Jim's Posts

2026 is off to a much better start. Her aortic stents that extend to the SMA artery are being watched by Dr Gustavo Oderich at Baylor Medicine in Houston. She had a EVAR extension to seal a type Ib endoleak in September 2024 by her team in Cleveland. Dr Quatramoni vascular surgeon was tasked to do the endovascular surgical procedure to spare her from having to endure a thoracoabdominal open repair her thoracic surgeon didn't feel she would survive and we really didn't want to endure another lengthy stay in Cleveland. Her open arch repair and mechanical valve replacement was 12 hours in length the previous year. Eleven days in CICU trying to get her off the ventilator and avoid a tracheostomy was just more than either of us could handle. Her endovascular stents that begin in the descending aorta at the distal arch and runs through her diaphragm and seals just above the SMA artery must be monitored yearly. Since Cleveland Clinic didn't offer a branched, sleeved fenestrated repair of her juxtarenal aneurysm, we sought out a surgeon that specializes in BEVAR repairs to see if she was a candidate for that procedure. Dr Oderich at our first consultation in March 2025 and her follow up image from her Fall 2024 EVAR he agreed to take on her case and continue monitoring her stents. We had our Zoom consultation after having the imaging done in January, and he gave us wonderful news. Her false lumen has shrunk around her stents and the endoleak is stable. No blood is leaking and the seal is intact. The remodeling of the aorta is good since it helps hold the stents in place. He is going to continue monitoring her condition with the next image scheduled for 2027. We just have to keep her inflammation under control, so her Large Vessel Vasculitis doesn't damage anymore tissue in the aorta. Dr Oderich didn't see any evidence of hemolytic anemia caused by excessive turbulence coming from her mechanical valves or the aortic grafts or stents which is also extremely good news. It is a kind of anemia that is a complication of some mechanical valves or indicator of a leak around the valve itself. It is a rare condition and there isn't a lot of information available on this site. Her local cardiologist has never mentioned it as possible cause of her anemia that was actually discovered incidentally by her rheumatologist. Her journey began in 2017 with mitral valve failure and here we are after 3 open procedures and 5 endovascular procedures with 21 total weeks spent in hospitals both locally and Cleveland. The news that it doesn't appear to be a need for another surgical intervention this year is such a blessing.

Two years ago March 15th Debbie underwent the first of many procedures to repair her diseased aorta. Twelve hour open arch repair called a frozen elephant trunk. They also replaced two tissue heart valves with mechanical. Cleveland Clinic in Cleveland Ohio the largest and highest rated cardio vascular surgery centers in the US. We have had a very tough journey three other vascular surgeries, a TEVAR extension in her descending aorta in July 2023 450 mm long extending the repair to her celiac artery. September 2024 another EVAR extension to the SMA artery to seal an endoleak. An Iliac artery repair, a complication of the EVAR procedure to fix a dissected artery. She had survived so much, but we just didn't think she'd make it through the next open procedure to take the repair below the kidney arteries. Cleveland Clinic advised that should be the next procedure when strong enough. In November, we reached out to a vascular surgeon in Houston, Texas at Baylor Medicine. We had a Zoom appointment in November that gave us hope and scheduled an in person visit in March. We had a CT scan to check her current status, and he told us the good news. Her stent grafts are holding up well with no leaks, he recommended we return in a year. Dr Oderich at Baylor Medicine is a vascular surgeon that has been a pioneer in the branched, sleeved endovascular stent graft procedure for noninvasive aneurysm repair. He practiced at Mayo Clinic for 20 years before moving to Texas. Not only was her current state good news, he assured us he could repair the next section endo vascularly.