The Marfan Clinic is an important part of the Centre, the only facility in the country specializing in the treatment of Marfan patients

India’s very first Centre for Aortic Diseases with Marfan Clinic has opened at the 1,300-bed Amrita Institute of Medical Sciences in Kochi. MLA, Kerala State Sri. O. Rajagopal inaugurated the function. It is the only facility dedicated to comprehensive care of aortic diseases with full range of interventions, both invasive and non-invasive. It also has a built-in clinic exclusively for the treatment of Marfan patients suffering from aortic disorders.

Said Dr. Vijayakumar M., Clinical Professor, Department of Cardiology, Amrita Institute of Medical Sciences, Kochi, “Aortic diseases account for a high number of heart-related deaths and health conditions. As the size of elderly population increases in India, the incidence of aortic diseases is expected to rise too. Setting up of this dedicated center for the treatment of complex aortic diseases gives patients immediate access to state-of-the-art diagnostic and treatment services.”

Aorta, the largest blood vessel in human body, supplies blood to all major organs. Aortic diseases can be life threatening and complex. They need timely management by a multi-disciplinary team involving a cardiac-surgeon, cardiologist, radiologist, anesthesiologist, critical-care specialists, genetic specialists, pathologist, blood-bank services, a dedicated cardiology cath lab and cardiac surgical theatre facilities.

The Marfan syndrome is a genetic disorder of the connective tissue. The patients tend to be tall and thin with long arms, legs, fingers and toes. Serious complications involve the heart and the aorta. These patients need not only the management of their aortic condition but also comprehensive treatment by genetic specialists and ophthalmologists.

Dr. Praveen Varma, Head, Cardiovascular and Thoracic Surgery, Amrita Institute of Medical Sciences, Kochi, explained, “Marfan syndrome, afflicting 1 in 5,000 people, impacts the aorta, which becomes dilated and weak, leading to internal splitting. This condition can also occur due to high blood pressure in normal individuals. The severe chest pain that arises is mistaken as a heart attack. This is a surgical emergency as the death rate is 1-2% per hour. Such patients need to be shifted immediately to centers with expertise in aortic dissection surgery. Establishment of the Amrita Centre of Aortic Diseases will help save many such lives in Kerala.”

He added, “The Marfan Clinic is one of the hallmarks of the Centre for Aortic Diseases. It is the first and only centre in India catering exclusively to Marfan patients. The care for these patients at present remains scattered over multiple specialties, leading to inefficient and often unsatisfactory long-term results.”

Aortic diseases need excellent radiological and interventional facilities for early diagnosis and further treatment planning. The Amrita Centre for Aortic Diseases has the latest 256 slice high-definition CT scanners and 3T MRI machines for aortic imaging, diagnosis and planning of complex aortic interventions.

Said Dr. K. Mahesh, Clinical Professor, Department of Pediatric Cardiology, Amrita Institute of Medical Sciences, “Birth defects of aorta account for 6-8% of all birth defects of the heart. In most such cases, there is obstruction to blood flow, leading to severe problems during newborn period or soon after. If not identified and treated immediately, it can lead to heart failure. Such babies can be treated through surgery or catheter interventions. Even after surgery, the patients require lifelong regular check-up and care. The Amrita Centre of Aortic Diseases will be able to provide excellent care to these cases.”

“Many genetic syndromes in children may be associated with aortic problems. Recently, doctors from the pediatric cardiology and pediatric genetics departments of Amrita Institute of Medical Sciences discovered a unique disease of aorta occurring only in children from the Malabar region of North Kerala. In this, the aorta is massively enlarged, and most children die in first year of life. Discovery of this disease now allows us to manage it better and diagnose it during pregnancy itself,” he added. 

Dr. Hans Joachim Schafers, Director, Department of Thoracic & Cardiovascular Surgery, Saarland, University Medical Center, Germany, said that bicuspid aortic valve disease roughly affects 1 to 2% of population. That puts roughly 60 million having this disease. In 50% of bicuspid can develop aortic dilation. This with genetic diseases like Marfan’s, increasing incidence of hypertension, inflammatory disorders we are looking into an enormous number of potential patients in society which requires centers of excellence for treatment.