A Walking Time Bomb

Consultant receives stunning diagnosis of dangerous aortic aneurysm

It may sound like the plot of a TV medical drama, but for Bob Burkhardt it was all too real. The 64-year-old telecommunications consultant from Alexandria was in the middle of a routine cardiovascular health screening when he sensed trouble.“The clinician’s eyes suddenly got as wide as saucers,” he recalls. “She told me I was in critical condition and called for a doctor right away.” Tests revealed a 7.4-centimeter aortic aneurysm in Burkhardt’s abdomen. With a 90 percent chance it would rupture, and a 99 percent chance of death if it did, he was a walking time bomb.

Burkhardt went to the emergency room at Inova Alexandria Hospital where physicians conducted a battery of tests to confirm the diagnosis. A few days later, a team of interventional radiologists and vascular surgeons performed an endovascular aneurysm repair (EVAR) with a stent graft. Led by Keith Sterling, MD, the team inserted the stent graft inside the diseased portion of Burkhardt’s aorta to reinforce the weakened part of the vessel and create a new channel for the blood to flow through, eliminating the risk of rupture.

Dr. Sterling and his colleague, James Cooper, MD, have been performing EVAR at Inova Alexandria Hospital since 2000 with excellent results. “The majority of abdominal aortic aneurysms can now be repaired with this minimally invasive technique,” he explains. “Patients spend an average of one to two days in the hospital as compared to at least one week with open repair. In addition, EVAR is associated with a very low complication rate.”

 Learning Experience

As a dedicated lifelong athlete who swam regularly and performed the rigorous P90X workout, Burkhardt thought he was in excellent shape. “If anyone should not have been in this condition it was me,” he says. “I took good care of myself. I didn’t have any pain or other symptoms. The diagnosis left me dumbfounded.” His experience convinced many of his relatives, friends, and even some members of his care team, to have a screening.

Dr. Sterling confirms that most people with abdominal aortic aneurysms (AAA) don’t know they have them. Symptoms are often non-existent until a life-threatening event, such as rupture, occurs. The dominant risk factors are age, smoking and a family history of AAA. Men have a higher incidence of AAA than women. Other risk factors include hypertension and obesity.

Should You Get Screened?

“The issue we are always concerned about is rupture,” Dr. Sterling says. “Since this is a silent disease, a cardiovascular screening that includes an abdominal ultrasound can be very useful. If a small AAA is found, the patient will be placed in a routine surveillance program with periodic ultrasound examinations to determine if there is growth.” (See specific screening guidelines below.)

Burkhardt’s recovery has been trouble-free and he is gradually returning to more demanding exercise. He feels fortunate that this level of high-tech, comprehensive healthcare is available so close to home. “I’ve lived and worked all over the world with access to many medical facilities,” he says. “Without a doubt, Inova is right at the top of the list. The care and treatment are phenomenal.”

Treatment with EVAR

Abdominal endovascular aneurysm repair (EVAR) is a minimally invasive alternative to major open surgery for the repair of abdominal aortic aneurysms (AAAs). It results in reduced recovery times and potentially improved survival rates. In the open surgical procedure, the walls of the aneurysm are replaced with a synthetic graft. In the EVAR procedure, endovascular specialists insert a stent graft into the aneurysm through small incisions in the groin.

Screening Guidelines

An abdominal aortic aneurysm (AAA) is a localized bulging or abnormal enlargement of the abdominal aorta. AAAs are often attributed to degeneration caused by atherosclerosis, although there may be other causes, including trauma, cystic medial necrosis, arteritis, syphilis and inherited connective tissue disorders. An AAA is a major health risk, but most people don’t have any symptoms. The Society for Vascular Surgery and the Society for Vascular Medicine and Biology recommend abdominal ultrasound screening for these patients:

■ All men ages 60 to 85 years

■ All women ages 60 to 85 years with cardiovascular risk factors

■ All men and women ages 50 and older with a family history of AAA

Get Yourself Checked — It’s Easy

A cardiovascular health screening saved Bob Burkhardt’s life. Ask your primary care doctor, or if you prefer and/or your insurance allows, self-refer to a Cardiovascular specialist for an aortic aneurysm ultrasound.

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