Thank you for saving my life

John Farrell with Mr Riza Ibrahim, consultant vascular surgeon at The Royal Oldham Hospital

A 73-year-old man who underwent emergency cutting-edge surgery has praised the team who saved his life.

John Farrell, from Middleton, was given only a 25 per cent chance of survival when he was rushed to hospital with a leaking aneurysm.

The semi-conscious pensioner was in agony when he was taken to North Manchester General Hospital, from where he was transferred to the Royal Oldham Hospital, for the emergency procedure.

A surgical team, headed by consultant vascular surgeon, Mr Riza Ibrahim, was scrambled as the experts carried out keyhole surgery under local anaesthetic.

Mr Farrell said: “I can’t thank Mr Ibrahim and his team enough for saving my life.

“I was told when I was rushed into hospital that I was very lucky as 80 per cent of people die immediately.

“I didn’t worry too much about the operation as I knew that I was in safe hands.”

Mr Ibrahim said: “An aneurysm is a dilatation of a blood vessel. The aorta is the main blood vessel in the body and is connected to the heart. It is normally the size of a garden hose, but in some people it can blow up like a balloon and when it does so, it is called an aneurysm.

“As with blowing up a balloon, if the pressure continues to increase it can burst. An aneurysm which ruptures is usually fatal with 50 per cent of ruptured aneurysm patients dying at home, and 50 per cent of those who make it to hospital can also die. Only 25 per cent of ruptured aneurysms actually make it to emergency surgery and survive.”

Ruptured aneurysms have traditionally been treated with an emergency operation which involves a general anaesthetic and a large incision in the abdomen and replacement of the ruptured aorta with an artificial graft. The patients usually have a long stay in intensive care and the mortality rate is very high.

Aneurysms are therefore usually treated electively before they rupture, and with the introduction of the national aneurysm screening programme, all men on their 65th birthday are invited for an ultrasound scan and if an aneurysm is picked up they are referred for treatment. In spite of this however, most aneurysms are still picked up as incidental findings when a scan has been done for another reason or when patients present as an emergency at hospital with a rupture.
Mr Ibrahim continued: “Traditionally aneurysm repair has been done by an open operation, where the diseased aorta is replaced by an artificial tube. This is a major undertaking even in an elective setting and the traditional method has now largely been replaced by a key hole technique where a graft is placed inside the aorta through small incisions in the groin.

“This has reduced the morbidity and mortality of the procedure, but unfortunately it requires careful planning so that a stent that fits the patient's aneurysm can be ordered. Given this, when a ruptured aneurysm presents, the logistics of getting this done in an emergency setting is significant.”

There is increasing evidence that repairing a ruptured aneurysm by the key-hole method reduces mortality and this procedure is now being performed by a few units across the world.

The Pennine Acute Trust does carry out a large volume of key- hole elective aneurysm repairs, but until Mr Farrell became ill, the vascular team had not performed the procedure as an emergency repair.

Undergoing an hour long operation which involved a key hole repair under local anaesthetic, Mr Farrell was soon back on the high dependency unit, where he stayed for two weeks, before being discharged home.

Vascular Services were centralised last year at The Royal Oldham Hospital in a brand new dedicated unit (ward T3) as part of Healthy Futures, bringing together teams of specialist skilled surgeons, doctors and nurses to provide the very best care for patients.