At age 33, Anthony Russo thought he was healthier than he had ever been in his life. He exercised four times a week and maintained a well-balanced diet. Despite this picture of health, he began to experience a fluttering in his heart. One night, while exercising, the fluttering worsened and his right leg went numb. Mr. Russo’s wife took him to The Emergency Department at Saint Barnabas.

Physicians determined that he had a thoracic aneurysm that burst. His aortic valve had collapsed and, after difficult surgery, the damaged section was replaced. After a five-day hospital stay and a recovery period at home, Mr. Russo returned to health.

“I feel a thousand times better” says Mr. Russo, who has scans every six months to monitor the health of his heart. “I feel very lucky that I had my surgeon and that I survived the surgery. It could have gone either way.” Because of a family history of aneurysms, Mr., Russo will continue to have regular checkups.

Aneurysms Defined
An aneurysm is a swelling in the wall of a blood vessel. Over time, that bulge may become too large and pose the risk of rupture, a lifethreatening situation. A ruptured aneurysm is a very serious condition, often leading to death within minutes.

“If an aneurysm bursts and emergency surgery is required, there is over a 90 percent chance that the patient will not survive the surgery,” says Paul Burns, M.D., Clinical Director of the Division of Cardiac Surgery and attending cardiac surgeon at Saint Barnabas Medical Center. “Fortunately, the success rate for elective surgery to treat aneurysms is 98 percent. That is why it is important to have proper surveillance of an existing aneurysm and to operate in a timely fashion if it is large enough to potentially rupture.”

Aortic Aneurysms
An aortic aneurysm is a bulge in the aorta, the large blood vessel that carries blood from the heart to the rest of the body. Progressive thinning of the wall of the vessel can lead to rupture.

“They literally feel like they have a time bomb inside them,” says Dr. Hertz. “It can be a tremendous emotional relief when the aneurysm is repaired surgically.”

Surgical Management of Abdominal Aneurysms
Traditional surgery to repair an abdominal aortic aneurysm involves making a large incision in the abdomen and replacing the damaged portion of the blood vessel with a graft. It requires a general anesthetic and a four- to five day stay in the hospital.

Dr. Hertz describes a new technique that uses the placement of a stent using a catheter instead of open abdominal surgery. This procedure, which is done with local anesthetic in the spine and requires a hospital stay of less than 24-hours, can be especially beneficial to those patients whose medical condition precludes the use of traditional repair. While about three fourths of Dr. Hertz’s patients have this procedure, its use depends on the age of the patient and condition of the artery.

“While this procedure is no longer experimental and shows results that are quite promising, it is currently not for everyone,” says Dr. Hertz. “The original surgery is still a wonderful, lifesaving procedure.”

Thoracic Aortic Aneurysms
Most people with thoracic aortic aneurysms are unaware they have them and are often diagnosed during an evaluation for another problem. The size and location of the thoracic aneurysm dictates the risk of rupture. In the thoracic region, surgery is indicated if the aneurysm is six centimeters or larger. Those with small aneurysms are monitored every six to 12 months to see if the diameter of the blood vessels has enlarged.

“For most patients, it is four or five years by the time surgery is necessary,” says Dr. Burns. “For some it may be 10 years.” Surgical repair involves the replacement of the bulging section with a tube of strong synthetic material. This procedure, which uses general anesthesia and an open chest operation, is a permanent solution to the problem. Patients generally have a five–day stay in the hospital and for the vast majority, about 98 percent, the procedure is a complete success.

For a referral to a cardiac surgeon or a vascular surgeon, please call 1-888-SBHC-DOC.

To reach The HEART HOSPITAL of New Jersey, please call
(973) 322-5222.