Name: Zach Swafford
Age at time of Dissection: 23
Type of Dissection: Descending
Date of Aortic Dissection: 18 December 2011
Tell Us Your Story:

My story was not like most on this site that I’ve read because my injury was not dissection but a torn aorta as a result of a car accident. Though the onset of the condition was different the treatment for the my aortic tear was the same, a bypass. However, through a series of very lucky and timely coincidences I was saved by a groundbreaking procedure, an aortic stent.

Before I start this story I should say that I don’t remember anything about my accident. During severe trauma the body begins pumping so much adrenaline that your brain loses it’s ability to form memory. In many ways I’m glad I don’t remember it.

I had just graduated from the University of Idaho and was traveling home to Reno, NV with my car packed to the brim. I reached a stretch of road that receives no sunlight in the winter as the road enters a canyon. Unknown to me, rain from 2 days before had formed black ice on the road. I lost control, went sideways and was struck by an oncoming car on the driver’s side. I was knocked unconscious. When I came to a short time later I was pinned in my car. I was complaining of severe chest pain.

My aorta had almost entirely torn. Of the aorta’s 4 layers, the 3 inside had torn and the fourth had partially torn. I was losing blood fast. The accident had happened a couple miles south of a small town in Idaho called Cambridge and there was no cell phone reception. Luckily a truck driver came along only a minute later, radioed out to another driver who called 911. The accident occurred at 11:45am…the volunteer ambulance out of Cambridge was dispatched at 11:46. When the paramedics got there they had to use the jaws of life to get me out of the car. That took around 10 or 15 minutes because the drivers side of my car was so crushed in. Once they got it open, they got me on a back brace and headed south with me to meet the professional paramedic crew who was heading north out of Weiser to meet them.

When the ambulance met they stopped on the side of the road, the professional paramedics jumped into the other ambulance and tried to get an IV going. I was in such a severe state of shock at this point that it was nearly impossible. I was fading in and out of consciousness but I was talking. Apparently I kept cracking jokes (I really need to find a less dark sense of humor). The paramedic said that it was the toughest stick he’s had to do in the 25 years he’s been doing it but they eventually got 2 going, one in each arm and they began squeezing fluids into me. Once they got those going they headed to Midvale Airport to meet the Lifeflight helicopter that was coming in to get me.

By the time the helo landed they had pushed 5 units of fluid (5 liters) in 25 minutes. They had thought about hanging a sixth bag but were worried it would dilute my blood so much I wouldn’t be able to carry oxygen. When they got me on the helicopter the paramedics thought I wouldn’t even ma
ke it to the hospital in Boise.

The trip on the helicopter is a mystery. I don’t know if they did anything else to stabilize me or if that didn’t happen until the hospital because I survived a couple more hours until my surgery. When I got to the hospital they gave me a CT scan and determined I had a ruptured aorta. This is where I become extremely lucky. Dr. Christopher Alessi.

As most of you know the standard procedure for repairing the aorta is open heart surgery. The risk level of that surgery is high when it’s planned and in the best circumstances. The survival rate for that surgery for a person in my state was less than 10%. However, Dr. Alessi had pioneered a procedure for repairing an aortic tear with an aortic stent. The imaging was sent to Dr. Alessi at his home in Boise and he said he could repair the damage and headed to the hospital. They had me ready when he arrived.

The procedure involved cutting into the top of my left leg to access my femoral artery where they slipped the stent in. They moved the stent up the femoral artery and all the way up my aorta until it reached the damaged area. The problem was that my tear had knocked my aorta out of the alignment and the stent couldn’t slide through so they had to wrench my body around on the table to get the damaged ends of my aorta to line up. Finally the stent slid into the damaged area and was deployed by inflating a balloon. After the stent was deployed I began to stabilize. The procedure took a little more than a half an hour.

I woke up a day later, intibated and unable to see in the ICU. I couldn’t remember anything so naturally I was a bit confused. By this time my parents had made the trip up to Boise and were there to explain what happened. My dad’s side of the family all lives in Boise so I had tremendous family support for my recovery.

I later found out that this procedure has only been done for 2 years. Dr. Alessi pioneered the procedure and I was in 1 of the 3 places in the country (Seattle, Atlanta, and Boise) that I could receive this procedure. Dr. Alessi estimated that I’m around the 20th person in the world to have this done.

I sustained a number of other injuries in the accident. Fractures in every rib on my left side and a couple on my right, lacerated spleen and liver, non-displaced fractures in my pelvis, non-displaced fractures in my L3 and L4 vertebra and a partially collapsed lung. I had a chest tube put in to drain all the blood that I had lost internally. The first few days I was putting out nearly 4000ccs of fluid a day but that tailed off quickly and I was released from the hospital 8 days later. I spent a couple weeks with family and my amazing girlfriend who flew in to see me in Boise. Then I headed home. I’ve been here in Reno healing for a few weeks now and I expect a full recovery soon.

I’ve had a lot of time to think about the accident and how lucky I am. It’s been a weird thing to think about. In fact, in many ways I still haven’t really come to terms with it. Had it happened a couple years earlier, a few miles more remote, if the car had hit mine farther forward, if I wasn’t as calm as I was after the accident, if I wasn’t near Boise, if Dr. Alessi hadn’t have been there…all those things run through my head constantly. I just remind myself to be thankful for the new lot on life that I have and make the most of it. I have a supportive family and an amazing and loving girlfriend. I am lucky in so many more ways than just the accident and it’s helped me see that. I won’t waste it.

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