North Texas Mom Survives Brush With Death 12/21/2011
DALLAS — Whitney Davis looked out the window of the helicopter as it passed over Lake Ray Hubbard, then the lush green trees of East Dallas. The Dallas skyline passed in the distance.
The Davis Family: Chad and Whitney, son Carson and daughter Willow. Click photo to download hi-res image
“I remember how beautiful everything looked, how peaceful and quiet it seemed,” the 33-year-old mother of two recalls. “I think it was my brain’s way of trying to calm myself. I knew that with every beat of my heart, I was bleeding to death.”
Whitney was being rushed to Texas Health Presbyterian Hospital Dallas with a dissecting aorta, one of the deadliest medical conditions on Earth. The condition happens when the aorta, the major artery that runs down the center of the chest cavity and carries blood throughout the body, begins to tear. A tiny hole in the wall of this pipeline can quickly grow, leading to severe internal bleeding and, in a matter of minutes, death. Aortic dissections that rupture have an 80 percent mortality rate, with 50 percent of patients never making it to the hospital. It’s the same medical condition that killed actor John Ritter.
But Whitney’s condition was even more complicated. The tear was also ripping a hole in her left main coronary artery, which branches off the aorta. It’s the primary blood supply to the heart. If the tear broke open and ruptured in that branch of the aorta, it could be instantly fatal.
“As soon as we landed, there was a team of nurses and doctors right there, looking over me, hooking me up to machines, getting me ready for surgery,” she said. “I just kept praying and had faith that I would see my family again. I put my life in their hands.”
Whitney had just given birth three days earlier to her second child, daughter Willow. Pain Whitney had felt radiating down her back and neck was from the epidural for the C-section, she thought. Or maybe it was just general discomfort after delivery and the aftereffects of pre-eclampsia (high blood pressure during pregnancy). That’s why doctors decided to deliver Willow early.
The discomfort led her to a follow-up appointment with her obstetrician who sent her across the street to Texas Health Presbyterian Hospital Rockwall for a precautionary CT scan. She had the diagnostic test after seeing her daughter in the NICU for the first time and just one day after being discharged from giving birth. The test revealed the potentially deadly tear in her aorta, a condition that was worsening by the second.
"I can cut and sew, but only God can save somebody's life," said Dr. Mark Pool, a cardiothoracic surgeon on the medical staff at Texas Health Presbyterian Hospital Dallas.
She still had never held Willow.
“I remember lying in the Rockwall ER and everyone was talking about CareFlite and an emergency transfer,” she recalls. “I asked who the helicopter was for, and a doctor turned to me and said, ‘It’s for you.’”
Minutes later Whitney was on that helicopter ride to Texas Health Dallas.
Once there, Dr. Mark Pool, a cardiovascular surgeon on the medical staff at Texas Health Dallas, entered the room and talked to Whitney and her husband, Chad, about what was going to happen. She needed major open-heart surgery to fix the aorta. The large tear was traveling up the ascending part of the blood vessel, then going down the descending aorta, which delivers blood to abdominal organs and the rest of the lower body.
“What we didn’t know at the time was the dissection of her coronary artery,” Pool said.
He wouldn’t know that until surgery was under way. The complication meant Pool would have to do a complete aortic root replacement: implanting a new mechanical aortic valve in her heart, replacing the damaged aorta, and stitching shut the tear in the left main cardiac artery.
“When they were wheeling me down to surgery, I started praying and this peace came over me,” she recalls. “I said, ‘I’m not going to die.’ I told myself that over and over again.”
During the procedure, Whitney’s heart was stopped and she was put on a heart-lung machine. Pool and Dr. Thomas Russell, an anesthesiologist on the medical staff at Texas Health Dallas, cooled Whitney’s body to 15 degrees Celsius to lower her metabolism. Called deep hypothermic circulatory arrest, the procedure slowed her blood circulation to near standstill.
“This both reduces the organs' need for blood and allows the surgeons to repair the damaged aorta,” Russell said.
Dr. Mark Pool, cardiovascular surgeon on the medical staff at Texas Health Dallas. Click photo to download hi-res image
Because aortic surgeries can cause brain injury due to oxygen deprivation, Pool performed a type of bypass, called selective antegrade cerebral perfusion, that kept her brain supplied with oxygen-rich blood. In this specialized procedure, Pool connected the heart pump directly to the arteries supplying the brain with blood. Arteries feeding less important tissue were clamped off. Once he got to the critical point of repairing the torn section of aorta, the heart-lung machine was turned off, stopping blood circulation completely. That keeps blood from circulating through the heart cavity and aorta, allowing Pool to see the tissue more clearly and operate more precisely.
