As Susan Stahl woke up from hernia repair surgery last February – just before the coronavirus escalated – she had a strange feeling. And it wasn’t just her anesthesia wearing off.
“I felt like I had a big cement block on my chest,” remembers Susan. “It really hurt.”
Susan’s cardiologist, Robert Toltzis, MD, was already monitoring her aortic valve because it wasn’t functioning properly and would need repair at some point. To find out what else was happening with Susan’s heart, doctors ordered a stress test and an angiogram.
Kevin Miller, MD, an interventional cardiologist with the St. Elizabeth Heart & Vascular Institute, used X-ray imaging to see the blood vessels and chambers of her heart. And the test revealed much more than a bad valve.
“Susan had three blockages in her heart arteries – 70, 80 and 90 percent respectively – all significant and all needed treatment,” says Dr. Miller. “Her heart was not getting enough blood flow.”
Some signs missed; others came on suddenly
Thinking back, Susan wonders if she missed the early signs of trouble.
“One Sunday I was singing in church, and all of a sudden my jaws and teeth were hurting,” she remembers. “But the pain wore off.”
Susan, who’s 76, has already survived four types of cancer. She takes care of her 77-year-old husband, Edwin, who is in a wheelchair. They live on beautiful, wooded land in rural Kenton County. It’s her happy place – where she loves to feed hummingbirds, watch wildlife, and take her 11 grandchildren on wagon rides. (And she has one great grandchild too.)
Despite her health issues, Susan’s always tried to stay active.
“Years ago, I used to jog a lot, and I walked three miles around our driveway. But recently, I got so breathless that I had to sit on the porch for a while,” says Susan. “All of a sudden, I was having trouble doing housework and got very tired. But I didn’t get a chance to tell the doctor.”
It’s decision time – how to save Susan with the best possible care
Susan’s doctors had a complex decision to make. Could she withstand open-heart surgery to clear those three blockages and repair her aortic valve? Or, should doctors take another approach?
Complicating matters, Susan had part of a lung removed during a past cancer surgery.
“This is where the expertise and collaboration of our Heart & Vascular Institute team is so valuable. We carefully review each patient’s unique health history,” says Dr. Miller. “For Susan’s case, Dr. Victor Schmelzer, and I put our heads together in consult. We calculated the potential problems Susan might encounter with open-heart surgery.”
“The doctors came in and talked with my family, and we decided open-heart surgery would be too risky,” remembers Susan. “I might not live through it.”
Instead, Susan’s doctors recommended two separate, minimally invasive procedures – on two separate days.
First, in early April, Dr. Miller opened Susan’s three blockages with a procedure called angioplasty, with stenting Using a catheter inserted into her wrist, Dr. Miller delivered a special balloon to the site of the blockages. He inflated the balloon to clear the blocked artery and inserted a mesh stent to keep it propped open.
In mid-May, surgeons replaced Susan’s aortic valve with a procedure called transcatheter aortic valve replacement (TAVR) Using a catheter inserted into a blood vessel in the leg, the surgeon delivered a new replacement valve up through the arteries and into the heart. A balloon was expanded to push Susan’s old valve out of the way and put the new valve into place, allowing it to take over the job of regulating blood flow.
“These less invasive strategies are a huge advancement in cardiology,” explains Dr. Miller. “Susan got her blockages fixed and valve replaced – without open-heart surgery. She spent no time on a respirator, had a shorter recovery time, and left the hospital with a good outcome.”
St. Elizabeth safe for surgery during the pandemic
At first, due to the coronavirus, Susan was afraid to go back to the hospital to get her heart valve repair. She worried about her immune system.
“The nurse navigator called us every week to check on me,” remembers Susan. “Finally, I got tired of not feeling well and worrying – am I just going to die? So, I called back and said I’m ready to go ahead with it.”
She now wishes she had done it sooner.
“Early in the pandemic, St. Elizabeth took all the right steps to keep patients safe. The risk of contracting the virus by coming to the hospital seeking medical care is almost zero, with all the precautions that are taken” explains Dr. Miller. “If people are having symptoms that they are concerned may be heart related, they should always call their doctor or seek emergency care right away.”
Happy and healthier
Today, Susan is going to cardiac rehab. She’s grateful for the eight cardiovascular specialists involved in her diagnosis, decision-making and treatment – plus lots of nurses and technicians.
“They were awesome. I tell everyone how great they were. They would come in and explain things,” says Susan. “I didn’t have to worry. They made sure I had everything I wanted or needed.”
“That’s what makes this job fun and rewarding,” says Dr. Miller. “At St. Elizabeth, we’re happy that we can work as a team to use our knowledge and combined expertise to help people.”
Now, Susan looks forward to spending more time with her grandchildren – taking them on wagon rides and, of course, feeding the wild hummingbirds.
“I got my heart fixed, and I’m hoping I can go on for a long time. I feel so much better.”