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Repairing Ruptured Aortas And Saving Lives

Repairing Ruptured Aortas And Saving Lives

David Paterson is a very lucky young man. Fortunate that Professor Tim Buckenham from Otago University’s Christchurch School of Medicine and Health Sciences had the skill and experience to deal with his horrific injury.

A year ago David Paterson’s life was hanging by a torn membrane, a membrane that was just holding together the largest blood vessel in his body. David had gone off the road on the West Coast, suffered multiple injuries and was leaking blood into his chest cavity from his aorta, which carries blood directly from the heart under high pressure to the brain and vital organs. Urgent repair of this life threatening injury was required.

Professor Buckenham had recently returned to New Zealand after 13 years as a consultant in the UK and brought back a radical new technique which enables repair of ruptured arteries like the aorta through a small incision in the groin, rather than by open heart surgery. David Paterson’s life-saving operation was one of the first of its type in New Zealand and Australia.

“This is approach is huge advance for road accident victims like David Paterson who have suffered multiple injuries and are very unstable. It enables us to repair the damaged aorta without major surgery, which can cause life threatening stress to a multiply injured patient’s system,” explains Professor Buckenham.

“The early experience has been very encouraging when compared with conventional surgery, death rates have been reduced to around 5 to 10% instead of 50% with conventional procedures in trauma case. And the dreaded complication of paraplegia is much rarer with our new approach”

The key to the new procedure is a special stent, or internal patch, which is fed up through the aorta from the groin on the end of a long tube. It is then opened out and locked into place, sealing the rupture from the inside. This is a very delicate procedure requiring the skills of a large team headed by Prof. Buckenham, an Interventional Radiologist, and including Nurses, Radiographers and Surgeons.

“We monitor the placement of the device using X-rays and when it is in place the spring-loaded stent is released, gripping the walls of the artery with special teeth and allowing blood to flow through the centre of this tube sealing the aortic tear. Eventually the aorta will repair itself by growing around the stent.”

Professor Buckenham says he is involved in teaching other clinicians this new endoluminal thoracic aortic repair, and eventually it should become available in other major New Zealand hospitals. He anticipates this technique will continue to evolve and establish itself as the treatment of choice for this type of life threatening injury that up to now has been associated with a depressingly high mortality.

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