with an artificial graft, preventing rupture or heart failure.

Without Surgery: Most patients do not survive beyond a few days.

With Surgery: Survival improves significantly, and patients can enjoy long-term recovery.

Newer Techniques: The Frozen Elephant Trunk Earlier surgeries focused only on replacing the ascending aorta. Today, newer methods like the Frozen Elephant Trunk procedure combine open surgery with a stent graft.

This technique not only repairs the immediate tear but also protects the arch and descending aorta, reducing future complications and improving quality of life in suitable patients.

Message to the Public “Aortic dissection may not be as widely known as a heart attack or stroke, but it is equally dangerous. Awareness, quick recognition of symptoms, and immediate referral to a cardiac surgery center can save lives. With advanced surgical procedures like the Frozen Elephant Trunk, many patients can return to active and meaningful lives after recovery.”, Dr. Lokeswara Rao Sajja Conclusion Aortic dissection is a silent yet deadly emergency that demands urgent recognition and timely surgical intervention. With his nationwide survey and ongoing efforts, Dr. Lokeswara Rao Sajja, Senior Consultant Cardiothoracic Surgeon at Star Hospitals, Hyderabad, and Chairman of the Sajja Heart Foundation, continues to lead the way in raising awareness and improving outcomes for patients across India.

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