Posts Tagged ‘aortic aneurysm’

During my most recent visit to Cartagena, I stopped in to re-visit Dr. Barbosa, cardiac surgeon at Hospital Nuevo Bocagrande. We talked about some of the changes that had taken place since my last visit – as well as Dr. Barbosa’s future plans. (I wrote about it a little during a previous post but I wanted to talk a bit more about the procedure itself, now that I have the video to accompany the post).

Recent global downturns in the economy have begun affecting Cartagena as well, which has led to some slow downs at the hospital. Dr. Pulido, during his short tenure there had initiated several upgrades and expansion plans, including a new, larger emergency department. While the new ER was completed last year – during my visit to Cartagena, some of the other plans have been deferred due to the weakening peso.

Of course, that doesn’t stop Dr. Barbosa from providing his patients with excellent care. During my visit, I joined Dr. Barbosa and his team in the operating room as an observer. (Unfortunately much of the video footage was damaged), but I was able to make a short film showing Dr. Barbosa performing the Bentall procedure.

Dr. Barbosa on YouTube.com

The Bentall procedure is replacement of the aortic root with aortic valve replacement. Essentially a long prosthetic graft (which resembles a stiff tube sock with a prosthetic valve attached at one end) is used to replace the damaged segment of the aorta. In this case, the patient has a very large aneurysm of the ascending aorta (which is marked on one segment of the clip above – visible on full screen settings). Due to the size and location of the aneurysm, the aortic valve was no longer able to function – and it was this dysfunction (not the aneurysm itself*) that caused the patient’s symptoms (from severe aortic valve regurgitation). However, had this aneurysm remained untreated/ corrected this patient certainly would have died when the aneurysm eventually being leaking/ ruptured.

Instead – the patient was in the operating room with Dr. Barbosa where everything went quickly and smoothly. The aneurysmal section and aortic valve were replaced – the patient was transferred to the ICU and discharged a few days later.

As you can imagine, this is a fairly complex operation – requiring CPB (cardiopulmonary bypass or the heart-lung machine) which carries some risk of death, and serious complications such as organ failure.

Luckily for patients needing this surgery – for most cardiac surgery programs, it’s also a fairly routine procedure (which means we’ve gotten good at it.)
*intact aortic aneurysms rarely cause symptoms.


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Hospital Nuevo Bocagrande, Cartagena –

Dr. Barbosa (right with loops) and Dr. Pomares (assisting surgeon)

Spent the day in the operating room with one of my favorite people, watching him perform a complex case – a Bentall procedure, which is ascending aortic replacement with aortic valve replacement.  This surgery is used to treat large aortic aneurysms, when the aneurysm has damaged the aortic valve.  (The aneurysmal segment gets so large the valve develops severe insufficiency  – so it’s basically stuck open all the time.)

It was good to see Dr. Barbosa and his team again – they are a great bunch of dedicated people.  A lot has changed since my last visit – the economy has taken a toll on the beachfront hospital but Dr. Barbosa’s surgical talents remain superb!

Alfredo de Leon

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