August 16, 2007

Mercy’s Expertise Benefits Patients With Abdominal Aortic Aneurysms

Five years ago, there was a chance that an abdominal aortic aneurysm could have ended the active life of 64-year-old John Galles of Kingsley. Left untreated, the weakened area in the wall of his abdominal aorta (the main artery that provides blood to the lower body) could have expanded and ruptured causing a sudden and possibly fatal loss of blood.

It is a medical condition that is the tenth leading cause of death in the U.S. for men over the age of 55.

However, Galles luckily got a kind of wake-up call when he began experiencing chest pain one day in May 2002 as he and his wife, Lois, were traveling to a 50th wedding anniversary celebration in Minnesota. After stopping at a hospital in Algona, Iowa, he was flown by medical helicopter to Mercy Medical Center—Sioux City, where medical tests revealed the aneurysm.

Not long after discovering the bulging artery, doctors at Mercy began to consider scheduling Galles for what was then in the region an unprecedented endovascular procedure. On Aug. 5, 2002, he became the first person to undergo an abdominal aortic stent graft procedure at a Sioux City area hospital. An interventional cardiology team headed by Dr. Bruce Miller of Cardiovascular Associates and a surgical team led by Dr. Joseph Morris of Siouxland Surgical Care performed the procedure in one of the Mercy Heart Center’s cardiac catheterization (cath) labs.

Because the contemporary endovascular procedure allows for surgical entry through small incisions in the groin and does not require opening up the patient’s entire abdomen like traditional surgery for aortic aneurysm repair, Galles was discharged from the Mercy just 24 hours after the successful stent graft procedure.

In the five years since he and his doctors marked a medical first, Galles, who turns 70 in November, has ostensibly put his new lease on life to very good use.

“I’m able to keep busy,” he will modestly tell you. “In the fall, I will again be helping a friend harvest his corn and beans.”

“I also like doing all the PA announcing at the Kingsley-Pierson (High School) volleyball, basketball, wrestling, track, softball and baseball games. I’ve done that since 1958,” he adds.

Galles also serves on the panels of Sioux City’s drug court and a restorative justice program in Sheldon.

He also makes plenty of time for Lois, the love of his life, his six adult children, and 9 grandchildren.

For the sake of John Galles and many other Siouxland residents, Mercy Medical Center uses state-of-the-art technology and the hospital’s regionally and nationally renowned clinical expertise to effectively diagnose and treat abdominal aortic aneurysms and other vascular problems.

Mercy currently ranks No. 1 among all the hospitals in the state of Iowa for vascular care, according to a study released last fall by HealthGrades, the nation’s leading provider of independent hospital ratings. The same study also ranks Mercy No. 1 in Iowa for cardiac interventional procedures.

Mercy was also the only hospital in northwest Iowa to receive HealthGrades’ 2006 Vascular Care Excellence Award for distinction in the field of vascular care based on its overall clinical outcomes in resection/replacement of the abdominal aorta, carotid endarterectomy, and peripheral vascular bypass surgery.

Like the many other entries on Mercy’s lengthy list of medical firsts for the region, the first abdominal aortic stent graft procedure five years ago marked another chapter in the rapid evolution of medicine.

“Before the use of aortic stents, the standard treatment for an abdominal aneurysm involved major surgery with a large incision, a seven- to ten-day hospital stay and a two- to three-month recovery time at home,” explains Dr. Jerome Pierson, an interventional cardiologist in practice with Cardiovascular Associates, P.C. who performs stent graft procedures at Mercy. “After an aortic stent graft, however, the patient leaves the hospital in one or two days and is able to resume his or her normal routine in a very short time.”

According to Pierson, two small incisions in the patient’s groin allowed the physician to thread a guide wire from the groin up into the abdominal aorta and insert the stent graft, which consists of a polyester tube covered by a metal mesh. Guided by X-ray, the physician places the stent at the aneurysm site.

“When we have the stent in place, it expands and attaches to the normal sections of the artery above and below the aneurysm,” Pierson explains. “Blood then flows through the stent and avoids the aneurysm, which shrinks over time.”

Because not all patients with aortic aneurysms are candidates for endovascular stent grafting, the ready availability of open surgical aneurysm repair ensures that the best interests of all patients are covered at Mercy.

Dr. Richard Gitter, a cardiovascular surgeon with Mercy Cardiovascular Surgeons, is able to perform both the less invasive endovascular stent graft procedure and the more traditional operation. Gitter was recently recruited from Birmingham, Ala. to direct the Cardiovascular Surgery department at Mercy.

“Mercy offers its patients advantages in that it has an entire team of local experts who provide vascular and cardiovascular intervention and care,” he says. “As a result, care is more comprehensive and well integrated.”

Physicians are also quick to add that the early detection of medical problems like abdominal aortic aneurysms is key. In fact, more than half of abdominal aortic aneurysms do not produce any noticeable symptoms.

Fortunately for Siouxland residents, Mercy offers a comprehensive program that taps the latest diagnostic technology to complete outpatient vascular screenings, cardiovascular risk panels, and cardiac calcium scoring. Armed with the results of those tests, physicians can identify abdominal aortic aneurysms and other underlying medical problems.

The hospital offers such screenings by appointment. An abdominal aortic aneurysm screening is just $45. Similar screenings for stroke/carotid artery and peripheral arterial disease are also just $45 each. Or, all three screenings can be purchased for $99. Each screening also includes a complementary cardiovascular risk assessment, blood pressure check and body mass index calculation.

John Galles would underscore the importance of early detection.

“Pay attention to your body, and go to the doctor to get things taken care of before you have bigger problems,” he says. “You can then get on with your life like I have.”

“I’ve been able to enjoy my life and give back more to the community thanks to the abdominal aortic stent graft procedure and cardiac interventional procedures I’ve had. Quite frankly, they saved my life.”

“And, the care at Mercy is super. I couldn’t ask for better.”

For more information about Mercy’s “Heart Smart” cardiac and vascular screening program, or to make an appointment, contact the Mercy Heart Center at (712) 279-2098.