Doctor performs procedure for first time
in S.J., saves 82-year-old's life
News article courtesy of The Record.
By Joe Goldeen
Record Staff Writer
February 02, 2010
STOCKTON - Chalk up another first in the world of San Joaquin County medical milestones.
Earlier this month, Dr. Andrew Macbeth successfully repaired a life-threatening thoracic aortic aneurysm on an 82-year-old Stockton woman who left the hospital two days later able to walk, eat what she wanted and get back to her normal life with relatively minor or no pain. She had originally sought medical attention for a sore back.
Typically, such a procedure would entail surgically opening up the patient's chest and possibly the abdomen, with all the attendant risks of a complicated, four- to eight-hour major operation.
That alone results in up to 12 days recovering in the hospital and an additional six weeks recuperating in a skilled-nursing facility before going home, Macbeth said.
Macbeth, a vascular surgeon with Sutter Gould Medical Foundation, performed instead a one-hour thoracic aneurysm stent graft - for the first time in San Joaquin County - on the woman at St. Joseph's Medical Center. Health care privacy rules restrict him from saying more about the patient, and she declined a request to be interviewed.
An aortic aneurysm is a serious medical condition in which the wall of the blood vessel has thinned out. In this case, it's on the aorta, the body's largest artery, which carries blood directly from the heart to the abdomen before branching off to the legs.
"The risk (from an aneurysm) is obviously rupture and sudden death," Macbeth said. And, generally, patients show no previous symptoms.
"This patient had back pain, and this is when the problem was discovered. Some study was done looking for something else," he said, noting that the aneurysm was not the cause of the back pain.
"We do not understand why these form. It may have something to do with hardening of the arteries, but again we don't have these mechanisms worked out," Macbeth said.
The procedure that Macbeth performed involved placing a stent graft inside the affected area of the aorta, essentially "a new pipe inside the old pipe, preventing the pressurized flow (of blood) from going down the native aorta."
The significance, he said, is "it's the first time it's been done electively for this type of graft. ... The aneurysm is still repaired with the patient asleep but done through a small groin incision rather than a large chest and/or abdominal incision. The repairs themselves have been durable and have had good results with preventing complications with the aneurysm itself."
One of the primary risks of treating thoracic aneurysms is the possibility of causing permanent paralysis of the legs, but that did not occur, Macbeth said.
He said people should be aware that if there is any family history of aneurysmal disease or hardening of the arteries, they should be screened for an aneurysm in the chest or abdomen.
"It's as simple as an ultrasound of the abdomen or, more commonly now, CT scans of the chest and abdomen. These tests can be ordered by family practitioners, cardiologists and vascular surgeons," Macbeth said.
Now that the procedure has been successfully done in Stockton, he expects to see four to five similar cases per year.