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New Treatment for Aortic Aneurysms

Patients with a thoracic aortic aneurysm (TAA) can now undergo less invasive heart surgery to treat their cardiac condition, thanks to the team of thoracic surgeons, radiologists and clinical staff at Palomar Health .

“The GORE TAG thoracic endoprosthesis repairs a thoracic aortic aneurysm using minimally invasive endovascular surgery,” says Robert Reichman, M.D., a board-certified thoracic surgeon. “This device allows us to repair the aneurysm without making a major incision in the patient’s chest.”

An aneurysm is a balloon-like bulge that develops when a section of the aorta becomes weak. It can occur anywhere along the aorta, which extends from the heart to the abdomen and then divides in two, one for each leg. If an aortic aneurysm increases in size, it may rupture and cause life-threatening internal bleeding.

Until recently, patients with a TAA had to have open-heart surgery during which the aorta, the body’s largest blood vessel that carries oxygen-rich blood, was cut and an artificial graft was sewn in place with permanent sutures to repair the aneurysm.

In endovascular surgery, which is a stent-graft, a Teflon-like mesh fabric (the graft) inside of a metal support cylinder (the stent), is inserted into the artery in the leg through a small incision in the groin.

Dr. Reichman uses fluoroscopy (“live” x-ray) to guide the catheter to a site that bridges the aneurysm and then deploys the graft, which expands to support the weakened blood vessel walls and allow blood to flow freely. The graft seals off the aneurysm and relines the artery wall causing the aneurysm to eventually shrink.

“This type of surgery is excellent for those patients who are elderly, have other pre-existing medical conditions and would not tolerate open surgery,” says Dr. Reichman, who trained under Ted Diethrich, M.D., the Arizona Heart Institute founder and medical director who pioneered this procedure.

To be considered for endovascular surgery, patients must undergo a series of preoperative imaging and implantation studies. to determine the size and placement of the stent-graft. Each stent-graft is customized to fit the length, diameter and width of a patient’s aorta. The surgery lasts approximately one to two hours and has minimal blood loss. The average length of stay in the hospital is two to three days following surgery and most patients resume normal activities with two weeks.

 

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