As bad a scenario as that was, a far more serious injury than paramedics could diagnose at the scene, also occurred.
Rushed to Southside Hospital, a chest CT scan revealed that Ms. Barretta had suffered an aortic transection, a condition in which the aorta, the largest artery in the body, is torn or ruptured. The condition is frequently fatal due to the significant amount of blood loss that results from the rupture.
“I was driving by myself,” Ms. Barretta said. “Fortunately, somebody stopped and called 911 and an ambulance came to the scene. They told me that night at the hospital I had a rupture in the aorta. My mom came down to the hospital so she knew how serious it was but I didn’t understand the severity of the situation. I knew it was life- threatening but that’s about all, I was induced into a coma.”
Ms. Barretta was lucky. Many patients are found dead at the scene of motor vehicle accidents from a complete aortic transection. Some studies indicate that up to 15 percent of all deaths following motor vehicle collisions are due to injury to the thoracic aorta. Next to traumatic brain injury, aortic transection from blunt chest trauma is the second leading cause of death from motor vehicle accidents. Fortunately, Ms. Barretta didn’t suffer a complete transection. Still, even a partial tear, if not diagnosed correctly and treated promptly can prove fatal.
While time is of the essence for a correct diagnosis and treatment of an aortic transection, patients are frequently asymptomatic; that complicates a diagnosis even further. Fortunately, Ms. Barretta was rushed to Southside Hospital and received excellent care along with an accurate diagnosis through a chest scan.
Whisked to Southside’s hybrid operating room, the only hybrid cardiac OR in Suffolk, which integrates advanced imaging and diagnostic technology in the same space used for surgical procedures on complex cases, the surgical trauma team inserted a catheter through Ms. Barretta’s groin so they could view the damaged aorta and perform the necessary repair. It was a procedure, performed by Robert Kalimi, MD, one of Southside’s top cardiac surgeons and vascular surgeon, Luis Davila-Santini, MD.
It saved Ms. Barretta’s life.
“If the accident happened more than a year earlier things may have been different,” Dr. Kalimi said. That’s because a year ago, Ms. Barretta would have needed to have been stabilized and transported out of Southside to have the procedure on her aorta performed. Timing, as they say, is everything – especially when it comes to emergency surgery.
The reason Ms. Barretta was able to be treated at Southside was because in February of 2011, North Shore University Hospital extended its cardiac surgery program to the Bay Shore hospital, in a $14.3 million program upgrade launched after the New York State Department of Health had given its approval for the Southside extension in November 2010. Alan Hartman, MD, chair of cardiothoracic surgery, said that since the program’s debut on Valentine’s Day, February 14, 2011, Southside has performed over 300 cardiac surgery procedures, showing just how vital a service it has become to the Suffolk County’s south shore.
“The hospital was so wonderful,” Ms. Barretta said. “I couldn’t have asked for better care. They gave me my life back. They gave my children back their mother.”
In a strange case of irony that illustrates the importance of having a program on the south shore of Suffolk County, three years ago, Nicole’s stepfather, 60 at the time, was rushed to a Suffolk hospital with chest pain. He needed coronary artery by-pass graft surgery (CABG or open heart surgery) but the hospital he was taken to wasn’t authorized to perform the procedure. He was transferred to North Shore University Hospital in Manhasset, where the procedure was successfully performed by the same surgeon who saved his stepdaughter, Nicole’s life – Robert Kalimi, MD. Although it was a positive result for Nicole’s stepfather as well, sometimes, Dr. Kalimi cautioned the amount of time is more important than it is at others.
“Ms. Barretta’s case shows the importance of establishing the program at Southside,” Dr. Kalimi said. “When you have a rupture in an organ as vital as the aorta or other vital organ, there is no time to wait. Time is of the essence – you have to get care to the patient immediately.”
In this case, a procedure performed in the nick of time saved a heart, a life and allowed two young children to have their mother to share their love on Valentine’s Day.
For more information on this story go to our video –http://www.northshorelij.com/NSLIJ/media-portal/homepage-video-channel/aortic-transection
Media Contact: Brian Mulligan