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Aortic Dissection Repair Gives Utah Woman Second Chance at Life

 In July 2022, Allie Cochran will celebrate a special anniversary. Two years ago, on July 18, 2020, 52-year-old Cochran was rushed to the hospital. She ended up having emergency surgery that saved her life.

When Cochran began experiencing severe chest and abdominal pain, her husband took her to a nearby hospital—just six blocks away from their home in Orem. After an initial assessment, doctors discovered Cochran had suffered an acute aortic dissection, likely related to a thoracic aortic aneurysm.

Cochran was quickly transferred to University of Utah Hospital in Salt Lake City for emergency surgery.

The aorta is the largest artery in the body. Its job is to carry blood from the heart to the rest of the body. When the aorta grows larger than it should be, it is called an aneurysm. This increases a person's risk for aortic dissection, when there is a small tear on the inner lining of the aorta. The blood then gets into the layers of the aortic wall, destabilizing the entire structure.

Although fairly common, aortic dissection is an extremely dangerous, scary, and life-threatening emergency. Left untreated, it can be fatal.

Craig H. Selzman, MD, chief of the Division of Cardiothoracic Surgery at the Spencer Fox Eccles School of Medicine, performed Cochran's emergency surgery when she first arrived at University Hospital. "I was in surgery for many hours," she said. "I was also unconscious for a few days. I went into the hospital on Saturday and didn't wake up until the following Thursday."

Cochran had two strokes after coming out of surgery. "I remember Dr. Selzman telling me I was a real fighter," she said. "I was just trying to grasp all that had happened. He and his team totally saved my life."

Cochran's aneurysm and eventual aortic dissection were likely related to high blood pressure and stress, which are very common risk factors. After the initial emergency surgery, Cochran was in the cardiac unit at University Hospital for two weeks.

"Everybody took such great care of me," she said. "The nurses and ICU staff had to do everything for me, and I'm just so grateful to them. They gave me hope, and that's my main thing: there's hope."

Cochran was then transferred to the Craig H. Neilsen Rehabilitation Hospital, where she learned how to walk again.

"The stroke weakened my left leg—it was numb from the stroke," Cochran said. "But my therapists at the rehab hospital got me walking again. I'm still working on getting back my endurance and flexibility."

Cochran also had decreased mobility in her left hand but has since regained control and full range of motion in her fingers.

Jason Glotzbach, MD, co-director of the Aortic Disease Program at University of Utah Health, took on Cochran as a patient as she recovered from her first surgery.

"After Allie's initial emergency operation, Dr. Selzman transferred her care over to the Aortic Disease Program so we could coordinate the chronic management of her aortic health," Glotzbach said. "The chronic phase of aortic dissection is a little bit different than the emergency phase."

Over time, Glotzbach noticed more signs of weakness and aneurysm in Cochran's aortic wall—a sign that further surgical intervention was needed to stabilize the aortic wall. Because Cochran is young and otherwise healthy, Glotzbach was able to perform a thoracic endovascular aortic repair (TEVAR).

"The first surgery Allie had was a very invasive procedure," Glotzbach said. "Thankfully, the TEVAR procedure is much less invasive." In May 2021, Cochran went in for her second surgery—the TEVAR procedure.

Using small incisions made in the groin, the aortic surgery team, led by Dr. Glotzbach and Mark R. Sarfati, MD, used a live X-ray to guide the placement of the stent grafts (a small fabric tube, reinforced by metal stents) in Cochran's aorta. This procedure stabilizes the area of the chronic aortic dissection and eliminates the aneurysm. Depending upon the severity of the aneurysm and/or dissection, multiple surgeries may be needed to fully repair the damaged area of the aorta.

"Each section of the aorta that we stabilize with a stent graft or surgical graft improves the overall health of the aorta," Glotzbach said. "But we have to continue to watch the entire artery to make sure there aren't problems in other areas. Each patient is unique, and we tailor the treatment plan to each person's anatomy."

Both of Cochran's surgeries were successful, thanks to the Aortic Disease Program and its multidisciplinary team of providers.

"Our multidisciplinary approach to aortic disease is something that sets us apart," Glotzbach said. "Many institutions don't have a strong relationship across different medical teams. Members of the Aortic Disease Program meet monthly to discuss patients and care plans. We work closely to coordinate the best possible care for each patient, and it's proven to be quite effective."

Cochran's outcome is no exception.

"I just feel so blessed to have this time," Cochran said. "I'm able to garden. I'm able to babysit and play with my little grandbabies. That is life right there."

Like Cochran, most patients with chronic aortic disease do very well and are able to return to most if not all of their former activities. Being diligent about activity restrictions and blood pressure management are two of the most important things that can help ensure success, post-surgery.

Cochran looks forward to living a full life for many years to come.

"I feel so secure knowing that I have such an excellent team keeping an eye on me," Cochran said. "To me, the surgeons are the hands of God because they saved my life. I'm so grateful to have this time."