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Froedtert Today

March 2007 Issue

Minimally Invasive Surgery for Aorta Repair


Fixing the aorta, the largest blood vessel in the body, has traditionally required open surgery. Until now.

Thoracic endovasular artery repair, or TEVAR, is a minimally invasive procedure that uses a covered sleeve, or stent graft, to channel blood past an abnormal area of the aorta. Results are comparable to open-chest surgery, but patients experience less pain, fewer complications and a greatly decreased recovery time. Froedtert & the Medical College of Wisconsin are among the first to offer TEVAR.

While minimally invasive techniques have previously been used to repair aortic aneurysms in the abdomen, stent grafts have only recently been approved for use in the chest. (An aneurysm is a weakening in the wall of the aorta.)

“Because we have a program for endovascular repair in the abdominal aorta, we were ready to use the device as soon as it was released,” said Gary Seabrook, MD, Medical College of Wisconsin vascular surgeon. “We treated our first patient soon after FDA approval.”

Stent grafts are threaded up to the aorta via a small incision near the groin. Using X-ray guidance, physicians advance the device to the proper location. They then release it and it expands to line the wall of the aorta. The stent graft acts as an interior “sleeve,” allowing blood to safely flow through a weak area.

“Stent grafts have tremendously simplified the procedure for patients,” said Alfred Nicolosi, MD, Medical College of Wisconsin cardiothoracic surgeon. “They don’t have to have an extensive operation. We can also do these procedures for patients who have other diseases that would make an open operation risky.”

Medical College of Wisconsin physicians believe stent grafts are potentially revolutionary. “We’re excited at the potential for using the procedure for other disease processes,” said William Rilling, MD, Medical College of Wisconsin interventional radiologist and director of Vascular and Interventional Radiology at Froedtert & the Medical College.

“We’ve already used stent grafts for traumatic injuries to the thoracic aorta,” Dr. Nicolosi said. “We see a fair number here each year, and some of those people have multiple injuries; they’re not really great candidates for major surgery. Stent grafts work very well for those patients.”

 

 

Source: Froedtert Today

Date: March 2007

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