Giving birth is not exactly considered a stress-free experience, even under normal circumstances. But if the woman in labor suffers an aortic dissection during childbirth, then her experience suddenly becomes downright terrifying – and life-threatening. Recently, local resident Meredith Ford O’Neal had an aortic dissection and underwent two emergency surgeries at Texas Health Presbyterian Hospital Dallas, where physicians saved her and her newborn baby, Geoffrey!
“I couldn’t think of another operation where it was possible for two people to die, and that weighed heavily on me,” said Dr. Mark Pool, a cardiothoracic surgeon on the medical staff at Texas Health Dallas, in a recent press release. “I just did what I know how to do, and others in the operating room did what they knew how to do. And thanks to God’s grace, mom and baby survived.”
In his daily work, Pool performs some of the most complicated and high-risk heart operations in North Texas; however, he usually just works to save one life at a time. He explained that it is rare for a pregnant woman to suffer an aortic dissection – which is when the inner layer of the blood vessel tears, causing the inner and middle layers of the aorta to separate; if the blood vessel ruptures, it can lead to death.
According to findings from a 2015 study published in the Journal of the American College of Cardiology, http://www.onlinejacc.org/content/65/15/1600during the 10-year period between 1998 and 2008, there were more than 10 million pregnancies and 41,000 aortic dissections recorded in the Nationwide Inpatient Sample database. However, there were only 44 individual cases of aortic dissections during pregnancy. In addition, The National Institutes of Health estimates almost 10,000 people in the U.S. have an aortic dissection each year. If left untreated, more than 30 percent of patients die within the first 24 hours, while 50 percent die within 48 hours.
“It’s been like the big, bad wolf in my family for a long time,” said O’Neal in the press release, as she is the fifth person in four generations of family to be affected by aortic dissections. She added that her mother survived a dissection, her great aunt died of complications after a dissection and two of her family members have died from dissections. Before falling asleep from anesthesia in the operating room, Pool and O’Neal were able to meet for the first time. In the release, Pool said, “I told her we would do everything we could to save her and Geoffrey, and then I said a prayer with her.”
O’Neal had Type A dissection: the most serious kind. It starts in the ascending aorta, which carries blood up from the left ventricle to the upper chest, arms and head. Her dissection further tore into the aortic arch and along the layers of the aorta that curved down into her abdomen.
She was about 37 weeks pregnant when a searing pain in her chest woke her up at 4 a.m. on Aug. 30, 2018. She got up to move around and her right leg went numb. Her and her husband, Kyle, went to Texas Health Plano. Labor and Delivery charge nurse Susan Neal noticed there was something wrong, and she alerted O’Neal’s OB-GYN, Dr. Christina Woods. From there, the O’Neals took a CareFlite helicopter to Texas Health Dallas, where Pool was alerted.
First, Dr. Jennifer Muller, the on-call obstetrician at Texas Health Dallas, delivered O’Neal’s baby via emergency C-section; then, Pool started his work to save her life. During the aortic repair, O’Neal’s heart was intentionally stopped, as the heart must be at rest for a surgeon to replace the aorta, which carries blood pumped from the left ventricle throughout the body. Then, O’Neal was placed on a mechanical heart and lung machine. Pool opened O’Neal’s chest through an incision, where he cut out the torn aorta near her heart and replaced the damaged portion with a synthetic tubing – a process which took approximately four hours.
“Meredith is the fifth person in four generations of our family afflicted by an aortic dissection, so our family knew better than most the risks involved with this condition,” stated Dr. Richard Vigness, a cardiothoracic surgeon at Texas Health Fort Worth who is also O’Neal’s uncle, in the press release. “When we learned of Meredith’s critical event, we were devasted, upset and apprehensive.”
Vigness was thankful for the quick reactions by caregivers at Texas Health Plano and Texas Health Dallas to diagnose O’Neal’s condition, and to the dozens of caregivers who jumped into save her and her baby. “Without that devotion and well-orchestrated care, Meredith and Geoffrey could have very easily died,” said Vigness in the release. “Instead, both are doing great, and for that, our family is forever grateful.”
Congratulations to the team at Texas Health Dallas and Texas Health Plano who worked quickly and expertly to save Meredith and Geoffrey’s lives! We are grateful to have such passionate and talented caregivers in our community.