Growing bonsai plants is an art that requires patience and creativity. Every branch and twig must be carefully shaped or eliminated until the chosen image is achieved. From then on, the image is maintained and improved by a constant regimen of pruning and trimming.

Nelson W. Davis, 64, of Glendale, Calif., is a bonsai artist. And his experience with this ancient craft has allowed him to appreciate art in all of its guises—even in the operating room, where attention to detail and careful follow-up are just as critical.

Davis’s health problems actually began in late 1998, when he underwent gall bladder and hernia surgeries. At the time, he didn’t know that he had cirrhosis of the liver—the disease had progressed, as it often does in its early stages, asymptomatically. But the general anesthesia from the operation changed all that—it exacerbated his liver problems, and in early 1999 his liver started to fail. At the same time, doctors noticed that he had an abdominal aortic aneurysm—a weakness in the wall of the heart’s main blood vessel as it traveled through the abdomen. A rupture of the aorta would likely kill him, but his liver condition made treating it impossible. He was placed on the United Network for Organ Sharing list for a cadaveric liver by the USC Abdominal Organ Transplant Program (see USC University Hospital Quarterly, Summer 2000).

Fast forward to the spring of 2000. Davis’s liver function started to improve, making treatment of his aneurysm a possibility. Still, an all-out operation—complete with anesthesia—would likely be too stressful on his body and his liver. But there was a brand-new option available: a minimally invasive endovascular treatment. On April 17, 2000, Fred A. Weaver, M.D., and Douglas B. Hood, M.D., gave Davis mild “twilight” sedation and proceeded with the revolutionary technique—inserting a scaffold called a stent-graft into the weakened portion of the aorta via two small incisions and a thin catheter.

“I remember hearing voices, and felt a sensation of light pressure and prodding—but nothing uncomfortable,” Davis says. “I went home two days later with a two-inch incision on the inside of each leg. Everyone was amazed at how well I looked. And I was pleased that a new treatment procedure was available that wouldn’t jeopardize my already-fragile liver.”