Personal Stories: George Campbell
My name is Cheryl. My husband George (57 years old) was diagnosed as
having a non-occlusive dissection of the proximal superior mesenteric
artery (SMA). The vascular surgeon report reads: "A review of the
abdominal CAT scan reveals a short dissection of the proximal superior
mesenteric artery with patency of both the true and false channels
(implying re-entry)." He actually suffered this dissection back in
August 2004, but it was not diagnosed until January 21, 2005, after
months of tests!
We haven't been able to get much information locally. The doctors say
that an SMA dissection is rare. The surgeon said there's nothing that
can be done surgically to repair the dissection. He could do a bypass,
but since my husband is stable (and has been since it occurred in
August), he doesn't recommend surgery since it has risks. He also
doesn't recommend an angiography at this time.
George's father suffered a Type A dissection which he survived; and
he died of an aneurysm, which may have actually been another dissection.
The surgeon says George probably inherited weak artery walls, but
there's no test to confirm that. We're concerned about the genetics
because we have a 23 year old son.
I'm writing to you because I feel very helpless and confused. The
doctors have not offered anything to help George. They say diet,
exercise, etc., wouldn't make a difference. A cardiologist we saw,
however, said it probably wouldn't hurt to avoid strenuous activities
(no marathons) and lifting heavy things (although his surgeon said that
wouldn't make a difference). George is a mechanic and his work can be
very physical, so I have a concern about that.
I'm not sure that George is getting all the help that may be out
there. They say that his condition is rare, but I'm wondering if there
is someone who may specialize or be knowledgeable about SMA dissections.
Also, I'd like to find out more about the genetic aspect; if there are
tests or studies that give us more information; and is there anything we
can do for my son if it is genetic.
I'm very worried, of course. My husband is my life and I want to be
sure we've exhausted every avenue and done everything possible to help
him. It may be that there *is* nothing more we can do but hope he
remains stable. I just don't feel confident in the information we've
received thus far.
I'm hoping that you will be able to refer us to someone who would be
willing to look at George's case. We would be able to travel for
consultation or testing if necessary.
Brian, thank you so very much for your website. It's a beacon of hope
and information in an otherwise bleak and dark area. As you said,
there's nothing much out there that's positive. It helps tremendously to
read emails from others who are going through this. Thank you so much
for maintaining your website.
Good health to you, Brian. Take care.
Response from Dr. David Liang
Your husbands SMA dissection probably does not need specific
treatment unless there is significant enlargement of the SMA or if there
is a problem with blood flow through the SMA. A good CT should answer
both those questions. NO matter what it should be followed closely for
progression in the future. I very much agree with your concern regarding
the genetic issue given the history of a dissection in your husbands
father. It definitely warrants further investigation. I would recommend
evaluation by a specialist familair with inherited weaknesses in the
tissue that form the blood vessels. Unfortunately there is no one in
your area that I can recommend. We would be happy to see you here at
Stanford. An alternative would be to see Peter Byers at the University
of Washington in Seattle. There are other centers as well, but we are
the two closest.