Rapid Intervention for Patients With Deadly Aortic Emergencies

Northwestern Medicine
Cardiology February 02, 2022
Crystal Lake resident Jeff Beck, 53, was walking on a treadmill when he suddenly felt a tightness in his chest and altered vision. His girlfriend insisted he go to the Emergency Department at Northwestern Medicine McHenry Hospital. Within hours, Beck was in an operating room 50 miles away at Northwestern Memorial Hospital in Chicago for emergency surgery.

Beck had an acute aortic dissection, a potentially catastrophic tear in the largest artery of the body. Upon diagnosis, McHenry Hospital Emergency Medicine Physician Olga K. Sarnov, MD, activated the Northwestern Medicine Code Aorta Program. This rapid transfer program provides a streamlined pathway for patients diagnosed with aortic emergencies at hospitals across Chicagoland to go directly into the operating room at Northwestern Memorial Hospital.

“By bringing patients directly to the operating room, we are able to provide life-saving surgery almost two hours faster than the traditional approach of bringing patients to the ICU first. The mortality rate of a type A aortic dissection increases 1% to 2% every hour, so every second counts,” said Christopher K. Mehta, MD, director of the Code Aorta Program and a cardiac surgeon at Northwestern Medicine Bluhm Cardiovascular Institute.

The Code Aorta Program offers a multidisciplinary team approach. Local emergency departments can contact a referral hotline where physicians connect with Northwestern Medicine cardiac and vascular surgeons within minutes. The physicians review imaging and test results in real time to determine if the patient needs to go directly to the operating room. If emergency surgical care is required, the operating room team is activated, and the patient is transferred.

In Mr. Beck’s case, the tear was in the lining of the ascending aorta and aortic arch. Blood was pooling between the layers of the wall creating an aneurysm, or bulge, that could rupture. Dr. Mehta surgically removed the damaged aorta and replaced it with a synthetic graft, a strong and flexible tube that promotes regular blood flow.
Beck was up and walking the next day and discharged from the hospital five days later. Within a month of his surgery, he was feeling well enough to travel to Baltimore for his daughter’s college graduation.

“I am so fortunate to be surrounded by an incredible medical community,” said Beck. “I’m keeping an eye on my blood pressure, watching my salt intake and continuing to exercise. My life is pretty much back to normal.”

Northwestern Medicine Bluhm Cardiovascular Institute launched the Code Aorta Program in January 2020, and Northwestern Memorial Hospital now repairs more aortic dissections than any other hospital in Illinois. Aortic emergency volume has increased 53% since the launch of the program.

“Our Code Aorta Program delivers swift and comprehensive care to patients in the region who suffer from these catastrophes,” said S. Chris Malaisrie, MD, director of thoracic aortic surgery at Northwestern Memorial Hospital. “The Code Aorta Program is a key facet in our specialized aortic center, which offers expert medical care, novel imaging modalities, and complex surgical and endovascular procedures for patients living with aortic disease.”

Acute aortic dissections involve the ascending aorta in approximately two-thirds of patients. Chest pain is the most common symptom, but patients may also feel other symptoms, including back pain, abdominal pain or neurological stroke-like symptoms. Beck encourages others to pay attention when something feels off about your health.

“I realized how short life can be,” said Beck. “Typically, I’m the guy who doesn’t go to the hospital. Had I not gone to the hospital or not listened to the doctor who wanted to run one last test, I could have died in my sleep. Take care of yourself and listen to your body.”
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