Emory Heart & Vascular

Emory Aortic Experts Coordinate Care Across Three Hospitals to Treat Acute Aortic Dissections 

Acute Type A Aortic Dissection is a rare but highly lethal condition that occurs in 3-6/100,000 people annually. It carries a 1%/hour mortality rate following diagnosis. Once this deadly condition is diagnosed, time is of the essence and emergent surgical repair provides life-saving therapy. It is well known that patients with acute Type A dissection have improved survival when they undergo surgical repair in high-volume aortic programs with surgeons who are experienced in treating patients with aortic dissection.

Recently, two patients in Atlanta, GA, and one patient in Columbus, GA were diagnosed with an Acute Type A Aortic Dissection. On that day, Brent Keeling, MD, was on call for the Emory Aortic Dissection Team. The Emory Aortic Program has a dedicated team of three highly experienced cardiac surgeons, along with several vascular surgeons, located at Emory University Hospital, Emory University Hospital Midtown, and Emory Saint Joseph’s Hospital with expertise in treating patients with acute Type A Aortic Dissection.

After Dr. Keeling received the phone call from the Emory Transfer Center regarding the first patient with a Type A dissection, he made plans to perform surgery at Emory University Hospital Midtown. He subsequently received phone calls regarding the other two patients with Type A dissections. As Emory is the only health system in metropolitan Atlanta that performs cardiac surgery at three different sites, Dr. Keeling was able to immediately activate the other two Emory Aortic Program cardiac surgeons and accommodate all three patients without a delay in treatment.

Brent Keeling, MD

Patient 1: A 73-year-old male who had been experiencing chest pain and dizziness at home. His family brought him into the Emory Hillandale Hospital Emergency Room to be evaluated. A Head CT was performed to rule out stroke which was negative. As the patient became more lucid, he began to complain of chest pain and a CT angiogram of the chest confirmed the diagnosis of acute Type A Aortic Dissection with cerebral malperfusion. The patient underwent emergent surgical repair at Emory University Hospital Midtown by Brent Keeling, MD, and was discharged home neurologically intact.

Woodrow Farrington, MD

Patient 2: A 47-year-old male who had been having three days of worsening back pain, suddenly developed an acute onset of crushing chest pain and went to an emergency room in Columbus, GA. He underwent a CT angiogram of the chest and was diagnosed with an Acute Type A Aortic Dissection. He was flown by helicopter to Emory Saint Joseph’s Hospital where he underwent emergent surgical repair by Woodrow Farrington, MD. The patient did well and was discharged home neurologically intact.

Bradley Leshnower, MD

Patient 3: A 53-year-old male drove to work with his son in their truck. Upon arrival at work, the son witnessed his father lose consciousness and his head roll back. When he regained consciousness, he was confused and the son called 911. The patient was initially taken to Grady Memorial Hospital for a stroke, but he was subsequently diagnosed by a CT angiogram of the chest with an acute Type A Aortic Dissection with cerebral, renal, and iliofemoral malperfusion. He underwent emergent surgical repair at Emory University Hospital by Brad Leshnower, MD, and was discharged home neurologically intact.

Emory’s Aortic Program Capabilities and Culture of Collaboration 

The Emory Aortic Program is multidisciplinary consisting of cardiac and vascular surgeons, adult and pediatric cardiologists, radiologists, geneticists, and nurse practitioners. Patients with aortic disease are treated at five different hospitals within Emory Healthcare and we perform >700 open and endovascular aortic procedures annually. Emory Aortic surgeons operate on 75 patients with Acute Type A Aortic Dissection and 60 Acute and Chronic Type B Aortic Dissections annually. Our program is currently enrolling in clinical trials for novel endovascular devices specifically designed to treat patients with aortic dissection.

This case highlights Emory’s Aortic expertise with a multidisciplinary team effort among cardiac surgery, vascular surgery, cardiology, and radiology that is critical for achieving optimal outcomes for all aspects of aortic surgery, whether endovascular or open, with the unique ability to perform complex operations in elective or emergent settings across a broad spectrum of patients.

Additionally, it demonstrates Emory’s unique ability to treat multiple patients with a simultaneous need for emergent cardiac surgery by having Emory Aortic experts available at three different Emory Healthcare hospitals in the Atlanta metro. This requires extensive collaboration with multiple operational teams involving administrative coordination, equipment availability, and well-trained staff.

To make a referral or consult with one of our Emory Aortic specialists, call our physician referral line at 404-778-5050.

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