A new technique for treating aortic arch aneurysms which removes the need for complex open-heart surgery is now available at Brisbane's St Andrew’s War Memorial Hospital.
It is the first hospital on the east coast to offer the endovascular procedure, using an arch branch device developed by an Australian company.
Vascular and endovascular specialist Dr Andrew Cartmill was the first surgeon at St Andrew's to perform the stent graft surgery, one of the first six times it had been done nationwide.
Dr Cartmill said while endovascular treatment of the aorta – the body's main artery – started in the 1990s, such procedures for the aortic arch – the upper part between its ascending and descending segments – are still new and will be of great benefit in cases previously considered inoperable.
His patient, in her fifties, previously had open cardiac and aortic surgeries which made further treatment more complicated. She had lost several family members to similar vascular problems which were not treatable at the time.
“As was the situation for this particular patient, the presence of comorbidities and prior cardiac surgery often presents cases where traditional open surgery is too risky and endovascular aortic arch surgery should be considered,” Dr Cartmill said.
For this procedure, the aneurysm – a bulge in the artery wall which can be fatal if it bursts – must be located beyond the ascending aortic arch.
Bypasses are performed to both arms from the neck, then the main stent graft – with two internal side branches – is inserted from the artery in the groin to the aortic arch in the chest.
The arch aneurysm is excluded from blood circulation – making it shrink – as separate stents are ‘docked’ with the side branches in the main graft via the carotid arteries on each side of the neck
“Much faster recovery times and significantly less peri-operative risk are also key benefits of this type of surgery,” Dr Cartmill said.
He performed the procedure in the presence of Professor Stephen Cheng – a world-leading expert from Hong Kong's Queen Elizabeth Hospital who has undertaken more than a dozen of these surgeries.
The branched arch device was developed by Cook Medical, which manufactures it in Brisbane.