Positivity: Man beats 1% survival odds after artery bursts
(December 23, 2007) — Trying to save Bruce “Spud” Szpakowski when his main blood vessel burst in August was as dramatic and messy as any ER episode.
His 17-year-old son, Alex, rushed him to Rochester General Hospital. Szpakowski had felt a severe, stabbing side pain at their Irondequoit home and told Alex to get him to the hospital. On the three-mile trip, the father collapsed in the front seat and turned a deathly gray.
Szpakowski’s wife, Eileen Halloran, whom Alex had frantically consulted by cell phone for directions, also raced to the emergency department entrance.
“Spud is being pulled out of the passenger side, looking dead, and I was screaming, ‘Is he breathing? Is he breathing?’” Halloran recounted.
Inside, a bedside ultrasound by Dr. Bryan Gargano, emergency room physician, revealed an aortic aneurysm had ruptured in the abdomen.
Dr. Patrick Riggs, chief of vascular surgery, alerted the operating room crew to get ready as he approached the 49-year-old patient’s side.
Riggs felt no pulse.
Szpakowski received chest compressions as he .was rolled to the operating room.
“For all intents and purposes, he’s dead,” said Riggs. But the team — including vascular surgeon Kevin Geary, anesthesiologist Jeff Rosenberg and scrub nurse Ginny Thomas— went to work.
Riggs cut down the middle of the abdomen and blood spilled over the table and their shoes.
“You have to reach in and operate on feel,” said Riggs. Szpakowski’s aorta, not pulsating, felt like everything around it. Riggs found and clamped it off..
Sewing the graft in place was like fighting underwater, said Riggs, a surgeon since 1994.
Until bags of blood could be hung and secured to pressurized devices, the anesthesiologist held and squeezed the bags in the air.
A cell-saving device sucked the spilled blood from the abdomen and strained out and returned the red cells. He received about 10 units of blood that way, as well as transfusions of 23 units of blood, 10 units of fresh frozen plasma and 10 units of cryoprecipitate to help restore blood clotting factors. The average adult body contains 10 pints of blood.
An hour of hectic work had gone by. The odds of survival kept dropping.
Szpakowski was so swollen that his abdomen couldn’t be sewn shut or he wouldn’t be able to breathe. So his incision was covered but not closed for days. His anxious family was able to see him in the surgical intensive care unit.
The next day, members of the medical team high-fived in the hall, amazed that Szpakowski was still alive. Griggs estimates that less than 1 percent of people in Szpakowski’s situation — ruptured aneurysm, major blood loss and needing chest compressions — survive. …..
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