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It was just about a year ago when Sue Horton went to hug her husband Mike, to put her arms around him.
That’s when she felt it, the bulge on his abdomen around his ribs. It alarmed her. It was pulsing. It was big enough to cover the palm of her hand.
Mike Horton hadn’t noticed that bulge before. He felt tremendous. He’d been working out a lot, practicing law, being an active grandpa and he had no symptoms – not one.
Until now. And now he had the pulsing bulge.
A few trips to different doctors resulted in the same diagnosis: That bulge was an abdominal aortic aneurysm. It was big enough that, had it ruptured, Horton likely would have died on the spot.
And not only did he have one aneurysm, ultrasounds revealed Horton had three.
After consulting with his daughter, an ER nurse in Indianapolis, and Sue Horton’s college roommate, an out-of-state physician married to a vascular surgeon, all said the same thing.
Horton should go see a man named Dr. Andres Fajardo, a renowned vascular surgeon at IU Health Methodist Hospital. Dr. Fajardo was an expert on these kinds of things.
When the Hortons met with Dr. Fajardo, they knew. All the suggestions had been right. The Hortons learned that Methodist had one of the top three programs in the nation for treating abdominal aortic aneurysms in a groundbreaking way.
Instead of being opened up for an invasive surgery, Dr. Fajardo would be able to fix Horton’s aneurysms with a tiny incision, going in through the groin with a custom-made stent.
The procedure would be much less risky. Much less scary.
“You’re turning your life over to this surgeon and you want to be sure they are the right person to do it,” Sue Horton says. “Dr. Fajardo was the answer to our prayers. He saved Mike’s life.”
An abdominal aneurysm?
“Many people hear aneurysm and they think brain aneurysm,” says Horton, a 72-year-old attorney in Fort Wayne. “Many people have never even heard of this.”
An abdominal aortic aneurysm is an enlarged area in the lower part of the aorta, the major blood vessel that supplies blood to the body. The aorta runs from the heart through the center of the chest to the abdomen.
Because of the aorta’s role as the body's main supplier of blood, a ruptured abdominal aortic aneurysm can cause life-threatening bleeding.
“If this ruptures then it’s a big problem,” says Dr. Fajardo. “If this ruptures, 90 percent of people will not make it into the hospital.”
In most cases, such aneurysms are not treated until they become a certain size, roughly just less than two inches, says Dr. Fajardo.
“Because the risk of rupture is higher than the risk of the aneurysm,” he says. “Often, we will survey until it is a certain size and then fix it.
But, often, people don’t figure out they even have an aneurysm until it’s big enough that it needs fixed.
That was the case with Horton. And he needed his fixed -- quickly.
‘It’s a custom-made stent’
Within a month, by October, Horton was in Dr. Fajardo’s office. The first order of business was to get a CT scan of the area.
After receiving that scan, Dr. Fajardo drew the Hortons a sketch of just what Horton’s aneurysms looked like. They loved the personal touch. They saved that drawing.
Horton’s scan was then put into a three-dimensional reconstruction site to see where the holes were for the mesenteric arteries and the renal arteries. Based on that, a fenestrated aortic stent graft was made just for Horton.
“It’s a custom-made stent,” Dr. Fajardo says. “It’s pretty cool.”
IU Health is top three in the country for implants of these grafts, having done more than 100 procedures in less than five years.
It started in 2012 when Methodist became the first hospital in Indiana and only second in the nation to use the fenestrated stent graft to treat abdominal aortic aneurysm.
Horton had two surgeries, one in November and then another in December. During the procedures, the aneurysms are not removed, but instead, blood flow is redirected through the stent – ending the possibility of rupture.
Average stay for the procedure is three days – versus 10 days for the traditional open surgery. Horton stayed just one night, leaving the day after surgery.
Nearly a year after his diagnosis, Horton feels great. Of course, he’s always thinking about how grateful he is.
‘The Lord’s Hands Were All Over This Case’
Sue Horton believes her husband wouldn’t be here today if it weren’t for a lot of things lining up just right. He wouldn’t be here for their four grown daughters and three grandsons.
“In my opinion, it was like Dominoes,” she says. “All these things going in the right order so, when you’re done, everything overlaps in the right way.”
That their daughter Mary, the ER nurse, had met Dr. Fajardo at Cross Fit, the same surgeon recommended through Sue’s college roommate.
That Horton had lost nearly 30 pounds after he decided to go on a health kick, ramping up exercise and eating better. If he hadn’t been so thin, Sue Horton likely wouldn’t have even noticed that bulge.
“I tell all my friends, ‘It pays to hug your husband,’” Sue Horton says.
And the blood pressure medicine. Two weeks before his wife found the area on his abdomen, Horton had been put on blood pressure medicine and filled the prescription.
Instead of taking it, he left it sitting on his desk. After the aneurysm was found, he figured he should start taking that medicine.
Within days, the bulge disappeared. If he’d been taking that medicine at that time, the bulge may never have appeared.
“There is no way I should have found it,” Horton says. “The Lord’s hands were all over this case.”
More On Abdominal Aortic Aneurysms
Symptoms: These aneurysms are hard to detect because they usually grow slowly and with no symptoms. As the aneurysm enlarges, people may experience back pain; intense, constant pain in the abdomen or side; or a pulsating feeling near the navel.
Most at risk: Men 65 and older with a history of smoking and those with a history of other aneurysms.
Causes: Most are unknown but among the most common causes are high blood pressure, tobacco use, hardening of the arteries, heredity, trauma, infection in the aorta and blood vessel diseases in the aorta.
-- By Dana Benbow, Senior Journalist at IU Health.
Reach Benbow via email email@example.com or on Twitter @danabenbow.