A Life-Saving Valentine
Genesis AAA Screenings Can Detect Serious Condition   
(Posted 1/23/06)

Lucille Ball, George C. Scott and Albert Einstein died from it.  Joe DiMaggio, Bob Uecker and Sen. bob Dole survived it.  Each battled a silent nemesis called an abdominal aortic aneurysm, or AAA - a balloon-like swelling of the aorta, the largest blood vessel in the body.  AAA's grow quietly within the abdomen and generally have no symptoms.  Allowed to grow undetected, the artery that runs from the heart to the legs can rupture. 

"As it grows larger, an abdominal aortic aneurysm eventually bursts causing sudden catastrophic bleeding and cardiovascular collapse," says Shauna Roberts, M.D., medical director of the Genesis Heart Institute.  "The problem is that there may not be outward signs that an AAA is even present until it ruptures.  When it does, more than 75 percent of people die." 

A Valentine's Day gift
To promote early detection of AAA, Genesis has a Valentine's Day gift idea for the husband, father, or friend who has everything. 

Four AAA screenings using brief, non-invasive ultrasound exams have been scheduled for National Heart Month in February at Scott County Family & facilities in Davenport and Bettendorf. 

Valentine's Day gift cards, redeemable for the $35 screening cost, are now available from the gift shops of Genesis Medical Center and from Genesis On Call at (563) 421-2000. 

The screenings are a cooperative effort of the Genesis Heart Institute, radiologists, and vascular surgeons. 

Studies suggest that between 5-7 percent of adults over the age of 60 have an AAA, but they often are not aware of it until the aneurysm bursts.  AAA kills more than 9,000 Americans each year. 

"About 75 percent of those with AAA do not experience any symptoms, and about 80 percent of diagnoses aren't made until there is a rupture," says Karen Doy, supervisor of Genesis Cardiac Rehabilitation. 

Abdominal aortic aneurysms are relatively easy to detect using ultrasound equipment, but screening is not frequently done in the United States.  They usually go undetected; grow progressively larger; and then rupture.  When that happens, the death rate is more than 75 percent. 

The Main Artery
The aorta is the largest artery in the body and carries all the blood that is pumped out of the heart and distributes it to all the organs of the body.  The aorta projects upwards from the heart in the chest and then arches downwards, traveling through the chest and into the abdomen. 

About 75 percent of aortic aneurysms occur in the abdominal aorta, mainly from atherosclerosis, or fatty deposits in the walls of the arteries that cause them to become less elastic and weaker, according to the Society of Thoracic Surgeons.  People who smoke have a much greater chance of forming an AAA than a non-smoker.  Other risk factors include being age 55 or older; being male; and having a family history of AAA. 

Many people can have an aortic aneurysm for years before any symptoms develop.  When they do become evident, symptoms of an AAA can include: a pulsating feeling in the abdomen, abdominal pain or back pain.  

"The rupture of an AAA is a catastrophic event due to the massive internal bleeding is produces," Dr. Roberts says.  "Many choose to have elective surgery before the AAA gets larger and becomes an emergent condition." 

Intervention
Symptomatic aneurysms require early or urgent treatment.  The usual intervention involves a stent-graft, or a tubular coil made of synthetic material that imitates the shape of a normal aorta and is placed inside the aneurysm. 

Open surgery, which was used for AAA stent-graft operations before 1999, requires opening the abdominal cavity.  Fortunately, newer endovascular procedures that are less traumatic, invasive and painful are now often used to place the stent-graft.  The choice of procedure, open versus endovascular, depends on several factors. 

"Endovascular repair is an exciting alternative that we will always offer the patient if the aneurysm can be fixed in that way.  However, about half of all aneurysms still require open surgery because of their anatomy," says vascular surgeon Chris Cunningham, M.D., of Vascular and Thoracic Associates, Ltd. 

During endovascular surgery, a synthetic graft is attached to the end of a thin tube or catheter that is inserted into the bloodstream, usually through an artery in the leg.  Watching the progress of a catheter on an X-ray monitor, the surgeon threads the stent-graft to the weak part of the aorta where the aneurysm is located.  Once in place, the graft is expanded.  The stent-graft reinforces the weakened section of the aorta to prevent rupture of the aneurysm.  

The aorta is the body's largest artery - about the width of a garden hose - and is well protected inside the body.  As a result, abdominal aortic aneurysms are not easily detected.  In fact, they are often identified by chance during radiological investigations for other diseases, Dr. Cunningham says. 

"That's why screening is so important for this life-threatening diagnosis.  Abdominal aortic aneurysms can be easily missed without screening."  

There are several things you can do to reduce your chance of developing an aneurysm: 
*  Do not smoke. 
*  If you have a family history of arterial disease, have regular medical checkups. 
*  Have your blood pressure checked regularly. 

"The important message is if these AAA's are detected early and when they are smaller, the outcomes are better," Dr. Roberts says.  "If you have risk factors, talk it over with your physician and see if an ultrasound is appropriate."  

Four screenings, using non-invasive ultrasound exams, are scheduled for National Heart Month at YMCA facilities in Davenport and Bettendorf. 
Date and times are: 
8 am - Noon - February 2, West YMCA, 3503 W. Locust St, Davenport
8 am - Noon - February 9, Bettendorf Family YMCA, 3800 Tanglefoot Lane
8 am - Noon - February 16, North YMCA, 624 W. 53rd St., Davenport
1:30-5:30 pm - February 23, downtown YMCA, 606 W. 2nd St., Davenport