The new
endovascular
surgical suite at
Miami Valley
Hospital was
designed so
surgeons like
Nnamdi Azie, MD,
(pictured) can
perform
less-invasive
vascular surgery.
MVH’s Endovascular
Surgical Suite
By Alison Bour
When John Morgan, a 66-year-old
Endovascular Surgical Suite. While an
retired welder from Casstown, had
AAA is traditionally treated via an open
trouble breathing, his pulmonary
incision in the abdomen, surgeons can
physician ordered a CT Scan. Since John
now perform a less-invasive procedure
suffers from both chronic obstructive
considered safer for patients like John
pulmonary disease and emphysema, his
who have co-existing medical conditions.
doctor wanted to see if either condition
The new suite was designed for this
had worsened.
type of vascular surgery.
What the scan showed was another
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Nnamdi Azie, MD, is a cardiothoracic
problem that was potentially deadly.
vascular and endovascular surgeon with
John had an abdominal aortic aneurysm
Miami Valley Heart & Lung Surgeons.
(AAA). The surgeon whom John initially
He is also an assistant clinical professor
consulted recommended his aneurysm
of surgery at Wright State University
be treated at Miami Valley Hospital’s
Boonshoft School of Medicine. Dr. Azie
describes an aneurysm as a bulge in a
the aneurysm. This excludes the
blood vessel of more than 50 percent its
aneurysm from the pressure of
normal size in diameter. Since the aorta
blood flow.
is the largest blood vessel in the body,
quick treatment of AAA is critical.
John, who had the surgery Jan. 22,
came through the procedure with flying
“The aorta carries blood to the
colors and is awaiting warmer weather
heart, brain, kidneys and liver,” explains
so he can pursue outdoor hobbies. “He
Dr. Azie. “An aortic aneurysm is a result
is doing wonderfully,” says his wife Jean,
of a weakening of the walls of the
After surgery to
prevent his aortic
aneurysm from
rupturing, John
Morgan is back
to his normal
activities, including
walks with wife
Jean.
aorta. As blood flows through the
aorta, the weak area bulges out like a
balloon and loses elasticity. High blood
pressure can lead to a rupture. Ninety
percent of ruptures are fatal.”
An AAA can be caused by fatty
degeneration within the aorta, but
it’s also believed there’s a hereditary
component. Men are more likely to
have this condition, especially if
they’ve smoked.
A Paradigm Shift
Dr. Azie performed his own evaluation to
ensure John was a good candidate for a
surgical technique called endovascular
stent grafting. “It’s a new paradigm
shift in vascular surgery,” Dr. Azie
explains.
Rather than utilizing an open
abdominal incision to replace the
damaged portion of the blood vessel
with a synthetic graft, Dr. Azie makes
two small incisions in the groin. He then
uses guide wires and sophisticated
imaging equipment to reach the exact
location of the aneurysm. A woven
polyester tube (graft) covered by an
expanding tubular metal web (stent) is
placed inside the blood vessel without
the need to open the tissue surrounding
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endovascular stent grafting. Prior to
his diagnosis, he felt something in his
stomach he suspected wasn’t right.
Like John, Harold was evaluated
first by another surgeon and then
referred to Dr. Azie. “My aneurysm was
on the verge of bursting,” explains
Harold. “They said I needed a specialist
and that Miami Valley Hospital had the
Fond of riding his
all-terrain vehicle,
John doesn’t let
his pulmonary
conditions slow
him down. But,
he came close to
being shut down
permanently
when an
aneurysm
threatened his
life.
who has high praise for Dr. Azie. “He
explains things very well and keeps the
family informed.”
John’s quick recovery is one of the
best technology to treat my condition.”
Harold, who also had co-existing
medical conditions, successfully
recovered from the procedure and has
procedure’s main benefits, says Dr. Azie.
been gradually improving. “All I can say
“There are fewer days in the hospital
is, Dr. Azie saved my life. He is one of my
and a return to normal activities usually
heroes,” says the septuagenarian.
within two to three weeks compared
Even though endovascular stent
with open repair, which can take six
grafting is currently the best choice for
to eight weeks of recovery.” Because
patients like John and Harold, for whom
endovascular stent grafting is a
traditional surgery is risky, Dr. Azie thinks
minimally invasive procedure, it also
it could eventually be more widely
lessens the chance of post-operative
used: “It’s the wave of the future.”
complications and infections.
Harold Yoder, a retired truck driver
Improved Capabilities
MVH is the first hospital in the area to
from Versailles, is another of Dr. Azie’s
offer a dedicated suite for endovascular
patients who was treated with
surgery. The suite includes advanced
equipment such as a tilting table,
A Silent Killer
control room console and fixed imaging
Abdominal aortic aneurysms (AAA) are known as silent killers because patients
pictures.
usually do not know they exist until a rupture occurs. An ultrasound test can
machines that offer very high resolution
Other types of surgery performed
facilitate early detection of this potentially fatal condition. Dr. Azie recommends
in the suite include repair of thoracic
screenings for the following at-risk groups:
aneurysms and aortic transections;
• Men 65-75 years old who have smoked 100 or more cigarettes in their life.
elimination of obstructions in peripheral
• Men and women over 50 who have a family history of AAA.
arteries via angioplasty; mechanical
• Men and women between 60 and 80 who have other cardiovascular risk factors.
thrombectomy (removal of a blood clot);
Medicare covers a one-time screening ultrasound for patients at risk for AAA.
They must receive the referral within the first six months they have Medicare B.
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and placement of vena cava filters, a
device that prevents blood clots from
going to pulmonary arteries.