When Thomas York was diagnosed with an aortic aneurysm, he says it felt as though he had a bomb in his chest.
“I use the word (bomb) because I figured if it blew up I’m dead,” said the 71-year-old man from Belleville, Ont.
But his worry was lifted when York became the first in Canada to undergo a novel minimally invasive repair at the Peter Munk Cardiac Centre in Toronto.
The aorta is the body’s biggest artery. It carries blood directly from the heart. An aortic aneurysm occurs when the blood vessel bulges, weakening its wall. Aneurysms are usually silent. If one bursts, it can cause deadly bleeding.
Doctors are seeing more aortic aneurysms in Canada as the population ages, according to University Health Network vascular surgeon Dr. Thomas Lindsay.
The surgery to repair them takes a major toll particularly on older patients. That’s why newer minimally invasive procedures – that avoid open chest surgery and shorten hospital stays – are so vital.
In York’s case, doctors pushed the boundaries with a new kind of custom-made stent. It runs 60 centimtres in length, from near his heart to the middle of his abdomen. It’s made of metal and fabric to reinforce the weakened aorta wall.
Because of the size of his aneurysm, the stent was also designed to reinforce four arteries to the bowel and kidneys. All of the device was collapsed into a small tube that was threaded into York’s artery.
Doctors had to carefully open the branches of the device in each artery before it was deployed in the main blood vessel.
On a CT scan, you can see the metal outlines of the stent, where it functions like a new aorta.
“The pressure of the blood is no longer pushing against the aneurysm,” Dr. Lindsay explained.
Tom York's stent cost about $25,000 with an added cost per branch.
While his device is much larger than most used, Dr. Lindsay says the concept of repairing aneurysms with minimally invasive approaches should become the norm.
“We are seeing that the type of aneurysm that Mr. York had and more of those 80 to 90 per cent can be fixed using this kind of approach,” Lindsay said.
According to a recent study from Ontario, more than half of aneurysms are treated with surgery. Only 3 per cent are repaired with less invasive endovascular procedures.
Doctors believe these procedures will also result in faster recovery times. In York’s case, he was better within a day, and able to leave Toronto General Hospital within a week.
“I don't have this on my mind all the time now, I don't even think about it,” he said. “It’s fixed and I’m right back to normal when I was born.”
Doctors are also trying to raise awareness for the condition. Thoracic aneurysms tend to affect men more than women, smokers more than non-smokers and tend to run in families.
“If you have first-degree relatives and let’s say you have a couple of relatives who had aneurysm, then it is worthwhile being screened,” said Dr. Lindsay. Screening could include ultrasounds, electrocardiography, CT scans or MRIs.
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With a report by CTV News Medical Affairs Specialist Avis Favaro and producer Elizabeth St. Philip
