Stopping the Silent Killer Known as Aortic Aneurysm

It’s often called the “silent killer.” Most people with an aortic aneurysm don’t have any noticeable symptoms, and a rupture can come without warning. For Michael Stickley, an open-heart procedure at Bridgeport Hospital came just in the nick of time.

“We had been monitoring my aneurysm for about 16 years,” said Stickley, who has a family history of heart disease. Last fall, he was shocked to learn his aneurysm had grown to 5.4 cm, large enough to require surgery.

Stickley’s cardiologist referred him immediately to Gabriele Di Luozzo, MD, section chief of Cardiac Surgery at Bridgeport Hospital’s Joel E. Smilow Heart Institute – part of Yale New Haven Health’s Heart and Vascular Center – and associate professor of surgery, Yale School of Medicine.

“I went in to meet with Dr. Di Luozzo and he floored me,” Stickley recalled. “He said, ‘You need surgery,’ and I said, ‘When?’ and he said, ‘Thirty days.’ I was blown away. I actually had to cut our meeting short to go home and absorb this.”

An aneurysm is a dilation or a bulging of the aorta, the largest artery in the body, which extends from the center of the chest to the pelvis. Oxygen-rich blood travels from the heart through the aorta to every part of the body. But as an aneurysm grows over time, the aortic wall can weaken and a tear or rupture can occur.

“The worst thing is that people can die from an undiagnosed aneurysm,” Dr. Di Luozzo said. “You can have a tear in the aorta, which is referred to as an aortic dissection, or you can have a rupture. The good news is that an aortic aneurysm that is diagnosed early can be monitored and treated successfully before it becomes dangerous,” he said.

Aortic aneurysm surveillance

The new Aortic Surveillance Program at Bridgeport Hospital, led by Dr. Di Luozzo, is helping to do just that.

“In our program, we will see the patient periodically to make sure that his or her blood pressure is well controlled, and we will also do periodic imaging to make sure the aneurysm is stable,” Dr. Di Luozzo said. “We’ll perform either a CT scan or an MRI, and sometimes an echocardiogram to make sure that the valves of the heart are not being affected by the aneurysm.

“Most patients are seen annually,” he explained. “If you have a moderate to large aneurysm, which is approaching or is at 5 cm in diameter, we will see you every six months. If you’re having symptoms, we can determine if an intervention is needed, or whether we can modify certain risk factors, like blood pressure, smoking habits and strenuous activities, to avoid surgery.”

Patients are also provided with support resources such as smoking cessation, genetic testing, screenings, and counseling as well as lifelong access to the Aortic Surveillance Program.

A plan for surgery

Large aneurysms, like Stickley’s, or those large enough to cause symptoms, are typically treated with surgery.

Stickley, a carpenter and home contractor, was concerned about taking time off for the surgery and weeks-long recovery period. “Not being able to work was my main concern. Finally, I decided, ‘I’ve got to take care of this or else I’m not even going to be around to worry about it.’”

Once Stickley agreed to the surgery, Dr. Di Luozzo and his team prepared for open-heart surgery to replace six inches of his aorta and aortic valve.

“If the aneurysm is located in the chest above the heart, it does require open-heart surgery to fix it,” Dr. Di Luozzo said. “If it’s in the descending thoracic aorta, we can typically fix it with a stent, and that is something that would be done in our state-of-the-art hybrid operating room. Abdominal aortic aneurysms would also be fixed with a stent,” he noted.

Whether open procedures or minimally invasive techniques are used, many people go on to lead active lifestyles following aortic aneurysm repair.

A happy ending

Stickley’s surgery took about four hours, and he stayed in the hospital five days. “The surgery was in the morning, and that afternoon, I was standing and marching in place,” he said. “I felt great. When I got home, I didn’t need any pain medicine. In fact, the day I got home, I took a walk down by the water.” He returned to work on a reduced schedule within seven weeks.

“Your body tells you what you can and can’t do anymore,” Stickley said. “You have to listen to your body.”

To learn more about Bridgeport Hospital’s Aortic Surveillance Program, call 203-384-4868. The hospital’s Joel E. Smilow Heart Institute, part of Yale New Haven Health’s Heart and Vascular Center, specializes in cardiac rehabilitation, cardiac surgery, heart failure, heart rhythm disorders (electrophysiology), interventional cardiology, structural heart and valve disease, and vascular medicine and surgery. Learn more about heart and vascular services at Bridgeport Hospital.