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Time was critical for new mother’s heart surgery

Aug. 9, 2012, 10:35 AM

Samantha Neal, here with her husband, Corey, had surgery at Vanderbilt to repair a tear in her aorta. (photo by John Russell)

Two weeks after giving birth to her second child on July 10, 31-year-old Samantha Neal began to experience chest pain. Initially diagnosed with a gall bladder issue in her local ER, her true diagnosis would prove much more serious and potentially life-threatening.

Neal lives in Golconda, Ill., a small town nearly three hours from Nashville. When she went in for a follow-up appointment with her physician a week later, he sent her to a larger hospital nearby, where she underwent an echocardiogram that indicated Neal had an aortic dissection, a partial tear of the major artery carrying blood out of the heart.

A small tear can become larger and can lead to bleeding into and along the wall of the aorta. Actor John Ritter died after experiencing an aortic dissection.

“They got a little scared there at that little hospital,” said Neal, who is a registered nurse. “I knew it was serious. I wasn’t expecting that; I was expecting to have my gall bladder taken out.”

Neal was transported to Vanderbilt via LifeFlight, and she was taken directly from the helipad to the operating room. John Byrne, M.D., chair of the Department of Cardiac Surgery, repaired the torn aorta in a five-hour procedure. During the surgery, Neal’s body was cooled to 18 degrees Celsius (about 60 degrees Fahrenheit) because the surgical team must stop all circulation to the body – including the brain – for about 30 minutes in order to safely repair the torn aorta.

Patients with aortic dissections such as Neal’s require immediate surgery because few patients survive without repair. About half of all such patients die within 24 hours if untreated, according to Byrne.

“She’s pretty lucky,” Byrne said. “We never know for sure, but perhaps a day or two may have been all she had before a fatal complication.”

Family members brought her baby in to visit Neal during her six-day stay at Vanderbilt. She was discharged on Aug. 3.

“The care I’ve gotten here is 100 percent amazing, from the surgeon to the care partners. The nurses are extremely smart and caring,” she said.

Neal has been referred to Vanderbilt’s Inherited Heart Disease clinic for follow up as it is possible her aortic dissection was caused by genetic factors that may impact her children and other members of her family.

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