Lindsay Graham Aorta Dissection

Sad.

My aortic dissection was not noticed in the past. Unless there is a reason to i think most people don't even know they are at any risk. After my AB dissection three years ago I happened to have a scan for a gastric issue (that turned out to be nothing).
The sonographer asked me what my OHS scar was for. And I mentioned the dissection and said "why do you ask? "
And he said "Because if it wasn't managed then i would be calling an ambulance right now."
So, yes. Dissection can just happen.
I am (almost not) living proof of that.

Mine was discovered when having a calcium scan done to evaluate my LAD and RCA and was just blown off by the local cardiologists. In fact, they missed a 100% chronically occluded mid-LAD and complex coronary fistula system from the RCA to pulmonary artery and one from the LAD to pulmonary artery which "tricked" their nuclear perfusion test and didn't bother looking into the weird anomalies in their data. I 2nd opinion at Mayo Jacksonville found all that stuff and I was in open heart surgery inside of 4 weeks. While the mid ascending aortic aneurysm was 4.7cm, it was 4.8 at the root. It ruptured after they fixed all the other stuff and were bringing me back up to check homeostasis. That was Sep 10, 2024. I wouldn't have made it to New Years.

My mom died suddenly (within 4 hours including the ambulance ride) from an ascending aortal aneurysm. She had never been sick a day in her life, nor had she ever been obese (she was 5' 2" and never more than 100 pounds). She was very religious, had never touched any kind of tobacco and did not drink alcohol with the exception of a glass of red wine once in awhile. Our family had never heard of aneurysms. However, on the first anniversary of her death, my brother who was in his mid 50's at the time, and who was also very healthy had the same aneurysm. He was actually on stage playing the violin when he suddenly got sick. He left and drove himself to the closest hospital emergency. They told him he was lucky to be alive. His aneurysm (AAA) leaked instead of bursting. He was also a Tulsa police officer, the head of the bomb squad, and an under-cover detective for all of his career. That's important to this discussion because in his line of work, he was required to have complete physicals every year. Yet, nothing was ever noticed in any way. That was years ago (he just turned 80) and he now has his 3rd aneurysm. He had successful surgery for the second one. He is now waiting to have surgery for the 3rd one which is a size 5.6. After his 2nd aneurysm, I realized that this must be something genetic and I took myself to a heart specialist, who immediately had me tested. I did not show any signs of an aneurysm. I have a regular appointment with this specialist every year. Last year, I was diagnosed with a "very small beginning weakness that could be called an aneurysm." It was a 3.2. I just had my appointment for this year and it is now a 3.4, so my appointment with the heart doctor will become every 6 months. In the meantime, one of my mother's brothers has died as the result of an aneurysm. He survived the surgery for the aneurysm even though he was in his mid 80's, but contracted an infection while in the hospital and did not survive. I send out all of this information to remind people that this is, most often, a genetic issue. It can be controlled, but not if doctors don't discover it earlier and help the patient to manage. I am very happy to have found this site, since I know I must stay informed for the rest of my life (I am turning 79 in September). Please share your experiences and outcomes with me.

@rlhix What are the facts as you understand them concerning the size of the aneurysm before surgery is required? They told my brother that they will wait until his aneurysm is closer to a size 6 before surgery. It is currently a size 5.6. However, he recently had a major intestinal surgery. I think they consider another surgery right now to be dangerous. What can you tell me?

@professorkrh

Assuming no other issues such as I had, a high volume center that specializes in them usually recommends between 5.0 and 5.5cm using current guidelines. I strongly recommend he get a 2nd opinion at a place that specializes in these things. The local hospital and ER can't handle these things and the outcome isn't very good. My root ruptured at 4.8 after being brought off the bypass machine, heart restarted and they were checking my homeostasis. Fortunately, the surgeon and I had discussed this prior and had 3 possible scenarios. He had the materials needed on hand. That said, it took them 7 minutes to get me back on the bypass machine and 3.5 liter of blood lost (0.92 gallon). The surgeon literal had two fingers in the hole in aortic root while I was being put back on the bypass machine. Surgery started at 7 am that morning and went 14.5 hours. The surgeon working on me was the chair of cardiovascular surgery at Mayo Clinic in Jacksonville. The local guys couldn't have dealt with the double bypass on the LAD and the complex fistula situation on the RCA and LAD. There was also a large aneurysm on my RCA. They probably did my a favor when they missed all of that stuff and my primary care physician sent me for a second opinion at Mayo with a cardiologist that specializes in these sorts of things. They work as a team there as well.

