Thanks to quick thinking by Vonne and her husband, along with the expertise of a large team of UW Health physicians, nurses and therapists, Vonne survived this traumatic ordeal.
LaVonne O’Malley and her husband Dave will never forget the date they got the scare of a lifetime: Feb. 1, 2021. That morning, the couple left their home in Waunakee, Wis., for a few hours of cross-country skiing in Delafield, about 25 miles west of Milwaukee.
Minutes after pulling into the parking lot, LaVonne, then 62, suddenly saw her life flash before her eyes. She heard a loud buzzing sound, felt intense pain, and started to clutch her throat. The only good thing about the incident is that LaVonne was not entirely caught off guard. Since age 15, she was told she had a condition that one day could trigger a life-threatening aortic dissection. This was the day it happened.
The aorta is the most important blood vessel we have because it carries oxygen-rich blood from the heart to the rest of the body. An aortic dissection is a tear to the inner layer of the aortic wall. This event wreaks havoc on the body because blood begins flowing between the layers of the aortic wall instead of just through the center. Blood flow to other organs drops off and, in some cases, the aorta can fully rupture — an event that is almost always fatal.
Thanks to quick thinking by the O’Malleys and a large team of UW Health physicians, nurses and therapists, LaVonne — most people call her Vonne — survived this traumatic ordeal. Her recovery over the past few years has been bumpy and there were days she was ready to give up. But thanks to her care team, her unshakable will to survive and Dave, her incredibly dedicated husband, Vonne O’Malley is enjoying a more normal life with boundless gratitude.
Genetic condition made Vonne vulnerable
A one-time high school and college business education teacher, Vonne was born with a rare condition called Marfan syndrome. Those who have it are frequently not diagnosed until their teens or 20s; Vonne learned about her diagnosis at 15.
Marfan syndrome weakens the connective tissue that holds the muscles and bones together. People with Marfan are usually long- and thin-framed; they have a long face, arms, legs, fingers and toes. Many, including Vonne, also have scoliosis, or curvature of the spine. Even more worrisome, Marfan syndrome can threaten the cardiovascular system, especially the aorta, which can become weak and floppy instead of elastic, the way a sponge always springs back to its original shape.
In Vonne’s case, part of her aorta began to bulge outward. In time, the bulging causes the inner wall of the aorta to tear, which is when a dissection occurs.
“Aortic dissection is a very serious event because the blood flow gets heavily disrupted,” said Dr. Andreas de Biasi, a UW Health cardiothoracic surgeon who performed a life-saving, 10-hour operation on Vonne the day of her dissection. “Everything starts to go haywire and if not treated quickly, the dissection can rupture, which causes death almost instantly.”
Dr. Ford Ballantyne, a UW Health cardiologist who has cared for Vonne since her Marfan syndrome diagnosis more than 50 years ago, didn’t mince words when she was first diagnosed.
“When I was 15, Dr. Ballantyne told me how important it was to take my medication every day and always be ready to act if a dissection happens,” Vonne said.
“How’s it going to feel?” Dr. Ballantyne would ask Vonne. “What are you going to do?”
Quick action helped save Vonne’s life
Fast forward to 2021, when Vonne had her dissection in the parking lot. Knowing that his wife’s life was at stake, Dave immediately drove Vonne to the closest hospital.
“As soon as we walked into the emergency room, I yelled out that my wife was having an aortic dissection,” Dave said. “They took Vonne in right away, but I had to go back to the car because visitors were not allowed due to COVID.”
Nervously sitting in the parking lot, Dave reached Dr. Ballantyne on the phone.
“He told me that Vonne should be transferred to a larger hospital such as UW as soon as possible,” Dave said. “UW Health Med Flight was called immediately and within 25 minutes, I saw the helicopter arriving, ready to take Vonne to Madison.”
When she landed, the Med Flight crew took her straight to the operating room, where Dr. de Biasi and his team were ready to begin the highly complex surgery.
“Vonne’s outlook was far from certain, as is the case for anyone with a dissection who has to be operated on emergently,” said Dr. de Biasi. “It was also challenging because of her Marfan syndrome, making her body tissues harder to work with. During surgery, we replaced several inches of her aorta and her aortic valve with artificial substitutes made of synthetic material and cow tissue. We call this an aortic root replacement and hemiarch replacement.”
Surgeon was cautiously optimistic
Early signs during the first 48 hours after surgery left Dr. de Biasi feeling cautiously optimistic.
“Vonne’s heart and aorta were doing well,” he said. “She had no internal bleeding and her brain was doing well. These were big milestones because some patients have a stroke after aortic dissection surgery.”
Although Vonne survived the grueling operation, she was far from out of the woods. Patients like her typically have their breathing tube removed within six to 12 hours after surgery, but Vonne had trouble breathing on her own. It turned out that her airway (trachea) was floppy instead of rigid due to a condition called tracheobronchomalacia. Without a clear, open passageway, mucus would clog her airway, making breathing difficult.
UW Health colleagues from interventional pulmonology propped her airway open with stents, but they did not hold for more than a short period of time. It soon became clear that Vonne needed a tracheostomy tube, often called a trach for short.
“A trach is a small tube placed into an opening we make in the neck,” said Dr. David Sonetti, a UW Health interventional pulmonologist. “This allows air to flow directly into the lungs, bypassing the mouth and nose. Unfortunately, speaking with a trach is very hard, so patients have to communicate by writing things down or using hand signals.”
Vonne spent much of the next six months in a local rehab hospital. Even after going home, she was still hooked up to oxygen. To ensure proper air flow while she was asleep, Vonne was connected to a ventilator every night.
She desperately wanted to get rid of the trach. Nobody could promise that it would ever come out, however one day, Dr. Sonetti removed it for 30 minutes just to see how Vonne would do.
Thrilled to have trach removed
Finally, a full year after her aortic surgery — a year when she had thoughts of simply giving up and dying — Vonne’s trach came out for good and she could talk again. Her voice, which is a bit scratchy due to a paralyzed vocal cord, is much stronger, thanks to restorative care she received from Dr. Seth Dailey and Dr. David Francis, both UW Health ear, nose and throat doctors.
“Vonne was passionate about getting the trach out,” said Dr. Sonetti. “She kept physically active to get stronger and followed our instructions to a ‘T.’ I did what I could do to give her a chance, but Vonne truly did the hard work.”
Now 67, Vonne is in a much better place. About 3½ years have passed since her trach came out and she relishes every moment, whether it’s spending time with friends, riding her e-bike with Dave or traveling.
“It’s hard sometimes, because my lung capacity and stamina are not what they were before all of this happened," said Vonne. “Still, I am incredibly grateful. Dave and my sister Lajeanne have been my rocks, and the medical people who take care of me — Dr. Ballantyne, Dr. de Biasi, Dr. Sonetti, Dr. Dailey, Dr. Francis and my primary care physician, Dr. Pamela Ryan — are exceptional people. They listen and respect my desire to be involved in my care. I’ve never gone outside of UW Health. They’re like family and they are my people.”