Vascular Surgery Advancements Keep Patients Close to Home

September 1, 2016

Care Worth Sharing

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Eleanor and Sonny Mistretta of Hollywood, Maryland

“Would you recommend this doctor to a friend?”  It’s a common question found on satisfaction surveys delivered to inboxes or mailboxes. A better, more telling question – especially in the world of health care - might be, “Would you recommend this doctor to your family?”

Following the care she received from Arthur Flatau, MD, general and vascular surgeon at MedStar St. Mary’s Hospital, Eleanor Mistretta, of Hollywood, Maryland, answered that second question with a resounding, “Yes!”

Eleanor came to MedStar St. Mary’s Emergency Department in February with stomach pains. Dr. Flatau removed her gallbladder the next day. “We were having a discussion about surgery afterward,” said Eleanor, “and I asked him if he did aneurisms and he said, ‘Yes, I do.’ ”

Eleanor’s husband of 54 years, Sonny, knew he would eventually need  surgery for his aortic aneurism, which had been found by his urologist about four years ago, but he admits to trying “to stretch it out”  to delay the procedure. “When I did Eleanor’s surgery and everything went ok, she asked me about Sonny’s abdominal aortic aneurysm and I explained to her that was actually the type of surgery I was brought here to do,” said Dr. Flatau.

An abdominal aortic aneurysm occurs when a section of the aorta, the main blood vessel to the abdomen, pelvis and legs, enlarges. Often discovered through an ultrasound or CT scan, patients who have these types of aneurisms are typically followed closely by their doctor until the aneurysm reaches between 5 and 5.5 cm.

“Once the aneurysm is a size we know puts the patient at risk, we will fix the aneurysm electively,” said Dr. Flatau.

After recently traveling into Washington, D.C., for her own health concerns, Eleanor didn’t want Sonny’s surgery done in the city. “I preferred he have the surgery done right here in St. Mary’s,” said Eleanor. “The hospital’s only two miles away!”

Sonny’s surgery was performed on a Thursday morning in mid April, and he was released from the hospital late Friday night. “When we talked, Dr. Flatau told me exactly what was going to be done and showed us the stent he was going to use,” said Sonny. “He told me if the aneurysm ruptured, it would be an emergency situation, and if I went to the emergency room, there might not be a doctor available who could fix it.”

 “If a patient comes in with a rupture, we will certainly treat it here as long as it’s within our capabilities,” said Dr. Flatau. “It’s actually safer to treat patients here than to send them somewhere else. The quicker a patient goes from the ER to the OR, the better their outcome.

“We have definitely increased the complexity of what we are doing here and the bottom line is that we are able to do much of the same surgery here that is also done in larger hospitals,” said Dr. Flatau, “and we are happy to do it if that’s what the patient wants.”

Sharing More than a Brotherly Bond

Brothers Bernie, left, and Robbie Baird.
Brothers Bernie, left, and Robbie Baird.

When you are brothers you share a lot of things – family, hobbies, friends, likes and dislikes. But the Baird brothers of Avenue shared a medical condition which would ultimately lead them both to John Harvey, MD, general and vascular surgeon with MedStar Shah Medical Group. Both brothers suffer from peripheral artery disease, a narrowing of the peripheral arteries to the legs, stomach, arms, and head.

Dr. Harvey was recommended to Bernie Baird by his primary care physician after Bernie started having intense pain in the back of his left leg. “I would work a little bit and it would start hurting so badly it was unbelievable,” said Bernie, who is 65. “I didn’t know what it was and at first I thought it might have something to do with my back.”

Testing determined Bernie had a blocked artery behind his knee. Metal stints or a balloon procedure called angioplasty are often the first choices for opening a clogged artery. Relatively simple procedures, patients usually don’t require lengthy hospital stays or long recovery times. “He put a stent in and it worked well for a couple of weeks, then it started to hurt again,” said Bernie.  “My cardiologist said that for some reason my body just rejected that stent.”

“With stents or angioplasty, patients are in and out,” said Dr. Harvey. “We can fix the problem right away and they get better right away.  The down side is they don’t necessarily last as long.”

When Bernie went back to Dr. Harvey, the decision was made to perform a bypass of the clogged artery. “The bypass surgery is a bigger operation and may require several days in the hospital and maybe rehabilitation,” said Dr. Harvey, “but it is more durable in the long term.”

Much like his brother, Robbie Baird was also looking for a long-term solution to similar issues he was facing. Almost 20 years ago, Robbie, 60, had an aorta bypass surgery, which is a y-shaped graft that bypasses the blocked arteries in order to return blood flow to the legs.

“I wish Dr. Harvey had been here 20 years ago,” said Robbie. “I had been through it before and I knew what it felt like. I couldn’t work or do anything.”

“The surgery he had worked very well, but it doesn’t necessarily last for many years. Robbie’s concern was that he might have to go up to Washington to have a big redo surgery,” said Dr. Harvey. “We decided to insert a tube to take the blood from the left arm down to the left leg. The good thing about that surgery is it is fairly simple and it doesn’t involve being in the hospital for weeks.”

Robbie was in the hospital for several days and was out of work for a few weeks while he recovered. Today, he and his brother, are both back to their normal lives. “We can do complex surgeries at the hospital now, that keep patients in the county,” said Dr. Harvey. “We can take care of things that have been fixed a long time ago and do the revision or the repeat procedure and people can recover very well. If we can find a surgery that can fix their problem and keep them in the county, I am sure they will be very happy.”

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