Dr. Vishal Khullar successfully performs a Pioneering Aortic Arch Replacement Procedure - A Landmark in Life-saving Cardiac Surgery

 In a significant medical breakthrough, Dr. Vishal Khullar, a distinguished Cardiovascular & Thoracic Surgeon in Mumbai, successfully performed a complex aortic arch replacement on a 72-year-old male. Dr. Vishal Khullar used the cutting-edge frozen elephant trunk technique to resolve the patient's cardiac issue. The patient was diagnosed with a dangerous 6 cm aortic arch aneurysm for which Dr. Khullar recommended a complex aortic arch replacement.

Sharing his observations on the patient's condition before the surgery, Dr. Vishal Khullar said that the patient had developed a substantial, 6 cm aneurysm in his aortic arch – the curved section of the body's largest artery - due to weakening in the aortic wall. If untreated, the patient could experience rupture, dissection or similar life-threatening complications. Additionally, complications during the surgery included managing the vessels that supply blood to the brain. 

Although the surgery was a risky and challenging one, Dr. Vishal Khullar agreed to attempt to resolve the patient's condition, reflecting his determination to address the cardiac issue and help the patient recover as much as possible. 

Initial diagnosis includes chest X-rays and  CT scans of the chest to evaluate the extent, size and the exact location of the aneurysm. Following a thorough assessment, Dr. Khullar recommended and performed a classic two-stage aortic arch replacement using the innovative frozen elephant trunk technique. 

Dr. Khullar successfully performed the procedure, which included fixing the aneurysm and repairing the descending thoracic aorta. For effective circulatory arrest, Dr. Khullar used the right axillary artery for cannulation and ensured safety during the operation. 

Post-operation recovery was smooth, with zero complications. The patient received a follow-up on the seventh day post-surgery, indicating a successful procedure and speedy recovery despite immense challenges.

The frozen elephant trunk (FET) technique is a sophisticated surgical approach used to treat large aneurysms, dissections, and other complex issues of the aortic arch and descending thoracic aorta. It is an innovative surgery that combines the traditional open surgery on the aortic arch with the immediate placement of a stent graft into the descending aorta. Hence, instead of performing two separate, highly invasive surgeries, the cardiac surgeon performs a single-stage repair of extensive aortic disease. 

The term "frozen elephant trunk" refers to the stent graft segment placed in the descending aorta. The stent graft functions as a stable foundation for a potential future endovascular repair or as the definitive repair for that section. 

Along with a significant reduction in the overall surgical burden, the frozen elephant trunk technique considerably improves the patient outcomes for those with complex aortic conditions.

Sharing his experience, Dr. Vishal Khullar states, 'Cardiovascular treatment in elderly patients is indeed challenging because of the intricate network of vessels supplying the brain. The patient had developed a large aortic arch aneurysm, along with which we had to treat his descending aorta. With the successful application of the frozen elephant trunk technique, we were able to treat both of them together in a single comprehensive procedure. Fortunately, the patient recovered well and sooner than anticipated, and can live normally.' 

About Dr. Vishal Khullar 

Considered one of India's foremost cardiovascular and thoracic surgeons, Dr. Vishal Khullar is associated with Lilavati Hospital and Research Centre in Bandra, Mumbai. With over 30 years of experience and more than 7,000 surgeries performed, he has earned the trust of over 9,000 patients worldwide.

An accomplished cardiac surgeon, Dr. Khullar is an expert in performing heart surgeries, lung transplant surgery, and other complex procedures, including aortic root replacement, aortic arch replacement, and redo sternotomies, with great success since 2017. 

He also plays a crucial role as an integral member of the Transplant Selection Committee for both donors and recipients. A calm person, He connects well with his patients while taking conscious efforts to alleviate their anxieties about complex surgical procedures.

His experience at the Mayo Clinic as a Clinical Fellow in Cardiovascular Surgery also included serving as a primary assistant for all complex cardiac cases and managing their postoperative care.  

He has also received training at the Cleveland Clinic in Ohio, USA, completing clinical fellowships in Thoracic and Cardiovascular Surgery, Advanced Aortic Surgery, Heart/Lung Transplantation, and Mechanical Circulatory Support. 

Contact Dr. Vishal Khullar 

VLSR – The Clinic 
2nd floor, Corinthian, Linking Rd, 
Opposite DBS Bank, Khar West, 
Mumbai, Maharashtra 400052
Lilavati Hospital and Research Centre, 
OPD - 1, Lilavati Hospital, A-791, General Arunkumar Vaidya Nagar, 
Bandra West, Mumbai, Maharashtra 400050