Heart Surgery Eliminates Major Incision And Dramatically Decreases Recovery Time

November 14, 1997

CHAPEL HILL -- Elsie Taylor's 50th wedding anniversary was only two weeks away. In the meantime, however, Elsie, 68, needed surgery. She had a dangerously enlarged blood vessel called an aortic aneurysm that threatened to rupture at any time.

Thanks to a new procedure and a new product being tested by surgeons at the University of North Carolina at Chapel Hill, Elsie had surgery and was back home with her husband, a week before their anniversary.

"With this new procedure, called an endovascular repair, we make one small incision in an artery in the groin," said Dr. Enrique Criado, associate professor of surgery at the UNC-CH School of Medicine. "We then thread a state-of-the-art graft, which resembles a tiny piece of metal-lined tubing, up to the diseased area and attach it inside the damaged vessel."

Patients usually go home in three days, Criado said. Conventional surgery, which produces the same results, involves making a long incision in the abdomen and then clamping off and replacing the diseased vessel.

"Patients spend roughly 10 days in the hospital and go home with a large, painful incision,? he said. ?Full recovery takes six to eight weeks."

Elsie Taylor had surgery on a Wednesday and went home to Roseboro, N.C. that Saturday. "I'm walking all around the house and the yard every day," she said a week after her surgery. "Generally I feel pretty good. And I was so glad to be at home in time for my anniversary."

"With this new endovascular surgery, patients need less anesthesia, spend less time in intensive care and generally experience much less anxiety and fewer complications," Criado said. "Surgeons have been working on perfecting this complicated surgery for several years."

UNC-CH is one of 15 U.S. medical centers -- and the only one in North Carolina -- participating in an FDA-approved trial to test the new graft, called Vanguard. It is produced by Boston Scientific and is only available in this country through the FDA trial. .

"This graft is made out of Dacron with metal on the inside which keeps it open, said Criado. "The metal expands and has little barbs that stick to the aorta and hold the graft in place."

Also participating in the UNC-CH School of Medicine investigation are Drs. Bill Marston, assistant professor of surgery and Matt Mauro, professor of radiology.

"The endovascular procedure is technically demanding, and we rely heavily on X-ray imaging," Criado said. "Only about a third of patients with aortic aneurysms are candidates for this surgery at this time. The shape and the location of the aneurysm determine eligibility."

The endovascular approach will be a big advance for some patients, Criado said. "It will be used more and more for other types of surgeries as well. There's certainly a lot less risk and the recovery time is so much shorter."

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Note: Criado can be reached at (919) 966-3391.

Contact: David Williamson

University of North Carolina at Chapel Hill

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