Complete Aortic Dissection - Wesley David (Dave) Wilson

On March 25, 1994 at 4:50 pm I felt a excruciating, tearing sensation in my upper left chest. The tunica intima of my descending aorta, just below the arch, had torn. The pain and force of the sensation dropped me to my knees. The shift at the plant where I worked had ended at 4:30; there was only one other person in the building. I breathed a one sentence prayer, stood up and walked out of my office, down the ramp and around the corner to her office. Setting down on the floor, I leaned against the door jamb and asked her to call the local ER. I told her something was terribly wrong in my chest. The pain kept coming in waves; the force of each heartbeat was pumping blood between the tunica intima and the tunica media. The dissection continued through the abdomen into both iliac arteries. A flap of torn intima closed off the circulation to my right leg. By the time the paramedics arrived, my leg was losing feeling.

The paramedics began treating me for a heart attack. I listened to the stats they called out; I related my symptoms and repeatedly said I was sure it was not a heart attack. They began to morph me; it really didn't help. I was taken to the local hospital. At the emergency room, they could not diagnose me. They even told my wife they didn't know what was wrong. By now my right leg was becoming grey in color. For some inexplicable reason, the ER doc had not called for the Lifeline Helicopter. After a heated exchange between my wife, the doc and the paramedics, the rescue helicopter was called.

When the nurse from the copter came into the ER, she leaned over me and asked me to swallow something. She then inserted a portable transesophogeal scope into my throat. She called out "Aortic dissection", turned around, snapped two commands to the ER staff then said, "I mean stat, we are transporting in thirty seconds." The pain was still agonizing and coming in waves.

In transit to the trauma center at Methodist Hospital in Indianapolis, IN, I began to have new pain. When I told the nurse setting at my head, she took my right hand and said "Just hold on and stay with us" She then said something into her helmet mike then told me "We are going to have a rough landing. We're going to come in hard and fast; we have to get you inside." The dissection was now traveling from the origin, through the arch and ascending aorta, toward my heart. When it reached my heart, my aortic valve was irreparably damaged. The dissection stopped at the valve. We landed around 6:30 pm. I was conscious from the first ripping sensation until I was put into the C-scan unit; the last thing I remember was "Put your arms over your head."

The next morning, I was awakened and told I would be having surgery. I was given a fifty percent chance of survival and was told a stroke was a strong possibility. I said I was a Christian and ready to go, but wanted to see and pray with my wife and son before I went to surgery. In surgery, I had a St Jude heart valve put in, a Dacron resection of a part of the ascending aorta and a small reinforcing Dacron patch sewn on the aorta. My aorta was only repaired to just above the renal arteries. No other surgery was performed. I was on the heart/lung bypass for four hours and in surgery a total of eight hours. During the operation, a second surgical team was brought into the OR; if the circulation in my right leg did not return when my heart was restarted, it was to be amputated. Circulation to my right leg returned, with no side effects from twenty hours without blood. When I awoke, I thought a tree limb had been shoved into my throat; I was on a ventilator.

My recovery has been miraculous. The dissection occurred on a Friday afternoon. The surgery was done Saturday morning and afternoon. I was up walking Monday evening. I returned home on Friday morning, then went to Easter Service on Sunday. In six weeks, I began part time work at home and returned to work full time on June 6th, 1994. Fortunate to be alive does not begin to adequately describe this experience.

For a four to six month period after the operation, I experienced partial and full loss of sight to my left eye. The incidences of loss of sight would last from fifteen to twenty seconds to several minutes. It is thought micoscopic emboli were the cause. These symptoms ended in early 1995 and have not returned as of this writing. No other complications or detrimental side effects have occurred. I am taking Coumadin, alpha and beta blockers, a diuretic and baby aspirin daily. I thank God for every day! Some days are better than others, but every day I draw breath is a GOOD DAY! :)

Update 20 Apr 2000

G'day to my family and friends. "Thank you" to everyone for your concern and prayers. Today I visited with the cardiovascular thoracic surgeon. We discussed the aneurysm in my ascending and descending aortic arch. At this time, Dr. Halbrook feels the risks outweigh the benefits of any surgery. At this stage , he feels it is not life threatening and surgery poses a greater risk to my cardiovascular system; i.e., clots forming and affecting blood flow to vital organs or 25%+ possibility of a stroke during surgery. We are taking a wait and observe stance. Dr. Halbrook suggests a semi-annual or annual CAT scan and a transesophogeal echo gram to monitor the aneurysm. He considers a diameter greater than 6 centimeters something to possibly consider for surgery. Doc says the aneurysm may or may not grow larger, only future 'looks' will tell.

My daily routine and meds will remain the same. The only caution is not to do any 'strenuous' work. So there goes the luaus and 'All You Can Gorge' buffets; I really did work up a sweat participating in those. [grin] Doc does want me to do daily exercise of a non load bearing type. He suggested a stationary bicycle or swimming. AND to get my big butt in gear and lose weight. That is gonna be the hardest goal for me. Anyway, thanks again for your concern, prayers and thoughts for Diane and I. See everyone on the net!!