Aortic Dissection: The Condition That Led To Lindsey Graham's Death

Ryan talks with Director of the Vascular Center of Excellence at the TGH Heart and Vascular Institute and Chief of Vascular Surgery with USF Health, Dr. Jean Bismuth, about aortic dissection, the condition reported as the cause of Lindsey Graham’s death.

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Episode Transcript

Speaker 1 (00:00):
The Ryan Gorman Show podcast presented by Farah and Farah
Accident Attorneys from Tampa.

Speaker 2 (00:07):
Right now, let's bring in the director of the Vascular
Center of Excellence at the Tampa General Hospital Heart and
Vascular Institute and Chief of Vascular Surgery with usf Health,
doctor Jean Bismith is with US. Doctor Bismuth, thank you
so much for taking a few minutes to come on
the show. So obviously, in light of Senator Lindsey Graham's death,

(00:31):
there are many questions that people have about how exactly
he died and how concerned we should all be that
we could end up having this same issue. Tell us
about an aortic dissection due to ourteriosclerotic cardiovascular disease.

Speaker 3 (00:52):
Well, first of all, thank you for having me on. Yeah,
you know, it's interesting because for us, particularly when we're
in center like Tampa General, we see this with relative frequency.
I would say, although it's not a very common disease,
and so you know the reality for the general public,
it is not something that is super common, but it's

(01:16):
not something that's had you know, probably enough exposure. You know,
we talk a lot about stroke and there are you know,
all the signs that come along with stroke. They don't
really talk about the signs that come along with the
org dissection because it does come without warning. And although
you can have some genetic traits that made to predetermine
you or pre dispose you to having an a org dissection,

(01:40):
it is really a disease that comes sort of very unexpectedly.
We don't really screen for it.

Speaker 2 (01:46):
So in very simple terms, yeah, what exactly is it
that happened to him?

Speaker 3 (01:53):
Yeah, so you know, that's a really good question because
really what it is is pretty simple. So the A
or any artery in the body has three layers to it. Essentially,
what happens in an ort de section is there's a
tear in the inner of the three layers, and then
flow kind of goes in between the layers and the

(02:14):
wall and creates a tear which can propagate from the
start of the order, which is at the heart, all
the way down and can have very significant repercussions if
it happens in the chest. Sort of what happened to
Senator Graham is essentially that it can tear and affect

(02:35):
the heart, so it can affect the blood vessels to
the heart, It can it can bleed into the heart actually.

Speaker 2 (02:41):
On that tear occurs.

Speaker 3 (02:43):
That's a good way of putting it. Actually, it's a
I've never heard it that way, but it's actually a
good way of putting it. But it can it can
also affect any blood vessel and every every every part
of the bodies is supplied by the order, which is
where this happened, and so every blood best of that
comes off the order can be affected by that terror.

Speaker 2 (03:04):
And this is something and again we're joined by doctor
Jeane Bismuth from Tampa General Hospital. This is something that
generally when it happens, is not survivable.

Speaker 3 (03:14):
Well, so it depends, it depends. It's all about timing, right.
If we look at mortality rates of death rates with
a or death section untreated, we used to say one
to two percent mortality rate per hour for the first
forty eight hours, so you can see that's pretty substantial.
Probably more modern data tells us it's about twenty four

(03:36):
percent death rate at about forty eight hours for untreated
surgically treated patients. If you're surgically treated, the mortality rates
actually about five percent, which is very reasonable. And really
what's allowed us to do that is, you know, high
high volume centers like Tampa General. We're able to treat
these things and patients overall do pretty well, but it's

(03:57):
a it's a really bad illness and and you know,
untreated mortality rated significant.

Speaker 2 (04:03):
Last question for you real quick, is there anything that
we can do to help prevent this or to get
checked out to make sure that we don't have what
would lead up to something like this.

Speaker 3 (04:16):
Well, really, there isn't something specific other than really one
of the biggest determinant is high blood pressure, high flood pressure.
If you manage that, we don't really screen as I
set earlier for a ort disk section. One of the
things we've done, because I think there's not been enough
highlighting of this, is we've created actually a clinic for
a org disse section somewhere for people to belong if

(04:37):
they have a oric desk section. And really it's about
just elevating the awareness around a ortic dissection, which is
what you guys are doing today, which I commend. All Right.

Speaker 2 (04:48):
The director of the Vascular Center of Excellence at the
Tampa General Hospital Heart and Vascular Institute and Chief of
Vascular Surgery with the University of South Florida help doctor
Gene Bismuth with us this morning, Doctor Bismuth, thank you
so much for taking a few minutes to come on
the show and break that down. We really appreciate it.

Speaker 3 (05:06):
I appreciate you having me. Thank you so much.

Speaker 1 (05:09):
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