Aortic Aneurysm: Fixing Mr. Fix-it
With a reputation as “Mr. Fix-it,” Amado Velez usually doesn’t hesitate to repair anything around him that’s broken. But when a balloon-like bulge in his aortic artery, called an abdominal aortic aneurysm, grew so large it threatened to burst, Amado quickly turned to vascular surgeons at Southern Ocean Medical Center to pick up where his fix-it capabilities left off.
The 76-year-old retiree’s long medical history had included a pair of coronary artery bypass surgeries as well as chronic back pain and a bleeding ulcer. Diligent treatment over the years involved imaging tests that happened to reveal his abdominal aortic aneurysm, which can occur in the body’s largest blood vessel that carries oxygen-rich blood away from the heart to the lower body.
It was a discovery that couldn’t be ignored, since a tear or rupture in the aortic wall—especially in aneurysms that continue to grow, like Amado’s—is potentially deadly. Nearly 10,000 people in the United States die each year of aortic aneurysms, according to the Centers for Disease Control and Prevention. Monitored over nearly a decade, Amado’s aortic aneurysm steadily enlarged to a point where surgery became vital.
“Leaving it alone was not an option because of the threat of rupture associated with an aneurysm that size,” says Arthur DeMarsico, D.O., FACOS, the vascular surgeon at Southern Ocean who treated Amado. “We didn’t feel it was in his best interests to just watch it, with a 20 to 30 percent chance of it rupturing next year and then a 40 to 60 percent chance of rupture the following year.”
“They caught it in time and weren’t taking any chances,” adds Amado, who lives in Barnegat, New Jersey, with his wife of 25 years, Barbara.
Expanding Cutting-edge Care
Dr. DeMarsico’s arrival in late 2018 is part of Southern Ocean’s strong push to expand its offerings of cutting-edge vascular procedures. These include endovascular aneurysm repair (EVAR), a minimally invasive surgery to repair aortic aneurysms that boasts a much quicker recovery.
Instead of open surgery using a long incision in the abdomen, EVAR surgery requires only two small cuts in the groin. During the procedure, a device called
a stent graft (a tube covered with fabric) is threaded through blood vessels up
to the aorta.
When it’s placed inside the aneurysm, the stent is expanded, attaching to aortic walls and forming a seal to prevent blood from entering the aortic aneurysm.
The minimally invasive aortic repair was first done in the early 2000s but requires advanced surgical expertise. Southern Ocean’s location in a retiree-rich area makes the offering a natural fit, since aortic aneurysms are most common in adults after age 65, according to the National Institutes of Health.
Minimally Invasive Benefits
With no obvious symptoms of his aortic aneurysm, Amado was typical of many patients with the condition, whose risk factors also include smoking and heart disease, among others. Amado also made an ideal candidate for the minimally invasive surgery because of his “favorable anatomy” that includes certain blood vessel characteristics shown on imaging tests, Dr. DeMarsico explains.
“Not every patient is a candidate to get this fixed using the endovascular technique, but that technique continues to change and expand through the years,” he says. “Probably 70 to 80 percent of all patients with aortic aneurysms are now candidates.”
Dr. DeMarsico felt that this approach gave Amado, considering his age and other medical conditions, the best shot at getting back to his regular life.
“The minimally invasive procedure really only limits a patient from lifting anything heavy for 48 hours, compared to three to six months getting back to normal after an open operation,” he adds.
Enjoying Beloved Hobbies
Amado and Barbara were equally impressed with the speed of his January 2019 surgery, which took a little more than an hour, as well as his quick release from the hospital the following day. His successful outcome involved intricate collaboration by a variety of specialists at Southern Ocean, including those in cardiology, anesthesiology and radiology.
“It was painful for a couple of days, and then I was fine,” Amado recalls. “The next day I was walking down the street.”
Adds Barbara, “We both think it’s an amazing thing that people can have surgery like this right in our own area and not have to go to another hospital.”
The couple, parents to five adult children, are happily back to enjoying their hobbies. For Amado, that includes a longtime fascination with a fleet of radio control boats and drones, which he launches on local waterways and fields.
And when they break, Mr. Fix-it gets to work.
Learn about the minimally invasive vascular treatment options available
at Hackensack Meridian Health.
Dr. DeMarsico practices in Manahawkin and Toms River. To make an appointment, call 609-978-0778.
The material provided through HealthU is intended to be used as general information only and should not replace the advice of your physician. Always consult your physician for individual care.
CDC National Institutes for Health