How John Metz Beat an Abdominal Aortic Aneurysm

It all started with a little backache, the kind many of us experience when we overdo it at the gym or sit too long at the computer. But several hours later when John Metz’s pain became so severe that he screamed out in agony and begged his wife to call 911, he suspected his life was in danger.

“The pain was relentless,” says the 62-year-old Poway resident. “I thought I was dying.”

John was suffering from a ruptured abdominal aortic aneurysm, often called a “triple A.” And, in fact, he easily could have died if it weren’t for the quick and skillful procedure performed at Palomar Medical Center by vascular surgeon Alexander Salloum, M.D., and his team.

An abdominal aortic aneurysm (AAA) is a weakened and bulging area in the lower part of the aorta, the major blood vessel that supplies blood to the body. A ruptured AAA can cause life-threatening bleeding, just as John was experiencing.

The aorta lies on top of the spine, so when the aneurysm ruptured, John felt the pain in his back, Dr. Salloum explains.

“About 90 percent of patients with a ruptured triple-A die before they get to the hospital. Of those 10 percent who do make it to the hospital, half will die within 30 days,” Dr. Salloum says. “The odds were definitely against him so we had to move fast.”

Paramedics took John to Palomar Medical Center, where a team of experienced vascular experts awaited him. Meanwhile, John’s wife Julie was being prepared for the worst. “I was told that John’s chance of survival was very slim. When he went into surgery I thought it would be the last time I would see him,” she says, getting emotional when telling the story. “When Dr. Salloum came out (of surgery) I expected bad news. But all he said was, ‘he’s all fixed.’ That was it. And, that’s when we all started cheering.”

John and his family were amazed not only by the speed of the procedure, but also by the fact that John’s life-threatening situation was remedied without one incision.

“Within two hours from the time Dr. Salloum got the call about John’s emergency, John was fixed,” Julie says. “It was a miracle.”

The “old school” repair for a triple-A rupture is to open up the abdomen and repair the problem directly. Another surgical procedure often used is to make incisions at the groin through which a catheter is inserted into an artery in the leg to deliver a repair. However, Dr. Salloum chose the most minimally invasive technique possible – a percutaneous repair, in which there are no incisions.

The percutaneous approach involves a tiny needle puncture at the groin through which a stent graft is delivered, which “relined or repiped the hole inside the artery,” Dr. Salloum explains. The percutaneous access allows for faster recovery and less risk of infection and other post-surgery complications. And, because the procedure was minimally invasive, no general anesthesia was used.

“His blood pressure was so low, that I knew if I put him to sleep, he wouldn’t have made it. So we used a local anesthesia instead, and it worked out well,” Dr. Salloum says.

Dr. Salloum credits the advanced technology at Palomar Medical Center, along with the experienced surgical team with being able to treat John so quickly and effectively. Palomar Medical Center offers a hybrid room, which is both an operating room and a cardiac catheterization lab.

John’s recovery period was only three or four days and without much discomfort. In fact, the only pain medication he took after the surgery was an acetaminophen. Although John will have to be monitored once a year because of the stent placement, he doesn’t have to live his life any differently. Today, he says he feels “great, and very lucky.”

“Except for the pain (leading up to the surgery), everything about the experience was great. The hospital is a great place and Dr. Salloum really knows what he’s doing,” John says. “Dr. Salloum is a wizard of a surgeon. It’s a miracle that I’m still here, all thanks to him.”

John and Julie are also quick to sing the praises of the nursing staff on the 6th floor. “They were the most fantastic nurses. They were helpful and friendly and always had the time to talk and explain things,” Julie says. “The hospital, Dr. Salloum and staff turned our nightmare into a miracle.” 

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