Dr. A. Mohammed Idhrees MCh, FAIS, Cardio-Thoracic and Vascular Surgeon, Institute for Cardiac and Aortic Disorders, SRM Institute for Medical Sciences (SIMS Hospitals), Chennai, India. E-mail: a.m.idhrees@gmail. com
Aortic diseases, to a great extent, are a problem for the elderly. In the last 50 years, the life expectancy of an Indian has increased by 30 years. The technical developments have grown multi-folds, helping the diagnosis of patients at an early stage. The above in combination with lifestyle, diabetes, and increase in population has placed the country with a high incidence of cardiovascular and aortic disease. Aortic diseases include aortic dissections and aortic aneurysms. These can be catastrophic when not treated at the right time. If the patient is not treated, the mortality rate is 50% at 24 hours. At present a very few centers in India are performing complex aortic surgeries and providing emergency aortic services.
Challenges in India Certain vascular grafts and endovascular stents are not available in India. Unlike many western countries, the cost of the procedures falls on the shoulder of the patients themself. With a literacy rate close to 75% and the Gross National Income per capita $7060 (UK: Literacy rate is 99% and Gross national income per capita is $43160), most of the patients present to the doctor at a late stage of the disease. These patients have to accept a double burden, wherein they have to pay for the procedure and have lost pay during hospital admission. In case of emergency, the patients have few questions to ask him/her before deciding on treatment. Where to go to get treated? How to reach the center to get operated? How much will be the cost?