While working at home one day four years ago, Paul Sugg felt a ripping tear through his chest.
"I fell flat on my face and broke into a cold sweat," he says. "It seemed like a heart attack so I called for help."
That was August 2005. After initial treatment in Des Moines, he was flown by emergency helicopter to University of Iowa Hospitals and Clinic in Iowa City.
Sugg had suffered an acute aortic dissection of the descending thoracic aorta (a portion of the aorta running into the back of the chest)—a life-threatening splitting (dissection) of the inner layer of the aorta's artery wall. The dissection caused an enlargement of the aorta to about 1.5 inches, twice the normal.
Treatment of this type of dissection can be medical or, based on circumstance, surgical.
Fortunately, Sugg avoided surgery during a 10-day hospital stay. He was extensively evaluated in the UI Heart and Vascular Center and prescribed powerful heart medications that lowered his blood pressure and heart rate.
Following a period of recuperation, he left the country to do economic development work in Uganda, returning to Des Moines in 2008.
During a follow-up clinic visit to UI Hospitals and Clinics, Sugg learned that his dissected aorta had doubled in size to over three inches, making emergency surgery unavoidable.
Sugg was referred back to the UI Heart and Vascular Center, where his care was managed by Domenico Calcaterra, MD, director of the aortic surgery program. Calcaterra performed the repair—a thoraco-abdominal aortic aneurysm repair with graft replacement—on Nov. 10, 2008.
The complex procedure went well. After a long hospitalization, Sugg was discharged for rehabilitation.
Unforunatley, his problems with aortic dissection were only beginning. Three days later, he returned to UI Hospitals and Clinics with shortness of breath.
A new CT scan revealed a second aortic dissection, this time of his ascending aorta (the portion of the aorta coming off the heart and running behind the sternum). This type of dissection always requires emergency surgery because the risk of death within 48 hours is extremely high.
It was an unusual occurrence and a difficult challenge, but Calcaterra was again called upon to perform a high-risk aortic repair.
The outcome couldn't have been better. Sugg survived the ordeal and was discharged to an acute rehabilitation facility where he is still undergoing physical, occupational and speech therapy.
He continues to recover at home.
"I've lost over 50 pounds since November and my voice isn't the best," he says in a raspy voice. "But I feel a lot better. I guess you could say I'm a miracle survivor who owes everything to my doctors and to my faith. I'm very grateful!"
For more information about UI Heart and Vascular Care:
Aortic dissection 101
What happens?
When the aortic wall splits, blood gets inside the artery wall and under the inner layer, which can make the aorta split further. This tear usually continues down the descending aorta (away from the heart) and into its major branches.
Who is vulnerable?
- Men more than women
- People in their 50s, 60s, and 70s
Predisposing factors
- High blood pressure
- Aortic dilation
- Aortic aneurysm
- Congenital aortic valve abnormalities
- Coarctation of the aorta
- Marfan syndrome
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