Cardiothoracic Surgery Surgery News Archive Featured in the Media JeffNEWS

Louis Hankins was not in any shape for major surgery.

At age 82, the retired electronics engineer and great grandfather from Northeast Philadelphia had a long history of health problems including undergoing a triple bypass for his heart, renal disease, emphysema, diabetes and dialysis three times a week.

And now he just learned that he had a life-threatening descending thoracic aortic aneurysm (TAA) which would require him to have vascular surgery. He and his family knew he could not handle the physical trauma of an open surgical procedure.

Thoracic aortic aneurysms, which are diagnosed in more than 20,000 U.S. patients annually, occur when a section of the aorta, the body’s main circulatory vessel, weakens and bulges outward like a balloon in the section of the artery that runs through the chest. Should the aneurysm grow to the point where it ruptures, the patient would be at high risk for rapid death due to internal bleeding.

But surgeons at Thomas Jefferson University Hospital in Philadelphia were able to offer Mr. Hankins an alternative that successfully repaired the damage without putting him at such a major risk.

Mr. Hankins was recently part of a multi-center clinical trial, in which surgeons at Jefferson were the first to use a newly designed endovascular stent graft for patients with TAA. The surgical team led by Joseph Lombardi, M.D., chief of Vascular Surgery, Methodist Hospital Division of Thomas Jefferson University Hospital, has performed the procedure twice since March 30 without the need for the trauma of open surgical repair.

“Instead of working with parts, the parts are inside of me,” Mr. Hankins joked shortly after his surgery.

Patients diagnosed with TAA traditionally have had to undergo a highly invasive open surgical procedure where a surgeon opens the chest cavity, clamps off the aorta and sews a surgical graft in place to prevent the aneurysm from rupturing. Such open surgical procedures carry high health risks for many older patients, who may also suffer from other significant medical conditions such as diabetes or hypertension.

But using the investigational graft, which was designed by Cook Incorporated, Jefferson surgeons needed to make only one incision in Mr. Hankins' groin to allow the insertion of the graft’s advanced delivery system into the femoral artery. Once the catheter was guided into position through the patient’s arteries under fluoroscopy, a two-piece, fabric-covered, self-expanding stent graft was secured inside the weakened section of the thoracic aorta to relieve pressure on the aneurysm, greatly reducing the risk of rupture.

"The procedure was very straightforward and Mr. Hankins was virtually pain-free," said Dr. Lombardi, assistant professor of Surgery, Jefferson Medical College of Thomas Jefferson University, Philadelphia. “This research may demonstrate that there are significant benefits with the minimally invasive approach.”

Mr. Hankins was home, after just a few days as an inpatient, and has already resumed his hobby of puttering around the house, said daughter, Vicki Hess.

“He loves working with his hands,” she said.

With international headquarters in Bloomington, Ind., the privately held Cook is a designer, manufacturer and global distributor of minimally invasive medical device technology for diagnostic and therapeutic procedures.