Personal Stories: George Campbell

Hi, Brian!

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.

Cheryl :)

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.

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