At St Panteleymon Hospital of the First Medical Association of Lviv, cardiac surgeons have for the first time carried out one of the most complex procedures in cardiac surgery – aortic arch replacement – using a minimally invasive technique, without the traditional large incision. Thanks to this, they managed to save 58-year-old surgeon Dr Liubomyr Parokhoniak from Ivano-Frankivsk region, who had been diagnosed with an aortic aneurysm and a congenital aortic valve defect.
The man, who had led an active lifestyle all his life and had no serious complaints, learned about the dangerous condition during a routine heart ultrasound scan. Doctors detected a congenital defect of the aortic valve and an aortic aneurysm – a pathological dilation of the vessel that can rupture at any moment and lead to death. The patient then faced a decision: to monitor the disease and risk his life, or to agree to planned surgical intervention.
Liubomyr Parokhoniak chose surgery and turned to the cardiac surgeons of the Heart and Vessels Centre at St Panteleymon Hospital, asking for it to be performed in a minimally invasive way. The Lviv specialists already had experience of performing minimally traumatic procedures on the heart valves and aorta, but until now aortic arch replacement had always been done by the open method with a large incision. According to the head of the Heart and Vessels Centre, Roman Domashych, during such an operation it is necessary to expose the aortic arch and its branches, completely stop the blood circulation, connect the heart-lung machine, provide selective cerebral perfusion, and then replace the aortic arch with a vascular graft and connect its branches to it.
The cardiac surgery team considered two options: the standard operation with a chest incision of about 18 cm, or an attempt to perform the procedure through a 5–6 cm “mini-access”. After a detailed analysis of the tests and taking into account the patient's wishes, the specialists decided to choose the less traumatic approach. Despite the high technical complexity, they performed the aortic arch replacement using a minimally invasive technique.
During the operation through the small access, the cardiac surgeons replaced the aortic valve, the ascending aorta and the aortic arch with reimplantation of its branches, as well as part of the descending aorta. The procedure went smoothly, and already on the fifth day after the operation Liubomyr Parokhoniak was discharged home. The patient, who is himself a surgeon, notes that he feels significantly better than he had expected after such a complex procedure.
“People ask me: "How are you?" And I answer that if it weren't for the dressing, I wouldn't even feel that I had undergone surgery. My patients have already been waiting for me; I want to complete my rehabilitation as soon as possible and return to my favourite work – surgery,” the patient shared.
The First Medical Association of Lviv emphasises that within its structure it provides a full range of modern medical care – from diagnostics and conservative treatment to complex surgical interventions, rehabilitation and prosthetics. Here they save patients in extremely critical conditions and after serious injuries. The association includes St Panteleymon, St Luke, St Nicholas and St Anne hospitals, the UNBROKEN rehabilitation centre, and treatment and diagnostic centres.