Thank you so much for sharing your story. I'm so glad to hear the outcome was the right one. When you have a few minutes, please let me know how you are doing now.

While I know Mayo Clinic must be the best, for right now, I'm seeing a heart specialist (Dr. Chandwaney) at the Oklahoma Heart Institute in Tulsa, which is just a few minutes from where I live. This facility has a "high volume aortic center," and profess to be one of the best in the nation. I'm not sure who my brother sees, but I will be talking to him this Thursday and I plan to find out. Please keep sharing.

Addendum: for the first year after surgery I was asking: why me and what did I do to deserve this? And: were there any signs?
There were but of course these are disregarded because we get old and slow down and things just become harder.
A week before dissection we drove and stayed for vacation in another state and a competent hospital was far far away. Scary thought #1.
A few days before I played basketball with young kids and on the court I was bent over suddenly feeling tired and catching my breath. My sister said: gee you are out of shape. Scary thought #2.
A few days later getting ready for sleep I dissected near midnight with a 6.5cm aneurysm. Almost a very long sleep. Scary thought #3.
Of course i looked for signs.
If it had happened a week before I would be gone from this world - a major hospital two hours away.
Trouble swallowing food and pounding my chest after meals to get things moving.
Stopping for breath at the mall during a shopping trip.
The basketball trouble.
Even though I never smoked or drank, wasnt overweight, no family history of anything (both parents over eighty), wasn't an athlete but wasn't incapable either, and really had no medical issues at all.
Sometimes there can be no signs.
Sometimes signs can be misread.
Until the burning stabbing pain that feels like no other.
My sister still thinks three years later that the game with her kids caused my event. I am not sure it did. But it might have got me there faster.

In 2016, my neurologist caught aortic aneurysm from a MRI done for my back spondylosis, stenosis, and osteoarthritis.
I was diagnosed with an ascending aortic aneurysm from May 2017 echocardiogram, with moderately dilated ascending aorta at 4.6 cm.
Kaiser Permanente Cardiology clinic monitors with echocardiograms: 5-18-2017,
6-21-2018, 1-15-2023, and 10-13-2024, TBD: Oct 2026 or 2027(?).
Have been anxious in past year due RIFs and burn-out of medical and tech staff, and lack of medical schools' investments from govt.
Hoping when my next echocardiogram scheduling comes up that appointment will not have to wait 3 months or so.

I had a full aortic dissection in 2015. I, unlike Senator Graham, survived it. While I have absolutely nothing in common with the late Senator politically, I will tell you that I shed some tears for him because it's a really terrible terrible way to pass. I hope that he rests in peace. I also hope that everybody on this listserv takes aortic health as seriously as they possibly can. I can assure you, that when you have a sudden dissection there is a tremendous amount of pain and fear. Every minute counts. You do not have even a second to waste. You are dying and you know it. I don't wish it on anyone. I'm glad that I have the opportunity to least share with some of you the urgency of an aortic dissection and the necessity of taking good care of yourself.

Back in 2015, I had just gotten off a long flight across country and had a very stressful 13 hour day on my feet teaching a class to lawyers before I had a sudden dissection in my hotel room. I have to believe that Senator Graham had at least an equally stressful journey to and from Ukraine back to the United States. I have never forgotten the notion to travel is inherently stressful. Combining that with a very stressful diplomatic mission in the middle of a war was probably more than his heart could take. Lest we forget, a sudden aortic dissection for someone of that age is often lethal.

I am thankful for every moment of the last 11 years I've had on this earth. They are bonus days and I know it. Peace.