When 78-year-old Lynn Brebner looks out her front door, she relishes the peace and quiet that comes with living on 100 acres near Gillett, Wis. — a town of 1,300 people located about 35 miles northwest of Green Bay.
Aging has done little to slow Lynn down, especially when it comes to managing her endless list of chores both indoors and out.
Not surprisingly, Lynn was in good health for much of her life. Shortly before turning 70, however, Lynn was diagnosed with a potentially dangerous vascular condition known as an aortic aneurysm. The aorta, which leaves the heart, arches across the top of the chest like a candy cane and extends down to the pelvis, is the largest artery in the human anatomy. It’s the primary highway for moving blood from the heart to the rest of the body.
When part of the aortic wall gets weak — often a result of family history, high blood pressure or smoking — it starts bulging outward like a balloon growing off the side of a tube. This ballooning is an aortic aneurysm.
In its early stages, an aortic aneurysm typically doesn’t cause symptoms. Some aneurysms, however, continue to grow and bulge out, which makes the situation akin to a ticking time bomb. The bulge gets larger and can eventually rupture.
Meanwhile, as the aortic wall gets weaker, the patient is at increasing risk of a dissection, which means the aneurysm starts to burst, resulting in a tear to the inner lining of the aorta. Blood that would otherwise flow to the rest of the body starts accumulating in the aortic wall, putting the patient’s life in danger. Lynn’s mother died from an aortic dissection.
Nobody wants an aortic aneurysm, but luckily Lynn was aware she had one. That way, she’d be ready to call for help if she ever felt signs of a dissection or rupture — shortness of breath or sudden pain in the chest, back or abdomen.
Eventually, Lynn’s aneurysm grew large enough to warrant a permanent repair, which is done by a vascular surgeon. Lynn’s local doctor referred her to Dr. Paul DiMusto, a UW Health vascular surgeon trained to perform minimally invasive aortic repair surgery. The surgical method allows the patient to go home sooner and recover faster than historically has been the case.
Surgeon took Lynn’s lifestyle goals into account
“When I first met Lynn, it was pretty clear that she wanted to preserve her ability to stay as active as possible so she could continue to maintain her home and live independently,” Dr. DiMusto said. “Fortunately, she was a candidate for a recently developed two-step endovascular surgical procedure that is far less invasive than traditional open surgery.”
Rather than doing an open surgery, Dr. DiMusto described to Lynn how he could perform the two less-invasive surgeries.
“Essentially, endovascular surgery is like re-lining a damaged pipe,” Dr. DiMusto said. “We make a small incision at the patient’s groin and carefully guide a small metal tube with a mesh interior called a stent graft through her arteries until the device reaches the proper spot in the aorta.”
Because Lynn’s aneurysm was about 12 inches long, which is extensive, Dr. DiMusto performed the repair in two separate operations for maximum durability and safety.
First, he performed what is known as a TEVAR, which involves implanting the stent graft into the mid-section of the aorta, roughly midway between the heart and the belly. This provides a new pathway for blood at the site of the aneurysm, which eventually shrinks.
One month later, he did a TAMBE procedure to complete the job. The TAMBE stent graft overlapped with the TEVAR stent graft for reinforcement and also extended farther down the aorta, closer to the abdomen. The TAMBE device also has four small portals that ensure fresh blood reaches the kidneys, small bowel, liver and spleen.
“Both of these procedures are relatively new,” said Dr. DiMusto, adding that UW Health was part of the clinical trial that led to the TAMBE procedure being approved for general use in 2024.
Shorter hospital stay, faster recovery from newer surgical methods
Lynn recovered quickly after each procedure, spending just one night in the hospital after the TEVAR and four nights in the hospital after the more complex TAMBE.
“It was such a great experience,” Lynn said. “I felt so comfortable with Dr. DiMusto and his team. He always gave my daughter and I all the time we needed to get our questions answered.
“We never felt rushed.”
Julie Holmes, Lynn’s daughter, recalled how smoothly everything went during her mom’s pre-surgery meeting and especially on both days of surgery.
“The staff was so welcoming and made sure we knew when and where we had to be,” Julie said. “When Mom was in the operating room, the staff always knew where I would be and took good care of me, too.”
Julie stayed at hotel a couple of blocks away throughout her mother’s hospital stay, which provided great convenience.
An elementary school teacher in Oshkosh, Wis., Julie was fascinated by the clinical teaching at an academic medical center like University Hospital in Madison.
“Seeing the medical students and residents train under the physicians who truly are phenomenal role models was so heartwarming for me,” she said.
Recovery brought relief
Looking back several months removed from surgery, Lynn is thrilled to be living with a huge weight off her mind.
“Knowing that my aneurysm is not going to tear or blow up — that stress is gone now,” Lynn said.
It also means less worry for Julie, who no longer frets about the prospect of her mother overdoing it.
Dr. DiMusto finds fulfillment in caring for a patient like Lynn.
“The rewarding part comes from taking Lynn’s vigor and lifestyle preferences into account and coming up with a plan that helped her resume an independent lifestyle fairly quickly,” he said.
For all of this, Lynn is eternally grateful. But if you ask her what ultimately convinced her to have surgery, she gives you two reasons: Her grandchildren Frankie, 24, and Melia, 22.
“My grandkids were why I wanted to have this fixed,” Lynn said. “They are my world.”