While a diagnosis of a complex aortic aneurysm or dissection can be intimidating, the treatment doesn’t have to be. Residents in Fairfield County now have access to the experts from Hartford HealthCare’s Heart & Vascular Institute Aortic Center at St. Vincent’s Medical Center in Bridgeport.
On Sept. 19, vascular surgeons Akhilesh Jain, MD and Brian King, MD performed the first-ever fenestrated stent graft repair of an aortic aneurysm at St. Vincent’s Medical Center. This brings the new minimally invasive repair of complex aortic aneurysms to Fairfield County.
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What is a complex aortic aneurysm?
“If we think of our heart as the main pump in our body then aorta is the main hose supplying blood to our body. Sometimes the aortic wall gets weakened and balloons up which is known as aortic aneurysm,” said Dr. Jain. “An aneurysm involving main branch points of the aorta or involving the aorta in the chest and the belly or any aneurysm that does not respond to the conventional treatments is known as complex aortic aneruysm.”
Aortic aneurysms can be located in the chest (thoracic), the belly (abdominal) or both (thoracoabdominal aortic). If not caught and treated in time, aortic aneurysms can rupture and be fatal.
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How do I know if I have an aortic aneurysm?
There are typically no symptoms associated with aortic aneurysms. Most of the time it is diagnosed incidentally when a person is undergoing imaging for another condition.
“No wonder aortic aneurysms are also known as the silent killer,” said Dr. Jain. “They can keep growing in the background and suddenly rupture, leading to a fatal event.”
This is why it is extremely important to screen appropriate high risk individuals for aortic aneurysms.
The Society for Vascular Surgery recommends screening men and women ages 65 to 75 years with either a history of smoking or a family history of AAA (abdominal aortic aneurysm), as well as men and women over the age of 75 with a smoking history in otherwise good health who have not previously undergone screening.
Other vulnerable individuals with connective tissue disorders such as Marfan syndrome or Ehlers-Danlos syndrome should be screened at a much earlier age.
What is the treatment?
If found, the goal is to repair the aneurysm before it ruptures.
“The vast majority of aortic aneurysms can be repaired through minimally invasive techniques such as stent graft repairs which is essentially relining the artery from the inside,” explained Dr. Jain. “Some patients will require open surgical repair which involves removal and replacement of the affected portion of the aorta.”
Why do patients need such highly specialized care?
Aortic aneurysms are frequently associated with other conditions such as COPD, heart disease and connective tissue disorders. Often, aortic aneurysms are closely associated with blood supply to major organs of the body. These factors often call for input from experts from multiple specialties.
“The goal is to perform a safe and durable repair of the aneurysm while maintaining the quality of life of the patient,” said Dr. Jain. “Further, it is important to carefully consider both the open and endovascular treatment options when planning such repairs.”
The Center’s team of experts includes specialists in vascular and endovascular surgery, cardiac surgery, cardiology, vascular medicine, rheumatology, radiology and medical genetics. These experts work collaboratively to provide the most comprehensive and cutting-edge care for the entire spectrum of aortic conditions. The program started at Hartford Hospital, and is now being offered at St. Vincent’s.
“The Aortic Center is among a handful in the country that offers a full spectrum of both minimally invasive endovascular fenestrated/branched endograft repair as well as open surgical repair of aortic aneurysms and dissections,” said Dr. Jain.