Dr. M.: Green's a lucky guy

Dr. M.: Green's a lucky guy
December 17, 2011, 5:25 pm
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By Dr. Neil Minkoff
Special to CSNNE.comJeff Green is a lucky guy.Yes, he's out for the season because he needs surgery for an aortic aneurysm. But he's lucky because a) it was discovered and b) it can be fixed.About 13,000-15,000 people die from aneurysm every year in the United States. Almost none of them know they have a blood vessel waiting to rupture. At least Green does, early enough to repair it.An aneurysm is a weakness in the artery wall that stretches out from the high pressure of the blood flowing through it. Think of a bubble on a bicycle tire. Most aneurysms have no symptoms so the first sign of a problem is when they start to rupture. This can happen in two ways. The first is a straight rupture, where the artery bursts and the blood flows out into the chest or abdomen. The seecond type is called a dissectiob. In a dissection, the wall of the artery splits between layers and the blood flows into the wall itself, widening that tear.Both are incredibly dangerous and a rupturing or dissecting aneurysm requires emergency surgery. The outcome tends to be dicey, as well.An aneurysm can happen anywhere there is a blood vessel. Aneurysm in the vessels in the brain can cause a form of stroke.The most common aneurysms, like Green's, involve the aorta, which is the biggest artery in the body. The aorta takes blood from the heart through the chest and abdomen before splitting in two to go to the legs. An aneurysm can occur in either the section that goes through the chest (called a thoracic aneurysm) or the abdomen (called an abdominal aortic aneurysm or AAA). If the aneurysm is high enough on the aorta, it can interfere with the blood flowing out of the heart, leading to a leaky valve.The best outcomes for aortic aneurysms are the ones that are found by accident, like this one. This has gotten more common over the years, as more and more people get X-rays, CT scans and MRIs. The great advantage is that the patient can get a full work-up and have planned surgery before the aneurysm is rupturing or dissecting.The surgery depend on the locatiuon of the aneurysm, which I don't think is public knowledge. What will happen, though, is that the weak part of the vessel will be reinforced and stabilized. Even though this can now be done without a full, open surgery, I would opt for the full procedure in Green's case. That would provide the best peace of mind for a player who plans to resume full NBA schedule and the contact involved in banging on the floor.