Dr. James Stowell must not be good at poker, because patient Dennis Otto read his face.

Stowell, an ER physician at Fairview Ridges Hospital in Burnsville, had just learned that Otto had a tear in his aorta, the main artery carrying blood from his heart. He was weighing how to break the news of this aortic "dissection" — not wanting to cause spikes in Otto's blood pressure and adrenaline that could kill him.

"You need to get to the university [hospital right now," the doctor said.

"What am I looking at?" Otto replied. "Give it to me straight."

"If you make it to the hospital, you've got a chance."

Recalling the Dec. 2 conversation, Otto said, "He didn't think I was going to make it."

Whether he had the right words, Stowell made the right phone call — to Fairview colleagues at the University of Minnesota Medical Center via a new Aorta Code Red hot line.

Activated last fall, the hot line assembles experts in cardiology and radiology to assess patients with potentially fatal aortic conditions and determine treatment.

Hot lines have emerged for heart attacks and strokes — partly because they help hospitals vie to be the first choice for treatment — but this is a Twin Cities first for aortic conditions. "Within 5 to 10 minutes, we have all the ducks in a row," said Dr. Gabriel Loor, a U cardiothoracic surgeon.

Other metro hospitals treat aortic conditions, but the U is considered a top center because of its specialists and inventory of grafts to patch up most any size of aortic injury.

Otto, 56, a heavy equipment operator and father of five, was rushed to the U to repair the damage and replace a defective heart valve that started it all. He is slowly regaining strength after surgery.

Turns out, Stowell wasn't the only one to make the right phone call. When Otto first felt pain from his chest to his face, he figured it was a reaction to anesthesia from a dental visit and went ahead with plans to go ice fishing. Eventually he dialed "9" then "1," then paused to think if it was necessary before dialing "1" again. By the time paramedics arrived, Otto had to crawl to the door to let them in. "He would have died ice fishing," Stowell said.