TRAVIS AIR FORCE BASE, Calif. -- Evelyn Staley remembers very little about the condition that landed her in the David Grant USAF Medical Center emergency room at Travis Air Force Base, California, Dec. 15, 2017.
She doesn’t remember the ambulance ride from DGMC to the NorthBay Medical Center in Fairfield, California, where 60th Medical Group cardiothoracic surgeons Maj. (Dr.) Shea Pribyl and Lt. Col. (Dr.) Curtis Wozniazk performed emergency surgery.
But there is one thing Staley, age 70, said she will never forget: “My new bestest (sic) friends. They saved my life. ”
The wife of retired Chief Master Sgt. Ronald Staley, Evelyn beat the odds of most people who suffer an aortic dissection.
“About 20 percent of patients die before reaching the hospital,” said Pribyl.
Additionally, the condition can mimic other heart problems, which wastes precious time.
“For every hour the patient goes untreated, their chances of death increases 1 to 3 percent,” said Pribyl. “Even with treatment and surgery, the mortality rate is about 30 percent.”
Staley remembers being placed in the ambulance headed for Travis AFB, which is just minutes from her home, but nothing else until she woke up at NorthBay following surgery.
“I thought I was dying,” said Staley.
Staley suffered an aortic dissection in the ascending part of her aorta 10 days before Christmas and collapsed on her bathroom floor at her home.
The aorta is the large blood vessel branching off the heart. An aortic dissection occurs when the innermost layer of the aorta tears, causing the inner and middle layers to separate or dissect. The condition is life-threatening since it can divert blood from vital organs or the aorta can rupture.
Aortic dissection is more prevalent in 60- and 70-year old men and is associated with high blood pressure, high cholesterol, atherosclerosis and smoking.
Aortic dissection is so rare, doctors treat only one or two cases per year, said Pribyl.
Patients usually experience a shearing pain in the chest that radiates to the back but not Staley, who was preparing to shower, change and drive to the Travis AFB commissary when the attack occurred.
“I felt a little weakness in the legs, but no pain,” said Staley. When she fell, she was alert, but couldn’t move.
Staley was fortunate to have a husband who immediately called 911 as well as an emergency medicine provider on duty with prior experience with an aortic dissection.
“Her initial complaint was abdominal pain and new onset leg weakness,” said Capt. (Dr.) Michael Galante, 60th MDG emergency medicine physician. “She appeared to be in significant abdominal pain, much worse than would be expected based on her abdominal exam.”
After confirming his suspicions with a CT scan, Galante contacted Pribyl and Wozniak. He also contacted NorthBay for assistance since the support staff needed to perform the complicated surgery at DGMC was not available at the time.
DGMC has partnerships in Northern California with hospitals and medical services from the University of California in Davis to Stanford University in Silicon Valley. The agreements allow surgeons and specialty care providers to maintain their war readiness skills.
“Mrs. Staley’s condition required emergent attention, so having a partner hospital just up the road was an enormous asset,” said Galante.
Less than an hour after her arrival at NorthBay, Staley was in the operating room.
With assistance from Dr. Adam Tibble, NorthBay’s cardiac anesthesiologist, and Dr. Gansevoort Dunnington, cardiothoracic surgeon from St. Helena, California, the two DGMC surgeons replaced the top half of Staley’s aorta with a synthetic graft. The procedure required them to put Staley in deep hypothermic circulatory arrest.
“This involves cooling the patient to 18 to 20 degrees Celsius to stop all blood flow in the body for a short period of time before restarting the heart,” said Pribyl. “Dr. Wozniak was co-surgeon for the procedure and instrumental in Evelyn’s postoperative care.”
Staley’s recovery has exceeded expectations, said Pribyl.
“She did extremely well postoperatively and was back home in less than a week to enjoy Christmas with her family,” said Pribyl. “That’s not only a testament to the critical care and intensive care unit at NorthBay, but also to Evelyn’s family.”
Staley considers herself blessed.
“When Dr. Wozniak explained to me in detail why I had this mark on my shoulder, I was amazed,” said Staley. “Every day I wake up, I’m blessed.”