From Ecuador to Bucaramanga: Aortic Surgery Restores Hope for María Patricia

• María Patricia, a 41-year-old woman from Ecuador with Turner syndrome, received an unexpected diagnosis during a routine medical checkup. This genetic condition, which affects only women, can sometimes be associated with cardiovascular complications such as severe aortic insufficiency and dilation of the ascending aorta. Although she had no symptoms, the findings carried a high risk of aortic rupture, requiring immediate medical attention.

• At the HIC Cardiovascular Institute, she underwent a highly complex surgery to replace the aortic root (the initial portion of the aorta) while preserving her native aortic valve, avoiding the need for an artificial prosthesis. The procedure, known as the David technique or aortic valve reimplantation, was led by HIC’s specialized aortic disease team.

• Thanks to an integrated approach and the work of a multidisciplinary team, the patient recovered successfully and was able to return to her country under medical follow-up. Her case demonstrates how timely access to advanced technology and highly trained specialists can transform the outlook of severe cardiovascular diseases into new opportunities for life.

Bucaramanga, Colombia, September 2025. María Patricia Enríquez, a 41-year-old patient from Ecuador, arrived at the HIC Cardiovascular Institute in Bucaramanga, Colombia, to undergo a high-complexity surgery that saved her life.

The diagnosis was completely unexpected. While preparing for orthopedic surgery due to hip dysplasia, her preoperative tests revealed severe aortic insufficiency and dilation of the ascending aorta—findings that posed a significant risk of life-threatening complications. These abnormalities were linked to Turner syndrome, a genetic condition exclusive to women that can be associated with congenital heart malformations and, in some cases, with aortic disease.

“I had no symptoms. Thanks to that checkup, we discovered it and began looking for the safest alternatives. We found that HIC was one of the referral centers in Latin America for heart conditions, and we decided to come,” says María Patricia.

A Surgical Challenge

Turner syndrome is a rare genetic condition that affects approximately 1 in every 2,500 women. Among its clinical manifestations are cardiovascular alterations, such as weakening and progressive dilation of the aorta, which significantly increase the risk of aortic rupture or dissection if not treated in time.

Dr. Gustavo Prieto, Head of Cardiovascular Surgery at HIC Cardiovascular Institute, explains: “It was a very complex surgery that included the David technique, which consists of replacing the aortic root and ascending segment while preserving the patient’s native valve. This way, we avoid implanting a mechanical valve that would require lifelong anticoagulation.”

But the challenge was even greater. Imaging studies showed that the disease also compromised the aortic arch—the portion of the aorta that gives rise to the vessels supplying blood to the head and arms. Since this region was dilated, it also needed to be replaced to prevent rupture. The involvement extended to the initial portion of the left subclavian artery and the beginning of the descending thoracic aorta, broadening the surgical scope.

To address this, the team used a hybrid prosthesis, a device that combines two components: a Dacron tube graft (a synthetic implant replacing the damaged section of the aorta) and an endovascular stent graft implanted during the same open-heart procedure.

“This type of prosthesis allowed us to reconstruct a large portion of the aorta safely in a single procedure,” adds Dr. Prieto.

The surgery lasted more than 10 hours and required the reconstruction of critical structures. The goal was to eliminate the risks of rupture or dissection and ensure the patient a much better life expectancy and quality of life.

Recovery and Comprehensive Support

Three weeks after surgery, María Patricia was already walking normally and even managed to visit parks, churches, and historic landmarks in Bucaramanga.

“I feel so much better, the pain has decreased, and I have been able to enjoy the city during my recovery. The support of the International Office has been invaluable; they guided and helped me at every step of the process,” she says.

Her mother, deeply moved, highlights the experience: “It was a difficult journey, but we placed our trust in God, in the doctor, and in the entire medical team that stood by us. Here we found the best care for such a complex case, and we feel nothing but profound gratitude.”