Vascular surgeon successfully bypasses torn aorta

Apr 29 2010

Rhonda Mullen was 38 years old and in perfect health when she suddenly felt a searing pain between her shoulder blades.

A few hours later, Mullen was being wheeled into an operating room at Loyola University Hospital for emergency surgery to repair an unusual tear in her aorta, the body's main blood vessel.

There was a good chance she would not survive the surgery. And even if she did live, she could lose both legs at the hips.

But during a four-hour surgery, vascular surgeon Dr. Ross Milner successfully bypassed Mullen's torn aorta with a Gore-Tex® tube that is about 3 inches wide and 2.5 feet long. The tube runs under her skin from her shoulder to her legs. Blood that used to flow through the aorta now flows through the Gore-Tex tube, which is expected to last her lifetime.

Mullen spent 27 days in the hospital, gradually recovering the use of her legs that had been damaged from inadequate blood supply. She has continued to undergo rehab since returning to her Downers Grove home on March 18.

About two weeks after surgery, Mullen was able to walk again with the aid of a walker and a therapist at her side. She graduated to two crutches, then one crutch. Today, she walks around the house without a crutch, although she still needs one on outings. "I'm getting better every day," she said.

Mullen suffered what is called an aortic dissection. The aorta carries blood from the heart to the rest of the body, and extends from the chest to the lower abdomen. In a dissection, a tear develops in the inner layer. Blood pushes through, causing the inner and middle layers of the aorta to separate (dissect). In Mullen's case, the tear ran the entire length of the aorta, impairing blow flow to her legs.

While aortic dissections can happen to anyone, they typically occur in men in their 60s. Mullen had none of the risk factors, including high blood pressure, hardening of the arteries, family history, smoking or heart disease.

"We don't know why it happened," Milner said.

It began around 10 a.m. Saturday, Feb. 20. Mullen, a personal banker, was at work talking to a customer at her office in Western Springs. Her husband Glenn was at home with their 7-year-old son and 5-year-old daughter.

The pain hit so hard she could not catch her breath. She drove herself to the local hospital emergency room. Glenn left the kids with their grandmother and came to her side.

By the time she arrived at the hospital, Mullen couldn't move her legs -- she needed a wheelchair to get from her car to the emergency room. But even though she couldn't move her legs, they still hurt terribly. She also had tremendous pain in her lower back. "I just wanted to curl up in a ball," she said.

After a CT scan, doctors diagnosed an aortic dissection and transferred Mullen to Loyola. Milner, who was on call, cancelled dinner plans and rushed to the hospital. The operation was a muldisciplinary effort. Cardiologist Dr. Charlotte Bai performed a transesophageal echocardiogram, and cardiothoracic surgeons Dr. Jeffrey Schwartz and Dr. Christopher Wigfield assisted on the case.

It would be a risky surgery, but there was no alternative. Milner told Glenn his wife might not live.

"It was the longest night of my life," Glenn said.

Two months after the surgery, Rhonda Mullen continues to get better every day. She still lacks control of her right ankle and has to wear a boot, but her ankle is improving. She's looking forward to activities such as camping with the kids and walking around the Morton Arboretum.

"I'm thankful for everything and everyone, and for Dr. Milner for saving my life," she said. "I'm grateful I get to have another day with my family."

SOURCE Loyola University Hospital