Right Time, Right Place: College Junior Survives Dangerous Aortic Dissection

Last October, high school track star and marathon runner Michael Spinelli was a healthy, busy junior at The Catholic University of America.

On Halloween, the then-20-year-old awoke from a sound sleep with piercing pain in his chest, a tight jaw, and pain down his arm. Minutes later an ambulance was transporting him to a nearby hospital. He was released after a few hours, armed with pain medication and anti-inflammatories. His chest discomfort was attributed to bronchitis. 

ezequiel-molina
Ezequiel Molina, MD

Days later and in pain again, Michael returned to the hospital. A CT scan was performed, and an alarmed ER doctor had him transported immediately to MedStar Washington Hospital Center. 

There, Ezequiel Molina, MD, the cardiac surgeon on call, took one look at the CT images and realized Michael had a dangerous and deadly aortic dissection
that had ruptured.

“If he hadn’t arrived when he did, his condition would surely have been fatal,” says Dr. Molina. “With every hour past the onset of chest pain, the risk of death increases by 1 percent. In cases like Michael’s, 80 percent of patients die without emergency surgery.” 

Michael had the more common and very dangerous Type A aortic dissection. Blood had surged through a tear in the ascending aorta and aortic root, causing the two layers of the vessel to separate—the result of pressure on a long-undiagnosed aortic aneurysm. 

“When we opened his chest and the pericardium, we could see blood from the leaking dissected aorta had started to accumulate around his heart. A deadly full aortic rupture was imminent,” Dr. Molina adds.

Michael’s body temperature was cooled to 28 degrees Celsius to protect the brain, heart and visceral organs, and the heart-lung machine was stopped. “We replaced the portion of aorta closest to the aortic arch with a permanent fabric graft," Dr. Molina explains. "This was performed in just 14 minutes to reduce risk of stroke.” 

The medical team restarted the heart-lung machine support, and Michael rewarmed, while his aortic root was replaced with a mechanical valve attached to a fabric graft, his coronary arteries were re-implanted and the two grafts connected together. “In essence, Michael has a new aorta that will last forever,” Dr. Molina says. 

Michael was out the hospital in just five days. “And while he will have to be monitored routinely and take a blood thinner daily, he should lead a full life,” Dr. Molina says. 

 

Building a Future

Leading up to this summer's opening of the Nancy and Harold Zirkin Heart & Vascular Hospital at MedStar Washington Hospital Center, we will be sharing a series of stories that provide a glimpse into the lives of some of our heart and vascular patients, the care they received and what life has been like for them since being treated. Today, we visit with Alberto Gomez. 

Advanced Heart Failure Takes its Toll

Alberto Gomez is the owner of a Washington, D.C.-based construction company who has always enjoyed good health, and who has rarely spent much time with doctors aside from yearly physical examinations.

However, noticeable fatigue and discomfort led him to seek care at MedStar Washington Hospital Center. At the age of 66, Alberto was diagnosed with advanced heart failure. He was given the sobering news that his heart was functioning at an estimated 15%, and that he would need a heart transplant in order to survive.

“It was a very sobering experience to come from not having seen doctors in a long time to seeing them every day, to every 5 minutes, to every 15 minutes,” shares Alberto.

A Second Chance

After meeting with Dr. Ezequiel Molina, a cardiac surgeon at MedStar Washington Hospital Center, Alberto learned that he was a candidate for a new technology called Left Ventricular Assist Device or LVAD, a device that is implanted into the chest that supports the pumping function of the heart. This would be his lifeline until he was able to receive a heart transplant.

After receiving the LVAD, Mr. Gomez suffered complications, such as strokes, that left him with limited movement and speech impairments. Throughout this process, he received a lot of therapy and encouragement from his team at MedStar, “and the smiles,” says Alberto. “I tell a lot of jokes so I can laugh when people laugh, and I can enjoy them when they enjoy them.”

Alberto’s willingness to work in conjunction with the doctors, as well as the holistic approach to care that Alberto received from the team at MedStar, made a huge impact on his recovery process. He shares that, “the support one receives from the professional staff, the administrative staff, the nurses, and everyone around, they create the environment for recovering much faster than it would normally take.”

A New Heart

On November 9, 2014, Alberto received a call from Jessica Rice, a heart transplant coordinator at MedStar Washington Hospital Center, letting him know that a matching heart had been found.

On December 10, 2014, the same influential team at the Hospital Center that worked with Alberto to diagnose and treat his advanced heart failure with the LVAD device, helped implant his new heart. Continuing his care with the same team was paramount in his process. “They knew what was inside, they knew what they had to take out, and now they knew how they were going to transplant the new organ in,” says Alberto. “My doctors were not just my doctors. They were my friends, they became part of the family, they were my confidence.”

Back To The Business Of Life

Alberto is still growing accustomed to life with his new heart. His motto is, “it’s not a fast race, it’s a race of endurance. It’s not how fast I go, it’s how secure I get there.” He is much more careful with how he cares for his body, he is more aware of the movements he makes and is careful not to put too much strain on his muscles until he recovers his full strength.

Now, Alberto is back to running his construction business, Prince Construction, with a keener outlook on life.

Alberto wakes up each day with gratitude, “you appreciate now what used to be somebody else’s heart, and it’s a heart that you take care of and every day the first thing you do is thank God for being alive and pray for the donor and the family who were generous enough to allow their sibling to provide a heart for you to keep living.”

He wants others experiencing a weakened heart or coping with advanced heart failure to know that, “there is hope that there are ways to overcome it, and with faith and determination and with professional knowledge of the doctors you are in great shape to recover."

Have any questions?

We are here to help! Contact us for more information about advanced heart failure or to schedule an appointment. Call us at 855-546-1974.

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