Circulation was stopped for 12 minutes, the time it took to take out the damaged aorta and implant a new section of artery. Then the heart lung machine was restarted, and the aortic valve was replaced and damaged coronary artery repaired.
In all, the surgery would take more than six hours. All the while, he and Russell vigilantly watched for bleeding, one of the most common and serious complications of aortic dissection. Russell used thrombelastography, which helps measure levels of blood components, to determine what was needed to help Whitney’s blood clot. Clotting factors were carefully administered, but no blood transfusions were needed.
Whitney’s body temperature was returned to normal and her circulatory system, including blood pressure, stabilized.
It would be almost midnight before Pool, Russell, and Dr. David Fosdick, a cardiothoracic surgeon on the medical staff at Texas Health Dallas who assisted during the procedure, completed the surgery.
“It was an emotional moment when I first went out to Chad and told him that it looked like she would be OK,” Pool said. “I thanked him for praying for her — and for me.”
Despite the seriousness of Whitney’s initial condition, a successful surgery meant her odds of recovery were almost flipped; now she had a greater than 80 percent chance of a full recovery, Pool said.
Less than 48 hours later, she remembers waking up, though she couldn’t see right away because of medications. But she could hear her sister’s voice.
“At that moment I knew I was alive.”
Chad spent that day going back and forth between the ICU room Whitney was in and the NICU at Texas Health Rockwall, where Willow was.
“I wanted to be in three places at one time,” he said. “Whitney and Willow were both still in critical situations and our little boy Carson (9 years old) was dealing with the emotional roller coaster of all of this as well. I just wanted the four of us to be together in one place for the first time.”
Whitney would be removed from the ventilator later that morning. Across town, her daughter Willow, still in the neonatal intensive care unit, was also “turning the corner,” Chad says. “At almost the same time Whitney was being taken off the respirator, Willow was taken off her respirator as well. They both started breathing on their own, almost simultaneously.”
While baby Willow was slowly putting on weight by the day, mom was working hard to recover from her surgery. She began to work with physical and respiratory therapists to get her strength back. In a matter of days she was out of the ICU and walking up and down the halls of the cardiac unit.
“Whatever they told me to do, I did: sitting up, breathing exercises, getting out of bed,” she said. “All I kept thinking was that I needed to be with Willow and Carson.”
Whitney was discharged on a Wednesday morning. First stop was Texas Health Rockwall to see Willow.
“She had been on a breathing machine and up until that day had not been allowed to be held outside the incubator in the NICU,” Whitney said. “I was the first one to hold her. That was a really special moment for me.”
Two days later, Willow was released from the hospital and joined Chad, Whitney and Carson at their home for the first night together as a healthy family of four.
“You’d never know Willow was in the neonatal ICU,” Whitney says. “For me, there’s a scar from the surgery, and if I am alone in a silent place I can hear the subtle clicking sound of my new mechanical valve working in my heart. My scar and that ‘click’ allow people to see and hear that miracles still happen.
“I’m living proof of it.”
A note of thanks from Chad Davis: “From the moment Whitney arrived at Texas Health Presbyterian Hospital Dallas, every doctor, nurse and employee that I came into contact with was very caring and helpful. On behalf of The Davis family I would like to thank the entire team of nurses, doctors and staff who saw to Whitney. We are so grateful and happy that in our split second decision of where to have Whitney taken to that we chose Texas Health Presbyterian Hospital Dallas. We were also so fortunate to have Dr. Pool available. He is a very special surgeon and a very special human being. Our family has a nickname for him, we simply call him ‘The Man.’ Now our son, Carson, wants to be a doctor when he grows up after seeing how Dr. Pool helped saved his mom’s life.”
About Texas Health Presbyterian Hospital Dallas Texas Health Presbyterian Hospital Dallas is an 866-bed acute care hospital and recognized clinical program leader, having provided compassionate care to the residents of Dallas and surrounding communities since 1966. U.S. News and World Report has ranked Texas Health Dallas among the nation’s best hospitals in digestive disorders, orthopedics, and neurology and neurosurgery. An affiliate of the faith-based, nonprofit Texas Health Resources system, Texas Health Dallas has approximately 4,000 employees and an active medical staff of more than 1,000 physicians. For more information, call 1-877-THR-WELL, or visit TexasHealth.org/Dallas.