Modern Miracles in Science

Austin marked a huge advancement in the treatment of descending thoracic aortic aneurysms this morning. The Heart Hospital of Austin was the site of the first Gore TAG Thoracic Endoprosthesis procedure. What, you say? A blogger talking about something serious and not related to celebrities, restaurants, sports or something equally mundane like what I had for breakfast this morning (bacon & egg taco)? Yes. Trust me when I say that the patient undergoing the surgery and his or her family members find this topic to be not only fascinating but the number one news flash on their internal CNN site today.

A descending thoracic aortic aneurysm occurs when a weakened section of the artery wall begins to balloon outward, filling with blood. Think of a tire with a bubble in the sidewall...if you continue to drive on it, eventually it will blow out. Same thing happens when the lining of an artery develops a weak spot, tears and begins to pool blood. If it isn’t fixed it may dissect, or rupture, causing life threatening internal bleeding.

The Gore TAG Endoprosthesis is a revolutionary process that moves the surgery from high risk with a large incision in the chest to a minimally invasive one where a small incision is made in the groin. The biggie here is that a synthetic stent/graft is put in place using a catheter placement technique. In other words, a compressed flexible tube is inserted into the area via a guided tour of either your femoral or iliac artery from the groin up your abdominal area, to the chest and the aneurysm site. Once in place, it self-inflates and a tri-lobe balloon helps out the process by ensuring it is sealed and properly seated in the artery. Check out the nifty video animation by clicking on the large red circle on the right side of the Gore TAG web page. The stent/graft basically relines the aorta, kind of like putting a permanent bandaid on the inside of the artery. Nifty, huh?

As simple as I’ve described it, this is a sensitive and delicate surgical procedure. Dr. Joe Wells of Cardiothoracic and Vascular Surgeons performed the surgery this morning. The descending thoracic aorta provides blood flow to the intercostals arteries that feed the spinal cord. Because of the possibility of rapid pressure changes, the plan was to give the patient a cerebral spinal fluid shunt, in order to be able to regulate pressure. There was neurological back up for monitoring, just to be on the safe side. It was a carefully orchestrated event designed to most efficiently repair the problem with the least amount of negative impact on the patient. And it was a success.

CTVS has quite the history of state-of-the-art performance in Austin. Their internationally respected surgeons were the first to do an open heart surgery in Central Texas way back in 1961. CTVS docs were also the first in Centex to perform a coronary artery bypass graft in ’68, kidney transplant in ’71 and heart transplant in 1986 among other equally important surgical breakthroughs. Their list of “first to do’s” is lengthy and impressive. I’m certain the patient today is grateful for the expertise of Dr. Wells and to Gore, for the advances they’ve made in device manufacturing.

It’s simply amazing what can be done with a skillful surgeon and the right materials.