Treating deadly aneurysm with thoraflex graft leads to quicker recovery

Fall 2019

Most days Barbara Palmateer swims lengths at the local pool. It is not unusual for her to do 20 to 30 laps, but three years ago she found herself suddenly doing less and less.

“One day I could only do one length and I couldn’t breathe. Within a week I had gone from 20 laps to one, and I felt sick,” says Barbara.

The Belleville resident went to her family doctor and was referred for diagnostic testing in Kingston.

The hospital in Kingston referred her to London Health Sciences Centre (LHSC) because, as Barbara puts it, there are only a few doctors and hospitals in Canada who do the type of surgery she needed and LHSC is one of them.

Tests showed that Barbara had a massive complex aortic aneurysm that stretched from her heart to her mid-back, impeding her breathing and causing the shortness of breath.

The aorta is the largest artery in the human body and is connected to the left ventricle of the heart. It sends the blood pumped by the heart to all of the organs of the body.

If the wall of the aorta becomes weakened it may become enlarged and, like a balloon, become thin and tear when it is stretched. This is known as a thoracic aortic aneurysm.

Dr. Michael Chu, LHSC cardiovascular surgeon, and Dr. Audra Duncan, LHSC vascular surgeon, headed the team of surgeons who operated on Barbara.

The team performed a less-invasive reconstruction by inserting a device called the Thoraflex Hybrid prosthesis. 

 

“Barbara had an aortic aneurysm in an area that is traditionally hard to access but this novel approach uses a much less invasive incision than traditionally required, allowing the patient to still receive extensive aortic repair with a much quicker recovery,” says Dr. Chu.

Complex aortic arch aneurysm surgery typically requires one of two types of openings in order for the surgeons to access the area.

It may require a large section of the chest to be cut vertically with an additional section opened from the mid-chest to the back of the patient.

Or, it requires a full horizontal cut opening the chest from one side of the patient to the other, called a clamshell incision.

For most patients it can take about a year to be fully well again.

“The thoraflex graft is a revolutionary design combining the best of open heart surgery techniques and endovascular techniques. This novel hybrid surgery enables a complete aortic arch replacement using a much less invasive technique with quicker recovery and perhaps better outcomes,” says Dr. Chu.

Indeed, Barbara had a remarkable recovery and returned home after six days in hospital.

“I felt better in about a month and resumed all my activities,” says Barbara. “And you’re darned right that I am swimming again, I’ve got to stay in shape.”

Barbara is one of close to 50 patients who have had a thoraflex graft at LHSC since 2014.

LHSC is a North American leader in the hybrid arch technique, treating patients from across Canada.

“We were fortunate enough to be an early adopter of this novel approach for patients and have developed the largest patient experience with this graft in Canada,” says Dr. Chu, who is seen as a pioneer in this field. “Early results have been really fabulous.”

Dr. Chu and his team, meanwhile, have been training surgeons from other hospitals around North America. Many have travelled to London to learn about the procedure, while other surgeons have asked for consults on their cases.

Not every patient with an aortic aneurysm is able to have a thoraflex graft. It depends on the type of aneurysm and its location within the aortic arch.

LHSC has a world class team of cardiac and vascular surgeons with expertise in advanced aortic surgery who are able to provide patients with all the surgical options, including novel, cutting edge techniques such as the thoraflex hybrid. 

Three years after her surgery, Barbara now has an annual appointment with Dr. Chu. Of her experience she recalls the calm way he laid out the information about her surgery and recovery.

“Dr. Chu and his staff are very knowledgeable, very kind and very understanding,” says Barbara.

Indeed she is back to her busy lifestyle, maintaining her own home, baking bread, doing yoga, keeping a big garden, and canning what she has grown. She also plays bridge with her friends, helps around the farm, and makes time to go to the cottage.

“I didn’t change my life, I resumed everything I did before but sometimes it takes a little longer,” says Barbara. “My philosophy is be thankful you survived and move on.”

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