Mordecai Zucker, MD, has made tens of thousands of house calls in his 63-year medical career. In the fall of 2016, he became concerned that shortness of breath and swelling in his legs impeded his commitment to caring for elderly patients.
An echocardiogram performed by his primary cardiologist, David Tarkoff, MD, of Long Island Cardiovascular Group in Cedarhurst, revealed severe cardiac dysfunction. Dr. Zucker’s mitral and tricuspid valves were regurgitating — that is, leaking blood backward as they pumped blood forward. His upper-right heart chamber enlarged to accommodate the increased volume of blood that was flowing backward, which added pressure to his overall heart function.
At a crossroads, Dr. Zucker, 91, could either undergo a heart procedure or be confined to a wheelchair. Looking forward to continuing to live alone and make house calls, he chose surgery, and Dr. Tarkoff referred him to the Sandra Atlas Bass Heart Hospital at North Shore University Hospital (NSUH).
“I noticed three things during my initial visit with Dr. Zucker,” said Alan Hartman, MD, Northwell Health’s senior vice president and executive director of cardiothoracic services. “He looked young for his age, he was mentally sharp and he needed surgery for multi-valve heart disease in order to continue his active lifestyle.”
Right diagnosis, right procedure
After studying Dr. Zucker’s outpatient echocardiogram data and signing off on preoperative testing, Dr. Hartman moved quickly. He scheduled open-heart surgery to restore blood flow in Dr. Zucker’s heart by replacing the mitral valve (left side), repairing the tricuspid valve (right side) and assessing the aortic valve.
“Robotic and minimally invasive heart procedures are talked about frequently as preferred treatments for heart failure,” Dr. Hartman said. “But not all heart disease is the same. It is more about pairing the right procedure with the right diagnosis. For Dr. Zucker, and many other candidates his age, open-heart surgery is preferred. It’s still the gold standard.”
The surgery went well, and the next morning Dr. Hartman found his patient out of bed and sitting up in a chair. Dr. Zucker was no longer in heart failure.
“I had prepared him for a potentially long and rocky recovery because he had a fair amount of heart failure to begin with and was no youngster,” Dr. Hartman said. “He recovered well, making steady daily progress before being discharged.”
Dr. Zucker then went to the Stern Family Center for Rehabilitation on the NSUH campus for short-term inpatient rehabilitation.
Doctor to doctor
During his experience at the Heart Hospital, all the members of the cardiac team performed their tasks with high competence, Dr. Zucker said.
“I prefer being the caretaker, of course, but deeply respect Dr. Hartman and the team,” Dr. Zucker said. “I’m biding my time until I can start seeing patients again.”
His recovery involves physical activity, although not house calls yet. While temporarily living with his daughter to recuperate, he exercises three days a week and takes the proper medications. He no longer suffers from the shortness of breath or intense swelling in his legs that typify heart failure patients, and he has lost excess water weight.
“I’m a big believer in learning by example, sometimes from the wrong example,” Dr. Zucker said. “I want my patients to remember weight maintenance is paramount to heart health.”