Jane Weiner: Minimally Invasive Surgery
Aneurysms run in Jane Weiner's family. Her brother survived a brain aneurysm, her grandfather did not. When Jane's mother was diagnosed with an abdominal aortic aneurysm, her surgeon told Jane and her sister it was time for them to get checked.
"I just happened to go and get an ultrasound and found that I did have the beginning of triple A."
Triple A or Abdominal Aortic Aneurism is the enlargement of the aortic artery - the largest artery in the body. The wall of the artery becomes weakened and as a result from the continued and relentless pressure pulsing against the wall on the inside from the heart beating, the diameter of the artery changes. The condition is most common in men over age 65 - especially those who have smoked. But as in Jane's case, it can affect women and can run in the family.
Despite the changes or bulging of the artery, Triple A does not show any symptoms, making it extremely difficult to detect. Jane never felt a thing. "Nothing, absolutely nothing. I would not have known."
A ruptured aneurysm can result in severe hemorrhaging and sudden death. But, when detected, Abdominal Aortic Aneurysms can be successfully treated. At the Cardiovascular Institute at Beth Israel Deaconess Medical Center, some of the best vascular surgeons in the world perform the two most common treatments for Triple A - open surgical repair and endovascular aneurysm repair.
With open surgical repair, an incision is made from the breastbone to below the bellybutton. Surgeons clamp and remove the portion of the aorta with the aneurysm, then replace it with an artificial graft made of Dacron. The procedure is major surgery. It can take anywhere from 2 to 5 hours. The average hospital length of stay runs into 8 to 10 days of which usually the first day or 2 might be in an intensive care unit and full recovery can take 3 to 6 months.
Jane opted for a newer, much less invasive treatment - endovascular aneurysm repair. Surgeons make small incisions in the groin and insert tiny Dacron covered wire mesh metal tubes called stent grafts. The grafts allow the blood to flow around the aneurysm and through the graft instead, eliminating the possibility of a rupture. It is like a new lining in the pipe; instead of actually replacing the pipe, it's placing a new lining within the pipe.
Because the procedure is less invasive, hospital stay and recovery time are much shorter. The operation usually takes about 2 hours. Most patients will go home the next day or the day after that. And complete recovery usually takes less than a month.
"Three weeks later we had a snowstorm and I was out shoveling snow so as you can see, the recovery time is very, very short."
Like most patients who undergo endovascular aneurysm repair, Jane must have an annual CT scan to ensure that the stent remains in the proper position.
Endovascular aneurysm repair results in fewer complications and reduces the mortality rate in patients from about 10 percent down to only one or 2 percent. It is especially beneficial for elderly patients who may not be healthy enough to handle major surgery.
Whatever Triple A procedure you and your doctor decide on, the team of cardiologists, vascular surgeons, nurses and medical assistants at BIDMC's Cardiovascular Institute will ensure you get the best care possible.
"I can't say enough about the doctors and the nurses they are wonderful. If you have questions they will certainly take the time to answer them all if you are nervous about something they will explain it. It's a wonderful hospital and I really, really would recommend it to anyone."