Treatment for abdominal aortic aneurysm
Feeling dizzy and weak during an advent service at her church, Ardis Morton, 90, sat down to rest. The next thing she knew, paramedics were rushing her to the Inova Fairfax Hospital Emergency Room. Ardis had suffered a ruptured abdominal aortic aneurysm – one of the most deadly cardiovascular events with a 95 percent fatality rate. The complexity of her condition, coupled with her age, made surgery extremely risky. Vascular surgeon Dipankar Mukherjee, MD, was willing to attempt an emergency repair.
"When Dr. Mukherjee came out to speak to us after the procedure, he had just two words: 'She's alive,'" recalls daughter Beverly. "The family was overjoyed and so thankful. We called it our Christmas miracle."
Ardis spent four days in the hospital before returning to her daughter’s home in Lovettsville to begin the slow process of recovery. Initially, she was carried up and down stairs in a wheelchair. But when she went to Dr. Mukherjee's office for a post-op appointment a month later, she insisted on walking up and down the stairs herself.
The grandmother of 13, great-grandmother of 18 and great-great-grandmother of two feels uniquely blessed. "So many things fell into place for me," she says. "Even Dr. Mukherjee calls it a miracle. We thanked each other for accomplishing such a wonderful result."
As Dr. Mukherjee explains, "Generally, we don't have to refer patients out or turn patients away. If there is a solution, then more than likely we'll come up with it."
Treatment: limb-saving surgery
Elmer (Lee) Lockhart is an enthusiastic 73-year-old who has seen a lot of trouble from diabetes. Most recently Mr. Lockhart, who lives in Front Royal, Virginia with his wife Jane, underwent a complex surgery to the peroneal artery in his lower leg to bypass severe blockages in his arteries in order to save his right leg from amputation. The procedure was long and hard, but it worked. “I can thank Inova for the fact I still have my foot,” Mr. Lockhart says.
Mr. Lockhart noticed an ulcer on the bottom of his foot midway through 2015. Tests showed he didn’t have enough blood flowing through the arteries in his legs to reach his foot and the wound simply would not heal. An infection made the situation critical. Mr. Lockhart was rushed to another area hospital and treated with an angioplasty. The procedure succeeded in allowing more blood to flow to the leg, but it soon became clear that blood wasn’t going far enough to reach the affected foot.
“I thought I’d lose my foot for sure,” Mr. Lockhart says. He was rushed to Inova Fairfax and Dr. Richard Neville, associate director of Inova Heart and Vascular Institute and vice-chairman of Surgery, became his doctor.
“Mr. Lockhart has a complex medical history and is the kind of patient that requires a multidisciplinary approach to limb preservation,” says Dr. Neville. “These patients require state-of-the-art bypass and endovascular revascularization procedures as well as a team approach to healing and optimal medical care.”
“Dr. Neville said he would do his best and that the surgery would last four-and-a-half hours,” remembers Jane Lockhart. “Four hours passed, then six hours. I was going crazy!”
In layman’s terms, Dr. Neville had taken a vein out of Mr. Lockhart’s left leg and put it into his right leg to allow blood to pass through. But it was clear during surgery this would only allow blood to pass to his right knee. It wouldn’t save his foot.
“So Dr. Neville spent another two-and-a-half hours in the operating room to connect the blood flow to Mr. Lockhart’s foot and make the surgery a success,” Mrs. Lockhart says.
Mr. Lockhart came through a long recovery with his health and foot intact. “It was all worth it,” he says. “I never thought I’d walk again and now my mobility is great.”
Treatment for peripheral artery disease (PAD)
Peripheral artery disease, or PAD, can take a toll on your mobility. That’s what Betsy Hamilton, 83, hates most about the disorder that she suffers from in both legs. A self-described “grumbly woman” from Scotland, Hamilton and her husband like to travel, take walks and enjoy the city. In the past 10 years, Ms. Hamilton has had several treatments for PAD, including bypass surgery on both legs, to help her keep moving.
Ms. Hamilton, who lives in Washington, DC, had been treated by Dr. Richard Neville, associate director of Inova Heart and Vascular Institute, and vice-chairman of surgery, for several years. When Dr. Neville joined Inova in July 2016, Ms. Hamilton moved with him. “He may have thought I was stalking him,” says Ms. Hamilton. “But I have faith in him so I use Uber to get to him,” she explains.
In fall 2016, Ms. Hamilton started to lose feeling in her left foot. “I couldn’t walk one block,” Ms. Hamilton remembers. “I had some serious blood clots in my leg. When the tests came back Dr. Neville thought I should have an operation straight away. That was a Tuesday. I went in for the operation for a patch on my femoral artery that Friday. I was out of the hospital on Saturday,” she says.
“Ms. Hamilton is an excellent example of the long-term relationships we build with our patients,” says Dr. Neville. “I have kept her walking with her legs intact for many years. It is a real pleasure to work with her. She’s like family.”
“I’m walking now!” Ms. Hamilton adds. “I do all my own housework and shopping. My husband and I go to the cinema and out to dinner.”
Ms. Hamilton says she can walk as much as 5 or 6 blocks before getting tired. That’s an improvement for sure, but she’s looking forward to even more progress.
“I’m grumbly that I still can’t walk very far or fast. I’m an ungrateful woman! But I know I’ve been very lucky. I’ve always come out better from every operation with Dr. Neville. He’s an excellent surgeon. He gave me my mobility back.”