In February 2012, Emory cardiothoracic surgeon Dr. Omar Lattouf experienced what he referred to as the most difficult case of his career: the emergency removal of a large blood clot in a young mother's heart immediately after her twins were delivered by c-section. When Dr. Lattouf and his team opened the patient's chest, they found one end of the clot dangling in her right atrium and the other in the left. "It was like someone shoots a bullet and you have to go in and grab that bullet before it hits the target," Dr. Lattouf said. The operation was a success, and the twins were sent home after several months in Emory University Hospital Midtown's (EUHM) special care neonatal and perinatal unit.
But for prominent surgeons like Dr. Lattouf, pinnacle events can become just one in a series of unprecedented situations. One afternoon in late April of this year, Dr. Lattouf was introduced to his next impossible, never-before-encountered case via several CT scans urgently sent to him over his cell phone. Relayed by an obstetrician from Northside Hospital, the scans were of the chest of eight-month pregnant Edita Tracey of Roswell, GA, who had presented at the ER with chest pains. The ER team was initially concerned that something might be wrong with the baby. What the scans revealed, however, was that Edita had a huge aneurysm in the wall of her aorta that was not only bulging, it was ripping apart. There was a foot-long tear in the inner wall of her aorta and blood was pooling around her heart.
"I have performed probably thousands of emergency heart operations and many dozens of aortic dissections, and I had never been so scared," says Dr. Lattouf. "That little soon to-be-born baby intimidated me like no one ever before. In her weakness she was the most powerful person I have ever encountered."
With time at a premium, Edita was airlifted from Northside to EUHM, where two surgical teams gathered: one led by Emory OB GYN Dr. John Horton to deliver the baby, and the other led by Dr. Lattouf to repair the aneurysm. "We had to do it right the first time," Dr. Lattouf says. "There was no room for error, there could be absolutely no missteps."
Being very aware that the general anesthesia going to Edita was also going to the baby, the c-section team performed their job very quickly. "As soon as mom went to sleep, it literally took about 30 seconds and that baby was out and screaming," says Dr. Lattouf. The child, named Arabella, was 6 pounds, 12 ounces, and perfectly healthy.
Dr. Lattouf's team immediately took over and began what would stretch into an almost nine-hour surgery. After opening her chest, they drained the blood pooling around Edita's heart and placed her on a heart-lung bypass machine. Dr. Lattouf replaced her aortic arch, reimplanted the great arteries supplying the arms and brain, replaced the ascending aorta and aortic valve, and re-implanted the coronary arteries. Once the last stitch was placed, the clamps removed, and the heart started beating on its own, Edita's various physiological processes began returning to near normal. Dr. Lattouf allowed himself to "take a deep breath."
"Those nine hours passed like nine minutes," he says. "There were no breaks, no story telling, no music in the room. Just full attention on one small area: Edita's heart. That was my entire world for that time period."
Despite one precarious moment after another, the procedure had gone well, and Edita awoke the next day in the ICU to her husband Ken and held Arabella for the first time. "What a great feeling to save a mom's life and see her holding her newborn child the next day," says Dr. Lattouf. "As I look back, I am so thankful that things turned out so well. I don't know if I could have continued my career if I had failed Arabella by not saving her mom."
