In a remarkable medical feat that has set a new benchmark in cardiovascular care, doctors at Fortis Memorial Research Institute (FMRI), Gurugram, have successfully performed an exceptionally rare and complex Hybrid Cardiac Surgery on a 29-year-old man suffering from a ruptured and massively dilated thoracoabdominal aorta — a condition known for its extremely high mortality rate.

 According to available medical literature, this is the first such procedure reported in South-East Asia. The patient, Saif Alam, a resident of Palamau district in Bihar, was battling for his life when he reached Fortis Gurugram. Months earlier, his condition had been misdiagnosed at multiple hospitals as fluid accumulation in the chest. A chest tube was inserted, inadvertently worsening the situation and triggering uncontrolled internal bleeding. As weeks passed, Saif’s health spiralled rapidly.

His heart function dropped to a dangerously low 15 per cent, confining him to bed for nearly a month due to the constant risk of sudden, fatal bleeding. Despite approaching hospitals in Bihar, Kolkata and Bengaluru, surgery was repeatedly ruled out because of the extraordinarily high risk involved. With options exhausted, Fortis Gurugram became his last hope. A Race Against Time A detailed evaluation at Fortis revealed the true extent of the crisis.

The patient’s entire thoracoabdominal aorta — the body’s main artery supplying blood to vital organs — was severely dilated and filled with extensive clots, drastically compromising blood flow to the kidneys, liver and intestines.

Leading the life-saving intervention, Dr Udgeath Dhir, Principal Director – Cardio Thoracic Vascular Surgery, FMRI Gurugram, said conventional open surgery was not an option due to the grave risk of paralysis, organ failure and death. “The patient’s heart was functioning at only about 15 per cent, making immediate intervention critical. Given the complexity, we opted for an advanced hybrid approach, combining open bypass surgery with minimally invasive endovascular repair,” Dr Dhir explained.

The surgery began with the placement of a stent graft to seal the ruptured aorta and stop the bleeding. This was followed by an extremely rare and technically demanding procedure called aortic debranching, which ensured uninterrupted blood supply to all vital organs.

“This hybrid debranching with endovascular repair is among the rarest vascular procedures performed globally. It also allowed us to protect the spinal cord and significantly reduce the risk of paralysis. Continuous spinal cord pressure monitoring was done throughout the surgery,” Dr Dhir added.

Despite an estimated mortality risk of nearly 50 per cent, the outcome was extraordinary.

Saif recovered well and was discharged within just six days. He is currently stable, on medical management for low heart function, and will undergo a planned cardiac procedure once fully recovered. Precision Anaesthesia Played a Key Role Highlighting the critical role of anaesthesia in such high-risk cases, Dr Anand Kumar, Senior Director, Cardiac Anaesthesia, FMRI Gurugram, said meticulous monitoring was vital.

“These patients have unstable blood pressure, severely compromised heart function and a high risk of neurological injury. Anaesthetic drugs must be precisely calculated and continuously adjusted to maintain hemodynamic stability and prevent neurological damage,” he said.

‘I Had Lost All Hope’ For Saif Alam, the surgery marked a second chance at life.

“For months, I had lost all hope of living after visiting numerous hospitals across North and South India without any solution. It was only after meeting Dr Udgeath Dhir at Fortis Gurugram that I finally received the right treatment. I am deeply grateful to the entire team for giving me my life back,” he said.

A Milestone for Indian Vascular Care Calling the case a landmark achievement, Yash Rawat, Facility Director and Senior Vice-President, FMRI Gurugram, said it underscores the hospital’s growing leadership in advanced cardiovascular care.

“This case reinforces Fortis Memorial Research Institute’s position as a centre of excellence for managing the most complex and high-risk vascular and endovascular conditions,” he said.

The successful surgery not only saved a young life but also marked a significant milestone for Indian and South-East Asian cardiovascular medicine, demonstrating how cutting-edge hybrid techniques can redefine outcomes in the most challenging cases.