Sophisticated Surgery and Dedication to Rehab Pull Young Father from the Brink of a Devastating Heart Attack
July 7th, 2008
The last thing 36-year-old Brad Malone, father of four, expected when he debarked from a cruise with his wife in January was that within a week, he would have undergone a quadruple bypass. “I knew that someday I’d probably have a heart problem because I have such a strong family history,” said Brad. “My father had double and triple bypasses and two of my uncles died of heart problems. But for me to be the youngest in the family to have it just floored me.”
Too Young for Heart Trouble?
“Brad has always been very active in sports and in coaching our daughters’ teams,” said his wife, Juanita, a multi- phasic radiologic technician in the Cardiac Catheterization Laboratory at Floyd Memorial. “I didn’t think much about him having heart trouble until the cruise when I got to be with him 24/7. That’s when I noticed he was becoming short of breath going up and down stairs. He also had some pain in his neck. I never really thought that someone my husband’s age could have heart trouble until I started working in the Cardiac Cath Lab at the hospital.” According to Brad, “She started getting after me to go to the doctor so I finally told her if she’d just leave me alone, I’d go right after the cruise. She works with Dr. Manchi at the hospital. He’s her good friend.” Brad paused. “Turns out, he’s mine, too,” he said.
Heart Catheterization Showed Severe Blockage
Srini Manchi, MD, is a specialist in cardiology. He gave Brad an EKG and later a heart catheterization, during which Brad’s problems became clear. “We found severe blockage,” explained Dr. Manchi. “His left anterior descending artery was nearly 100 percent blocked. There was just a trickle of blood getting through that kept him from having a heart attack. His right artery had similar blockage and the artery in the back of his heart had 70 percent blockage. We sent him straight from the cath lab to the hospital to prepare for bypass surgery.”
Brad underwent what turned out to be a quadruple bypass, performed by Cardiothoracic Surgeon Robert Dowling, MD. “We have many ways to treat cardiovascular problems and usually reserve bypass for people we can’t treat any other way,” said Dr. Dowling. “Brad had life-threatening blockage that was very advanced. When we see that kind of extreme blockage in a young person, they almost invariably have a family history. For him, we used a procedure called beating heart surgery. (See related article.) He was an ideal candidate and the surgery went extremely well.”
How Long Will the Bypass Last?
“People are always eager to know how long their bypasses will last,” said Dr. Dowling. “I tell them that the better they take care of themselves, the longer they will last. You have to emphasize this, particularly with younger people, because they have so much life ahead of them. They need to exercise faithfully, and definitely stop smoking. They should even get out of a room if somebody in it is smoking. They need to watch their cholesterol very closely, much more strictly than indicated by typical cholesterol guidelines. Finally, they have to eat a healthy balanced diet.
Dr. Dowling added, “To make your bypass last, you need to do everything right. And Brad did. He didn’t just go through the motions. He was truly focused.”
Cardiac Rehab Was Key to Recovery
“About a month after my surgery,” said Brad, “Dr. Manchi gave me the okay to start rehab. I was eager to get going, but afraid everybody would think I was an oddball being so young. But the staff and patients were wonderful. It’s amazing what it did for me.”
“We see patients right after their surgery to introduce them to upper and lower body exercise and walking,” said cardiac rehab nurse, Carol Griffitt, RN.“Then, when they’ve been okayed for rehab, we put together a very individualized program for each one. They wear a heart monitor so we can watch their heart through our computer telemetry system while they’re exercising. We check their blood pressure three times during each visit, and pay close attention and guide them through their activities. Brad worked hard to make the changes in his lifestyle that would lead to better health. He was very energetic. The nurses and patients all really enjoyed him.”
According to Brad, “Just six-and-a-half weeks after my surgery, I walked onto the basketball court. Man, did I have some people squirming,” he laughed. “But I knew I’d be fine. I haven’t felt this good since I was 16. Floyd Memorial really helped me turn my life around!”
“Brad would have had a very limited life expectancy without surgery. But now, as long as he does the right things to take care of his heart, he can do whatever he wants – whether that’s basketball or mountain climbing.”
-Robert Dowling,
MD Board Certified Cardiothoracic Surgeon, University Cardiothoracic Surgical Associates Professor of Cardiothoracic Surgery, University of Louisville School of Medicine
Dr. Srini Manchi offers this advice to anyone with a significant family history of heart disease:
- Do not smoke.
- Have your cholesterol checked at age 20. If it is normal, check it every 5 years. If it is elevated, check every year and follow your doctor’s advice.
- If you have diabetes or high blood pressure, control it carefully.
- Exercise regularly.
- Follow a heart healthy diet.
Beating Heart Surgery Offers Alternative to Stopping Heart for Procedure
Dr. Dowling explained that there are two ways to perform bypass surgery. “One uses a heart-lung machine,” he said. “You put the patient on the machine, stop the heart, do the bypass and then restart the heart. In beating heart surgery, however, you isolate and quiet only the area you are working on, which is about the size of a quarter. The rest of the heart keeps on pumping.” “Avoiding the heart-lung machine puts less stress on the lungs and kidneys, said Dr. Dowling, “and patients are far less likely to need a blood transfusion. You can only do it if it is appropriate for the patient, and there are times when it is better to use the heart- lung machine. But Brad was an excellent candidate for beating heart surgery.”
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