HeartScore: Aneurysm Repair

More and more heart problems are becoming easier to fix these days, including the life-threatening condition known as an aneurysm of the aorta. Dr. Emily Senay explains for Wednesday's Early Show as the HeartScore series continues this week.

An aortic aneurysm is like a time bomb ticking in the body. It forms when the artery wall weakens causing a section of it to blow up like a balloon that can burst at any moment. It requires immediate attention, which used to involve major surgery. But it's getting less invasive these days and much easier to bounce back from.

Sixty-six-year-old David Tobin was diagnosed with an aortic aneurysm by chance during a visit to the emergency room for food poisoning. It was a brush with bad food that may have saved his life.

"He had an imaging test done for another problem and they found this as an incidental finding, which I would say in excess of 90 percent of patients who we see in our practice here are diagnosed incidentally for other reasons," says Dr. Michael Marin, a cardiovascular surgeon at Mt. Sinai Medical Center.

There are 200,000 aneurysms diagnosed each year, but an estimated 1.5 million have one at any given time. Dr. Marin has seen his share.

"We don't know when most patients have an aortic aneurysm since it's an asymptomatic problem. It doesn't give them pain as a general rule until something disastrous has occurred. The majority of patients unfortunately who sustain a rupture or a leakage die," he says.

Traditional surgery to repair an aneurysm is nothing to look forward to.

"Large blood loss occurs. At the time of this, there's a lot of stress on the heart and lungs and other body organs and recovery is quite delayed. Most patients spend anywhere between seven to 14 days in the hospital and realistically it takes anywhere between three to five months before patients feel like they're back to what they were before we did the operation," says Dr. Marin.

But these days, patients like Tobin are being offered a much less fearsome option.

"We don't need to make large incisions to do this procedure. We make two very small incisions in the groin area that allows us to access the artery in the groin, which connects indirectly to the artery in the belly where the aneurysm is located," explains Dr. Marin.

The new procedure involves inserting a catheter into the aorta and gradually releasing a two-pronged stent, a protective covering for the weakened sections that might burst.

"It allows you to take care of a very life-threatening problem without the need for open or major aortic surgery, which means large anesthetics with breathing tube and artificial breathing, large incisions, and most importantly very long recovery periods," Dr. Marin says.

Tobin remains awake through the entire hour and a half procedure.

He was given a spinal epidural anesthetic like the one given to women during childbirth.

Afterwards, he was bright-eyed and curious and already on the road to recovery. He was so comfortable during the procedure, he told doctors after the surgery, that he was disappointed he couldn't see past the curtain to watch it on the screen.

Tobin was released from the hospital the next day and is expected to be back at work by next week.

A CT scan or an ultrasound can spot an aneurysm, but in many cases it's the experience of a doctor, feeling for it as he palpitates the lower abdomen during a regular physical, that is the first line of defense.
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