Personal Stories: Shawn Gallagher
In 2005, I was a healthy 51 year old male. Just
under 6 feet tall weighing in at around 225 pounds. I had never
smoked, drink moderately (most of the time), and exercised 3-5 times a
week running 4-5 miles in 45-60 minutes. I had retired from the Army
in 1997 and was working with another federal agency in the Hampton
Roads area of Virginia.
At about 3:00 AM on October 5, 2005, I awoke with
a very sharp pain in the middle of my chest. I stood up and had no
relief from the pain so asked my wife to call 911. Within 30 minutes,
I was at the emergency room at Riverside Hospital in Newport News,
VA. Because my blood pressure was so low, they did not administer any
medication for heart attack. About 9:30 AM they performed a heart
catheterization and as they were running the catheter up the aorta
they found they were going in and out of false lumens. Luckily, the
hospital has a team that trains for aortic dissections and they began
operating around 11:00 AM.
I came out of surgery around 6 or 7 PM, after
they had repaired the aortic arch, installing a small (2 cm) Dacron
graft. While I had no heart disease, one of the arteries feeding the
heart was so dissected I also received a single bypass before they
could restart my heart. It took me about three months to recover and
return to work, and like many others have noted, I was unable to find
much information on what kind of life I could expect with this
dissection. As a retired military service member I received my
follow-on cardiology work at Portsmouth Naval Hospital. The staff
there was excellent and very helpful. The follow-on MRIs and CAT
scans showed that my aortic dissection is from the carotids to the
iliac arteries, so both the ascending and descending aorta is
dissected. Additionally, some of the false lumens carried the
majority of the blood flow. Another factor was that my aortic valve
was leaking because of the dissection and it was not clear how long it
would be, if ever, that additional steps would have to be taken.
Throughout 2006 and into March 2007, I rebuilt my strength walking my
neighborhood with some light jogging around the cul de sacs.
In March 2007, the cardiologists informed me that
I was heading for heart failure because of the leaking aortic valve.
They said the aortic chamber of the heart was enlarging very minimally
every 3 months, but that it was steady over the preceding 14 months,
so much so that my mitral valve had also begun leaking. They referred
me to the surgeon at the hospital and he recommended that I have
aortic valve replacement surgery in April or May.
At this point, I began doing some investigation
and found that the hospital where they proposed to do the surgery did
roughly 350 valve replacements a year with a very low mortality rate.
However, no one could tell me how many of those operations were on
people whose chests had already been cracked by earlier heart
surgery. Consequently, I researched the issue and found that
Cleveland Clinic performed in excess of 2,000 valve replacements a
year and over 600 of those were on patients who had undergone earlier
heart surgery. Thankfully, I was able to convince Portsmouth Naval
Hospital and my primary medical facility to refer me to Cleveland
Clinic for assessment and surgery.
In May 2007, my wife and I went to Cleveland
Clinic for evaluation for aortic valve replacement surgery. The
cardiologists and surgeon were wonderful. After a battery of tests
they agreed I needed the aortic valve replaced, but also recommended I
undergo an elephant trunk procedure. This procedure is two
surgeries. The first surgery combines the aortic valve replacement
with the replacement of much of the ascending aorta and aortic arch
with a Dacron graft. It also leaves a portion of the graft to be
extended in the second surgery to replace a portion of the descending
aorta. When I asked why the descending aorta needed replacement the
surgeon told me a portion of my descending aorta was distended to
roughly twice the normal diameter for my height and weight (6í and 225
lbs). That certainly sounded to me like a serious aneurysm waiting to
I had the first surgery performed on July 9,
2007, and it was a long surgery. The aortic valve replacement was
very successful and the placement of the graft went well. However, my
recovery was quite difficult with an extended stay in ICU. However,
we were out of the hospital on July 21, 2007. Over the following
three months, I recovered and went to cardiac rehabilitation so that I
was able to have the second stage of the elephant trunk procedure done
on October 27, 2007. This procedure required the removal of a rib and
the deflation of a lung so the surgeons could remove about 5 CM of the
descending aorta and replace it with the pre-positioned graft material
coming down form the aortic arch.
This was followed by a short ICU stay and a
couple of weeks in the hospital, returning home November 15th.
I did not have any gout after the second surgery, as I had after the
original surgery in 2005 and in July 2007. Additionally, periods of
weakness in my legs after standing, which were prevalent after the
July 2007 surgery, disappeared. Both these observations by me
confirmed the surgical teamís observation that when they removed the
clamps after the graft was completed they noticed a marked improvement
in the perfusion of blood to my legs.
I returned to cardiac rehabilitation in December
2007 and was able to return to work part time in January 2008. I am
currently back to work full time. I am able to walk 4-5 miles without
undue effort. In addition, I have begun alternating jogging and
walking so that over 20-30 minutes I walk, jog, walk, at 2-3 minute
stretches over the entire 20-30 minutes.
My first cardiology appointment after the valve
replacement showed some recovery in heart size, I am scheduled for
follow-on echocardiograms, and CAT scans in the next two to three
Medications are relatively minimal, blood
thinning for the mechanical aortic valve, blood pressure medications
for obvious reasons, and cholesterol and triglyceride medications.
My surgeon told me that I can lift and carry up
to 50 lbs, run, do light weights, swim, bike and do light yard and
house work. As long as I keep it under 50 lbs and donít do any
straining I can resume a fairly normal life. So far Iíve been able to
return to work, drive, do light yard work and house work, use my
chainsaw, and exercise 3-4 times a week.
There have been a few downsides beside the trials
and tribulations of two major surgeries. These include:
- Some loss of feeling in my right arm on the
underside of the forearm (probably arising from the incision on the
upper right part of my chest so blood could be circulated bypassing
my aorta and heart).
- Some loss of feeling in my left breast and
around the incision on my left side (where the second part of the
elephant trunk surgery occurred).
- Loss of the left testicle due to loss of blood
flow (either due to the descending aortic repair or the multiple
incisions in the groin so blood could be circulated bypassing my
aorta and heart).
- The original surgery in 2005 resulted in some
memory loss Ė mainly associating names and faces (never a strong
suit of mine) and some short-term memory retention issues that have
been manageable with judicious note taking.
The upsides have been:
- Over two years of quality time with my
- A sure fire way to cut short insurance sales
- A slightly more enhanced desire to not put off
things until tomorrow (luckily I always felt that was not a good
plan for living a happy, full life and was pretty good about
implementing that attitude.)
- Meeting excellent and dedicated medical
personnel who have positively impacted the lives of my family and
I have nothing but praise for the surgical team
at Riverside Hospital, who did my 2005 surgery and the staff at the
emergency room who have seen me through several visits as we all
adjusted to living with a dissection. Without their outstanding
training and efforts, I would not be here today.
I also have been very fortunate to be attended to
by one of the finest cardiology clinics I have seen. The
cardiologists and staff at Portsmouth Naval Hospital have diligently
followed my progress, worked with me to avoid my being a cardiac
cripple, and made a timely diagnosis of my need for the aortic valve
Finally, I cannot tell you how much I appreciated
the surgical staff at Cleveland Clinic who performed the aortic valve
replacement and elephant trunk surgeries. They did a wonderful job
that I am very thankful for receiving. Also, the nursing staff at
Cleveland Clinic were excellent in their care of both me and my
family. In my opinion, Cleveland Clinic deserves its long-standing
rating by U.S. News & World Report as the number one heart hospital in
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