Aneurysm Repair: One Doctor's Quest for a Better Way

At the start of his career, vascular surgeon Michael L. Marin, MD, now Professor and Chair of Surgery, walked into the room of a patient whose chances of surviving surgery for aortic repair were slim to none. Rather than give up, Dr. Marin decided to find an alternate treatment.

"I had been in practice for only three months. I had a patient who had a large and painful abdominal aortic aneurysm, oxygen-dependent lung disease, and severe coronary artery disease," says Dr. Marin. "He would not have survived conventional open aortic aneurysm surgery."

Dr. Marin cast a wide net to find a solution. His answer came when he met Juan Parodi, MD, who had performed the world's first endovascular abdominal aortic aneurysm repair in Buenos Aires. Dr. Marin invited Dr. Parodi to New York, and under his supervision, Dr. Marin became the first surgeon in the United States to perform the procedure. This event sparked the rapid development of new and creative treatments by Dr. Marin and other physicians around the world for minimally invasive treatment of peripheral vascular disease.

"Mount Sinai recruited me in 1996 to create a program in minimally invasive endovascular surgery," Dr. Marin says. "When I started doing endovascular graft procedures for aneurysms, there were no devices readily available. Each device had to be hand built." Dr. Marin eventually gained support from the Food and Drug Administration for the graft. The operation has become the treatment of choice for patients whose aortic aneurysms place them at high risk from traditional surgery.

Studies are currently underway to look at the use of noninvasive pressure sensors to analyze the change in pressure in the aneurysm sac following a stent graft procedure, sounding an alarm if the vessel begins to leak. "The field of minimally invasive vascular surgery is in its infancy," Dr. Marin says. "This is just the beginning."

Mount Sinai Heart, under Dr. Marin's leadership, continues to perform more minimally invasive aortic aneurysm repairs than any other surgical center in the United States — more than 250 every year. Dr. Marin remains the most experienced practitioner of this procedure in the world, and he continues to train new generations of Mount Sinai surgeons to help aneurysm patients.

"It is amazing that after I put the device in and fix the aneurysm, a patient will eat lunch, stay overnight, and go home with his or her family in the morning," Dr. Marin says. "I've done more than 2,000 of these procedures, and every time is a miracle."


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