Anxiety and uncertainty about the pandemic is leading some patients to delay surgery. But how safe is that when you have an aneurysm in your heart?
By Johnny Diaz
MIAMI — I really did not want to have heart surgery. Who wants their chest sliced open and carved like a turkey in the middle of a pandemic hot zone? But that’s what I did in August.
An unruptured aneurysm quietly bulged in my aorta, the main artery of the body. For more than a year, blood pressure pills had helped manage it.
In January, the coronavirus — which was spreading in parts of Asia — still seemed like a distant problem.
My cardiologist said it was time. On his advice, I sought a second opinion from Dr. Steve Xydas, chief of the Columbia University Division of Cardiac and Thoracic Surgery at Mount Sinai Medical Center in Miami Beach, who specializes in aortic aneurysms.
Surgery was necessary, Dr. Xydas agreed, because I had two uncles who died from aneurysms and mine had grown to five centimeters. Any bigger, and I’d risk a rupture.
He urged me to have a valve sparing aortic root repair, a procedure that involved cutting out the aneurysm and implanting a soft cloth graft. Given my age (I was 46) and overall good health (I’m a runner), I would be a good candidate.
He suggested late spring for the surgery. You know what happened next.
While I am from Miami, I was living in New York City, where coronavirus infections surged in March and April. Hospitals were overwhelmed with people seriously ill and dying from Covid-19, the disease caused by the virus. The anxiety and uncertaintyled me to wait. The New York Times, where I am a reporter, shut down its newsroom and turned to remote work. I temporarily moved back to Florida.
I was not alone in wondering what to do about my surgery. Around the country, people like me with a heart issue or other health problems such as cancer were questioning whether to delay or cancel important or time-sensitive procedures that could save our lives. At the time, many hospitals had canceled elective surgeries as coronavirus cases spiked. But as virus safety measures took effect, elective surgeries eventually resumed.
I had always planned to have my procedure at Mount Sinai in South Florida, where I have my partner, family and friends. But the region was also becoming a coronavirus hot spot. In April, a 39-year-old sheriff’s deputy became Florida’s first law enforcement officer to die from the virus. Many tourists who had visited Miami Beach for a circuit party and for spring break returned home infected. By April 11, Florida had confirmed more than 17,500 coronavirus cases and nearly 400 deaths.
Covid-19 scared the hell out of me. But an inner voice nagged me to schedule surgery anyway. Every time I ran, I could not help but think of the aneurysm growing, waiting to burst.
Aortic aneurysms are most common in men over 60. Complications account for about 15,000 deaths each year, according to Columbia University Irving Medical Center in New York. Medicines for blood pressure or surgery are the main treatments for aneurysms. Covid-19 was new, and there was no cure.
I did not know which was worse, the silent grenade in my heart or the virus, but I wanted to take control of my situation.
In early July, I scheduled an appointment to plan the procedure. At the hospital entrance, a staff member took my temperature, asked why I was there and if I had any Covid-19 symptoms (I did not).
Dr. Xydas recommended having the repair sooner than later while it was a choice and not an emergency. He gently explained that Covid-19 patients were kept separately in an old section of the hospital. My surgery and recovery would be in a new surgical tower.
I felt reassured. It seemed like the hospital might be the safest place to be during the pandemic. A date was set — Aug. 17.
The day before, a nurse tested me for the virus. Negative. The following morning, I had the procedure. Success. The aneurysm was removed. No leaks from the graft.
When I came to, I noticed other safety measures that added to my peace of mind. I had my own room in the intensive care unit. Employees donned masks, changed gloves and used hand sanitizer whenever they visited. Local newscasts kept me abreast of pandemic developments, and I felt thankful that I was in a safe environment.
Two days later, I was in another private room that was wiped down, often every day. I was isolated from other patients, except those I saw from a distance when I walked with therapists. Hallways were mostly empty.
Like so many hospitals nationwide, Mount Sinai had banned most visitors. My family and friends were not allowed to see me, but Kelly Clarkson and Phil McGraw kept me company with their TV chatter.
After five days, I was discharged. When an aide wheeled me out of the hospital, nurses and patients wished me well.
Despite the soreness beneath the five-inch scar on my chest, I knew I would be OK. So far, I am — and grateful.
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