After Aortic Dissection and Intense Surgery, a ‘Miracle’
Aortic dissection can be deadly if not diagnosed and treated quickly. One patient shares the warning signs and his road to recovery.
The excruciating back pain is what Alan Wasserman, pictured above with his wife, Donna, remembers most.
He had finished a rigorous workout earlier that day in January 2008 and had gone home to relax. But when his back discomfort became persistent — and soon unbearable — the Ann Arbor resident, then 49, knew something was wrong.
Fortunately, Donna was quick to react. She called for an ambulance that whisked her spouse to the University of Michigan Health System emergency room.
A life-threatening diagnosis
Several tests and CT scans revealed a severe diagnosis: Wasserman was experiencing an aortic dissection that extended from his heart to his leg.
An aortic dissection occurs when the layers of the aorta pull apart, trapping blood between them. This weakens the aorta and may cause it to rupture.
Although the most common symptoms are chest and back pain, an aortic dissection is often difficult to diagnose. Treatments include an open surgical procedure, endovascular repair (inside the blood vessels) and medical management.
In Wasserman’s case, blood flow was no longer strong enough to keep his arteries open, which meant blood was not reaching his major organs. His life-threatening situation required back-to-back surgeries — the first to insert seven stents into his collapsed arteries to restore blood flow; the second to repair the aortic dissection by replacing his aortic valve, ascending aorta and aortic arch.
After the first emergency surgery, which lasted seven hours, Wasserman was put into a deep-freeze coma — a process known as therapeutic hypothermia — to allow his organs to recover.
Complications and “a miracle”
Days later, Wasserman was prepped for the second surgery.
To further complicate matters, he was diagnosed with a bicuspid aortic valve, a defect in the heart’s aortic valve that is present at birth. Normally, the aortic valve has three flaps controlling blood flow, but a person with a bicuspid aortic valve has only two flaps. An aortic dissection is often a complication of a bicuspid aortic valve.
Wasserman believes someone was watching over him on the day of his second surgery.
That’s because the operating team, led by U-M cardiac surgeon G. Michael Deeb, M.D., decided to begin surgery earlier than scheduled, a move that Wasserman says saved his life.
“It was a miracle, because an aneurysm had formed in my aortic arch and happened to burst at the very moment the surgery began,” Wasserman says.
His ascending aorta and aortic arch were successfully replaced with a graft, and his aortic valve was replaced with a tissue, or bioprosthetic, valve.
A lifestyle change
Now back at home, Wasserman is thankful that his condition is stable, although it prompted early retirement for the 57-year-old environmental attorney.
“This has a major impact on lifestyle,” he says, noting that chronic pain and fatigue are among the continued aftereffects.
Wasserman checks in with his doctors every six months.
Although restricted from strenuous activities that could raise his blood pressure, he is happy to be hiking again.
“It’s my form of relaxation, but I have to take it slow and rest often,” says Wasserman, who also swims three times a week to help combat chronic pain.
Despite the surgeries, the risk of developing another aortic dissection or aneurysm remains.
Still, he counts his blessings.
“If I hadn’t been taken to U-M, I would have died,” Wasserman says. “Many emergency rooms treat symptoms like mine as if it were a heart attack. But at U-M, they knew exactly what to do.”