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Rare Vascular Condition Made Eating Almost Impossible

Brandi Umbarger suffered from a rare vascular deformity that caused an artery to wrap around her esophagus. After having trouble swallowing for four years, she was treated at the University of Chicago Medicine and can now enjoy her favorite foods again.

Brandi Umbarger just wanted to eat a hamburger. Unfortunately, she could barely swallow a bite.

The 31-year-old clerical worker first discovered she was having trouble swallowing back in 2012, and by the end of 2016, it was incredibly difficult to keep any food down. "I couldn't eat burgers or steak anymore. If I did try, I had to suffer the consequences," she said. Those consequences were severe heartburn and choking.

Umbarger had Dysphagia Lusoria, a rare vascular deformity that caused an aberrant artery in her aortic arch to wrap around her esophagus, making it difficult to eat or drink. Food would get caught in the middle of her esophagus and then would have trouble moving to the stomach. She first started looking for treatment in 2012, but because her condition is rare, finding a physician with enough experience to make her feel confident in the treatment was a challenge. After ending up in the emergency room at Methodist Hospital in Crown Point, Indiana, in 2016, she was referred to the University of Chicago Medicine. While she still had some reservations about pursuing treatment, she knew coming here was the right choice, particularly since her mother received lifesaving surgery at UChicago Medicine years earlier.

Ross MilnerRoss Milner, MD

When she arrived Umbarger went through a series of tests with vascular and cardiac surgeons at UChicago Medicine to determine the best course of treatment. It began with a barium swallow test which showed a narrowed esophagus compressed by that artery. They followed it with a CT scan, which provided more detail on her exact condition. Umbarger met with surgeons, Dr. Ross Milner and Dr. Takeyoshi Ota, co-directors of the Center for Aortic Diseases, to discuss her treatment options. Noticing that she was apprehensive about surgery but wanted her life to improve, they explained that UChicago Medicine had the skill and expertise to safely treat her condition through open surgery or endovascular therapy. Upon hearing her options, and with her physicians' help, she chose to undergo open surgery.

Takeyoshi OtaTakeyoshi Ota, MD

Treating this rare condition would require a two-stage surgical approach in which the doctors remove part of the artery blocking her esophagus while maintaining the blood flow to the rest of her right subclavian artery. On December 19th, Umbarger underwent stage one, where Dr. Milner performed a right carotid-to-subclavian artery bypass, a procedure that diverted blood flow from the right carotid artery to the right subclavian artery that would enable consistent blood flow after the aberrant part of the artery was removed. Dr. Ota completed stage two on December 21st when he removed the abnormal portion the artery. After a life with Dysphagia Lusoria, it was finally treated.

Following her second surgery she remained under observation in the hospital, meaning Umbarger would have to spend Christmas at the University of Chicago Medicine. Though she was able to Skype with her family and had a small Christmas tree in her room, the best gift she received was when she was told that she could start eating solid foods again.

Following her second surgery she remained under observation in the hospital, meaning Umbarger would have to spend Christmas at the University of Chicago Medicine. Though she was able to Skype with her family and had a small Christmas tree in her room, the best gift she received was when she was told that she could start eating solid foods again.

"Who cries when they eat?" She thought as she looked through the hospital menu, tears running down her face as it dawned on her that she could select anything she wanted. Later that day, she tested her new found ability to eat solid food again when her family was visiting and her daughter gave her gummy worms – something she would have never tried to touch before – bringing tears to her eyes at the realization that she is no longer restricted by her condition. "It is such an amazing feeling to eat like a normal person," she said. "Everyone deserves to live as comfortably as possible, especially when it comes down to the necessities in life."

Today, Umbarger says she feels like a brand new person. And yes, she can eat that hamburger.