London, Ont. man first in North America to receive life-saving aortic surgery

(Left) Jeff Pitman, patient; (Right) Dr. John Landau, vascular surgeon at the London Health Science Centre. London Health Science Centre (LHSC)

A London, Ont., man is the first in North America to receive a life-saving aortic procedure at the London Health Science Centre (LHSC) with a newly approved medical device.

66-year-old Jeff Pitman experienced an aortic dissection and aneurysm, compromising blood flow to his legs and kidneys. In need of immediate action, the vascular surgery team at LHSC received approval through Health Canada’s physician-request special access program to use a device currently only approved for use in Europe.

Known as the Artivion E-nside aortic stent-graft, the device allows doctors to perform surgery through minimal entry points, “using approximately four-centimetre incisions in the arm and groin.”

Read more: Recovery times down to weeks, not months, for aortic aneurysm repairs with new procedure: LHSC

By using those “minimally invasive endovascular techniques” surgeons are able to treat aortic dissections and aneurysms without “compromising blood flow to other major abdominal organs.”

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While other devices exist on the market, health officials say they are “often custom-made and tailored to the patient’s anatomy, taking more time to make and requiring more intensive surgical installation.”

The E-nside stent-graft has “a unique design with branches that are nested inside the device” allowing it to be used on a wide range of people with varying anatomies.

According to the LHSC vascular surgery team, these types of less invasive procedures are also often safer, and “result in a better experience for the patient including reduced pain, fewer complications and a quicker recovery,” therefore requiring less time in the hospital.

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“Typically, aortic dissection would be a challenging procedure to treat and often the only option is traditional open surgery requiring invasive surgical access through the chest and abdomen,” said Dr. John Landau, a vascular surgeon at LHSC, and member of the team who performed the procedure. “A regular surgery would have required significantly more recovery than Jeff experienced.”

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According to Landeau, Pittman’s condition is “among the most anatomically challenging problems that are treated in vascular surgery.”

“We see a lot of patients that have aortic aneurysms, and a lot of the patients that have aortic dissections, [but] we don’t always have patients that end up having both problems at once,” he said.

Since Pittman’s condition was resulting in restricted blood flow to some of his major organs, Landau said that there was no better option than to use the E-nside stent-graft.

Read more: Two cardiac surgery firsts help patients avoid open-heart surgery at London hospital

Pitman underwent three advanced procedures to install the device which began back in October 2022.

Landau explained that the installation of this device not only repaired Pitman’s aorta but also significantly reduced his recovery time and any complications, getting him home and back to his regular activities in a matter of three weeks.

(Left) a pre-operative CT scan of Jeff Pitman’s aorta; (Right) a post-operative CT scan of Jeff Pitman’s aorta, with the Artivion E-nsideTM stent-graft installed. London Health Science Centre

“It’s been very refreshing not having to worry as much,” Pittman said. “Not only did this device and procedure save my life, but I had a remarkable recovery considering I had three surgeries over the course of a month.

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“I was able to be back home with my family much sooner than I ever expected,” he said, adding that he felt lucky enough to spend Christmas with them last year.

While this was the first time LHSC has used the E-nside stent-graft, Landau said that the local hospital performs approximately 10 to 20 advanced aortic procedures like this every year.

He said that the device is “absolutely something that was very rewarding to us for the first time and has a lot of potential for use in complicated situations moving forward.”

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