Last summer, Canadian native Francis Anthony Cornelius, 70, was enjoying a short visit with his daughter in New York when he suddenly felt a crushing pressure in his chest.
His daughter, Linda, wanted to call 911, but Mr. Cornelius said it was just indigestion and insisted that he was fine. But when his pain intensified, Ms. Cornelius called a cab to take them to her primary care physician’s office just a few blocks away. There, her doctor gave Mr. Cornelius an electrocardiogram to evaluate his heart’s electrical system. The news was not good:
was having a heart attack.
With no time to waste, an ambulance was summoned to transport Mr. Cornelius to LIJ Medical Center.
Ms. Cornelius was shocked because, although her father was being treated for high blood pressure and high cholesterol, he had no history of cardiac problems. En route in the ambulance, a crisis ensued: Mr. Cornelius suffered cardiac arrest, which means his heart and breathing completely stopped. The paramedic crew shocked his heart back into a normal rhythm with a defibrillator. Just as the vehicle reached the Emergency Department, Mr. Cornelius’ heart arrested a second time and he again needed defibrillation.
Whisked into the hospital, Mr. Cornelius was quickly examined by the Emergency Department team. The emergency medicine physicians placed him on a ventilator to help him breathe, then took images of his heart to confirm that Mr. Cornelius was in the midst of a massive heart attack.
Make way for the cath lab
To treat the attack, interventional cardiologist Perwaiz Meraj, MD, was called to the Emergency Department. He immediately transferred Mr. Cornelius to the cardiac catheterization lab.
“Because his health was so fragile at that point, we all moved very fast and it only took minutes from his arrival at the Emergency Department to the start of his cardiac catheterization,” said Dr. Meraj.
The procedure involved inserting a thin tube containing a miniature camera and a balloon through a small artery in his wrist, threading it to his chest and placing it into his heart. The camera transmitted images showing that Mr. Cornelius’ right coronary artery was completely blocked, his left coronary artery was about 70 to 80 percent blocked and his remaining heart function left him hanging by a thread.
To unblock the arteries and resume blood flow to the heart, Dr. Meraj inflated the balloon at the end of the catheter to break up the accumulated plaque. This action typically restores blood flow and instantly revives the heart, but because Mr. Cornelius’ coronary system was so compromised, his condition didn’t improve. In fact, his blood pressure continued to drop and his outlook was grim. That’s when Dr. Meraj decided to call in a cardiac surgeon.
“When none of our routine treatments worked, we had to get creative or Mr. Cornelius wouldn’t make it out of the cath lab alive,” said Dr. Meraj.
Call in the troops
After reviewing their patient’s status, the cardiac catheterization team and the cardiac surgery team conferred in a huddle and determined that the right chamber of Mr. Cornelius’ heart was not pumping well enough to sustain his life.
They concluded that his only option for survival was an innovative technology called right ventricular assist device with ECMO (extracorporeal membrane oxygenation), a machine that provides temporary circulatory support for patients with acute cardiac failure.
In 10 minutes, the cardiac catheterization lab was converted into an operating suite, a full cardiac surgical team was mobilized and, as rapidly as safely possible, Mr. Cornelius’ heart was connected to a right ventricular assist device. When the procedure was completed, the machine removed blood from Mr. Cornelius’ body, oxygenated it, then returned the fortified supply to his heart.
“This amazing device assists the pumping action of the heart, allowing it to rest and recover for several days,” said Dr. Meraj. “It’s similar to the support provided during coronary bypass surgery, except this device takes over the heart’s function for days instead of hours.”
Almost immediately after the assisted circulation began, Mr. Cornelius’ color improved, his blood pressure rose and his heart function stabilized.
Mr. Cornelius was aided by the right ventricular assist device for several days while his heart gradually improved. He recovered at LIJ Medical Center for about two weeks and is now back home in Canada.
“I am grateful for the care my father received while he was at LIJ Medical Center and thankful for his doctors and the whole team,” said Ms. Cornelius. “I think this heart attack happened while he was in New York for a reason and I’m so glad it had a happy ending.”
Mr. Cornelius rested at his daughter’s house for several weeks, visited Dr. Meraj for follow-up, then returned to Canada as good as new.
“Mr. Cornelius beat the odds because he had several factors in his favor: LIJ Medical Center is a tertiary care center with the technology to handle challenging cases. Also, we treat a lot of heart attacks and take a multidisciplinary approach to care and pool our resources for one goal — to save lives, especially when circumstances seem dire,” said Dr. Meraj.