Heart Insight - Vascular Disease Special Topic Supplement 2016

2 | Special Topic Supplement: Vascular Diseases
ason Philpot of Marietta, Georgia, was 37 years
old, a husband and father of two, when he went
in for a routine checkup in 2012. His doctor
listened to his heart and asked if he was aware
that he had a heart murmur. She suggested he
visit a cardiologist. At the time, he was working
in oncology as a field service support staff member for a well-
known company. “I very much enjoyed that career,” he said.

The Philpots didn’t take the heart murmur that seriously “because we didn’t see any signs of it causing any problems,” said Brandi, Jason’s wife of seven years.

It didn’t take long for that to change. “Within four months things went downhill quickly,” Jason said. He had a series of major complications over the next few years: a pacemaker was implanted; his heart valves began leaking seriously; he had two open-heart surgeries; and then there was the aneurysm, which was found in 2014 and grew from about the size of a peanut to the size of a watermelon in just a few months.

“Looking at images of his chest, all you could see was this huge pulsating mass in the front of his ribs,” said interventional cardiologist Mustafa Ahmed.

“Every time my heart beat, it felt like it was jumping out of my chest,” Jason said.

“It’s scary to see such movement, especially knowing that
it shouldn’t be happening! Then the question becomes, can
something be done to stop it without another open-heart
procedure? Meanwhile, I could see the growing concern and
fear within Brandi. With such a young family, I knew she was
wondering, what’s next for us?”
Without an operation to remove the aneurysm, Jason
would almost certainly die. Yet removing it was not without
risks, and surgical options were complicated by the fact that
the Philpots are members of the Jehovah’s Witness faith,
Brandi was terrified of losing her husband, who by then
had to take medical retirement from his job. Ahmed wracked
his brain for a solution. He assured Brandi that he would
do whatever he could, telling her that given the size of the
aneurysm and the no-transfusion restriction that whatever
they tried would be a “Hail Mary.”
The procedure that Ahmed proposed was to run a
catheter into the aneurysm and then fill it up with coils of
metal. This procedure, called coil embolization, is most often
used in treating brain aneurysms. A catheter is threaded
to the site of the aneurysm and then the coils are inserted
through the catheter into the aneurysm. The coils fill the cavity
of the aneurysm and block blood flow into it, preventing it
from rupturing or leaking. It is a delicate procedure that can
take hours even with much smaller aneurysms than Jason’s.

Jason was intrigued by the embolization process, but his aneurysm was huge. Filling such a large cavity with coils had never been done before. It would be neither quick nor easy. But he did not hesitate and immediately agreed to the procedure. “When are we doing it?” he asked as soon as Ahmed suggested it.