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Cardiac Team Helps ‘Miracle Man’ Survive Aortic Rupture

October 13, 2020
Dennis Anderson and wife

An aortic rupture is a medical event that occurs when the major blood vessel carrying oxygen-rich blood to the heart, brain, head and arms bursts. It is sudden, catastrophic, and often deadly, with up to 90 percent of patients dying before they reach the operating room. Thanks to the experienced team at Catholic Health Services (CHS), West Babylon resident Dennis Anderson beat those odds.

For Dennis, April 11, 2019, was a typical Thursday. A self-employed plumber, he had just gotten home from work when he felt what he described as a lightning strike. He fell to his knees and began to perspire. His wife, Kathleen, knew something was seriously wrong when the normally stoic Dennis asked her to call an ambulance.

In the emergency department at CHS’s Good Samaritan Hospital Medical Center in West Islip, a CAT scan revealed the problem: Dennis’ aorta had dissected, which meant there was a tear in the inner wall of the artery. As he was being transported to the operating room for emergency surgery, the aorta ruptured. His pericardium, the membrane surrounding his heart, was filling up with blood. Doctors had to act fast to save Dennis’ life.

Cardiothoracic surgeon and member of the St. Francis Hospital Open Heart Surgery Program at Good Samaritan Timothy Carter, MD, who specializes in aortic surgery, operated on Dennis for 11 hours to replace the damaged section of the aorta. But Dennis’ fight to survive was only just beginning.

“For the first three nights we were not sure if he would make it,” Kathleen recalled. “Then every day that he was making it they didn’t know how he was making it.”

After six weeks, Dennis was transferred to CHS’s St. Charles Hospital in Port Jefferson for two weeks of intense inpatient rehabilitation so he could relearn how to walk, climb stairs and perform basic tasks. For an active man who was accustomed to physical labor, including lifting boilers by himself, being sent home with orders to lift nothing heavier than 10 pounds was frustrating.

“I’m used to lifting heavy stuff. Now I couldn’t lift a case of water,” Dennis said.

Surveillance through CAT Scan Imaging would assist the team in detecting any additional issues requiring surgical intervention. They found that, following the dissection, the wall of Dennis’ aorta remained very weak. This led to an aneurysm – a section of the artery wall that stretches and thins – in the aortic arch where blood vessels branch off to the brain. Dr. Carter determined that Dennis’ aneurysm was enlarging at a rapid rate. At the same time, his condition was causing heart failure.

Shortly after Dennis was discharged from St. Charles, Dr. Carter told the couple that, because of the extent of the damage to Dennis’ heart, he would require medication management and three additional surgeries performed by a multidisciplinary team. To minimize the trauma and risk, these were spread out over several months. Procedures would eventually include a bypass operation, performed by surgeon Michael Sacca, MD, and replacement of the aortic arch and valve by Dr. Carter. Additionally, cardiologist John Asheld, MD, managed Dennis’ heart failure with an optimized medication regimen.

But with all that, Dennis was still not out of the woods. In the summer of 2020, he underwent a procedure known as TEVAR – thoracic endovascular aneurysm repair. This time, Dr. Carter inserted a catheter into an artery in Dennis’ groin. This catheter was threaded through the artery to the site of the aortic aneurysm. Once there, a polyester tube called a stent graft was deployed. It remains at the site of the aneurysm, protecting the artery walls and providing a strong conduit for blood to flow.

The procedures performed on Dennis constitute a total hybrid arch replacement, a highly specialized surgical repair not available elsewhere in the region. Dr. Carter is one of only a handful of experts in the metropolitan area with the expertise to perform these complex surgeries. Under his leadership, CHS has begun a comprehensive Aortic Surgery program at Good Samaritan.

“The important thing to understand is how serious an aneurysm or dissection can be,” said Dr. Carter. “With the St. Francis Open Heart Surgery Program at Good Samaritan, we are bringing the most cutting-edge aortic surgery procedures to the region and offering a highly individualized approach.”

Adding to the multidisciplinary team approach, Good Samaritan is one of a few hospitals in the region offering genetic testing to determine whether patients with aortic aneurysm or dissection might have a genetic predisposition for these conditions. Dr. Carter says this is vital, because while most cases appear to occur spontaneously, doctors are learning more about possible risk factors.

“Our program takes into account genetics, the size of the aneurysm, the timing of surgery, and follow-up care,” he said.

After his TEVAR procedure, Dennis finally got the green light to return to work, something he is eagerly looking forward to. As he prepares to resume his normal activities, he credits his survival to Dr. Carter, Dr. Asheld, Dr. Sacca, and the entire team at Good Samaritan Hospital.

“The fact that I’m breathing…I owe it to them,” he said.