Compliments of the Post and Courier
When Fredrick Deribas, a 69-year-old Surfside Beach resident, went to the Medical University of South Carolina with a torn aorta, he was sure he would need emergency surgery.
Earlier that day, Deribas went to his family physician for a sharp pain in his groin. It was the same pain he’d felt on and off for years.
“Most of the time, it wasn’t severe,” Deribas told The Post and Courier.
But the pain continued to grow more excruciating with each passing minute and X-rays performed by his local physician’s office showed he was suffering from an aortic dissection, a serious condition in which a tear occurs in the inner layer of the body’s main artery, or aorta.
Doctors rushed Deribas to a nearby emergency medical center fearing there was more to his condition than just a torn aorta. There, doctors also found an aneurysm, an abnormal bulge or ballooning in the wall of a blood vessel, and rushed him to MUSC’s Aortic Center.
Both conditions are often deadly if left untreated.
For many South Carolinians with uncontrolled hypertension the risk of getting an aneurysm or dissection is high. According to the S.C. Department of Health and Environmental Control, one in three people in the state has high blood pressure. And according to the Center for Disease Control and Prevention, less than 25 percent of adults in the U.S. with hypertension have their condition under control.
MUSC houses one of the state’s few Aortic Centers, offering patients access to an array of aortic disease specialists, therapies and treatment options.
Dr. Sanford Zeigler is the director of Thoracic Aortic Surgery at MUSC’s Aortic Center. Zeigler diagnosed Deribas with a chronic dissection and concluded that Deribas wouldn’t need emergency surgery after all.
“I was fortunate,” Deribas said, talking about his ability to return to Surfside Beach and lose a little bit of weight to reduce the risks involved with his operation. “Other people don’t have that luxury,” he added.
For many people who make it to the hospital with aortic dissections or aneurysms, doctors have to act quickly and perform life-altering surgeries to prevent the aneurysm from bursting and further tearing the aorta.
But the wait gave Zeigler time to order a unique and newly released aortic device for Deribas’ surgery called the Thoraflex Hybrid frozen elephant trunk device.
The device is custom-made to outfit the patient and combines a stent graft, a synthetic tube-like device used to replace a portion of an artery, with a polyester gelweave graft with multiple branches for blood vessels to run through.
“There are no ‘elephant trunks’ involved,” Zeigler said jokingly. The device’s name is an honorary tribute to early scientists and doctors who treated aneurysms and dissections by placing patients in ice to perform the surgery.
To date, these types of surgeries usually require a hypothermic circulatory arrest which temporarily suspends blood flow under very cold body temperatures, allowing blood flow to cease up to 40 minutes without harm to the patient.
The elephant trunk name comes from the device’s arch-like shape. This particular device is the first of its kind and allows doctors to perform aorta repair operations faster and potentially reduces the number of surgeries a patient must undergo.
Zeigler said a normal time frame to restore blood flow to the body during this type of procedure is 45 minutes.
“With a frozen elephant trunk, I’m usually (able to return blood flow) in 30 minutes,” Zeigler said.
The device was approved by the U.S. Food and Drug Administration earlier this year and according to officials from MUSC, the hospital was the first in the Southeast region to offer the device to patients.
“I feel so much better and I’m not on any more blood pressure medicine,” Deribas said. “He saved my life.”
Unfortunately, the device is not available to all patients with aortic issues. Instead it goes to patients able to be treated in non-emergency situations, which is considered rare when dealing with the risks of a burst aneurysm or a dangerously located dissection.
Doctors would have to act immediately, and the hospital doesn’t carry enough frozen elephant trunk devices for each patient since they require a unique fit.
But even patients who are unable to take advantage of the device are still in good hands, said Zeigler, who’s performed surgeries of this kind for many years.
Dr. James Benner is a thoracic surgeon at Trident Medical Center and recently performed an aortic repair surgery on an 80-year-old South Carolina resident.
Benner said without the elephant trunk device, doctors construct the device shape with a normal stent graft and sew it into the descending part of the aorta. Benner has even reconstructed entire ascending aortas by hand.
“It’s a neat device they have,” Benner said.
Both doctors agree that uncontrolled high blood pressure is a key contributor to aortic disease and aneurysms.
For more information on blood pressure levels visit www.scdhec.gov/health/diseases-conditions/heart-disease-stroke/know-your-numbers.