Team Effort -

Ingalls Doctor Work Together to Save Lynwood Woman's Life.

An ominous-looking shadow on a routine CAT scan was the first indication that something was wrong with 56-year-old Susan Tepper’s heart. The discovery of the abnormality by interventional radiologist Thomas Aquisto, M.D., last March led to a series of sophisticated medical procedures that ultimately saved the Lynwood woman’s life.

A part-time registered nurse and fulltime caregiver to a husband with advanced Alzheimer’s disease, Tepper had been undergoing regular CAT scans since early 2007 to keep an eye on a possible lung tumor.

To her relief, the nodule was benign. But that’s only the beginning of the story. Had it not been for Dr. Aquisto’s highly trained eye, a deadly thoracic aortic aneurysm could have made Tepper a walking time bomb.

“Dr. Aquisto went the extra mile. He saw something suspicious on a routine CAT scan and acted on it very quickly,” Tepper explained.

So quickly in fact that Tepper was called in to see her primary doctor - Bruce Parisi, M.D. - that very day for an emergency visit.

“He told me I didn’t have lung cancer,” she remembers. “But he explained that Dr. Aquisto had found a thoracic aortic aneurysm and that I needed treatment right away.” (A thoracic aortic aneurysm is a potentially deadly bulge on the main vessel in the chest carrying blood from the heart. If it ruptures, death can occur within minutes. But if detected in time - as in Tepper’s case - the aneurysm can be treated successfully.)

Over the next couple weeks, Tepper met with Dr. Aquisto and vascular surgeon Timothy Field, M.D., to discuss a course of action. Because of the aneurysm’s tricky location, doctors told Tepper a surgical procedure to bypass the nearby left subclavian arteries would be necessary first.

Blockages discovered in the affected arteries would also require treatment. But before any of this could happen, Tepper first needed medical clearance from a cardiologist.

That’s when Ingalls cardiologist Francis Almeda, M.D., got involved. A pre-surgical stress test and subsequent angiogram showed Tepper had severe blockages in two major coronary arteries that required immediate attention.

“I wouldn’t have survived the other operation,” she explained. “I’d been having neck and back pain for months but had no idea it was heart related. I was walking four miles several days a week. I could have died.”

So in early April, Dr. Almeda implanted two stents to open Tepper’s blocked heart arteries, carefully avoiding the aneurysm.

Following several weeks of rest and recuperation, Dr. Field performed surgery on Tepper’s neck arteries to bypass the blockages and make room for the upcoming aneurysm repair. Ten days later, Dr. Aquisto repaired the potentially deadly aneurysm with a minimally invasive endograft in the hospital’s sophisticated Interventional Radiology suite.

Thoracic aortic aneurysms weaken the main artery that carries blood from the heart to the body. As this bulge increases in size, the risk of rupture and internal bleeding also increases.

Until recently, patients with thoracic aortic aneurysms would have needed open surgery for repair, which includes a large chest incision and the temporary clamping of the aorta. Now, experienced interventional radiologists at Ingalls can use just one small incision to place a high-tech device inside the aorta, relieving the aneurysm from pressure.

“The big advantage for patients is the faster recovery and the decreased risks of surgical complications, such as paraplegia. They can typically go home from the hospital in a day or two, compared to a week or more for open surgery,” Dr. Aquisto explained.

After three medical procedures and recoveries in the space of just two months, Tepper returned to her part-time work as a home-care nurse in June and continues her role as primary caregiver to her husband.

“These four amazing men truly worked together to save my life and bring about a beautiful result,” she adds with gratitude. “I wasn’t a number to them. They cared about me.You don’t have to look 20 or 30 miles away when you’ve got excellent health care right here.”

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