Breakthroughs RHODE ISLAND HOSPITAL • 2024
TENACITY, TEAMWORK, AND TRIUMPH: A GRATEFUL PATIENT’S REMARKABLE JOURNEY
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n January 18, 2023, Allan Shapiro collapsed while helping his wife Marilyn bring groceries in from the car. “I didn’t feel quite right after the fall and knew something was wrong,” he recalls. “So, my granddaughter, Chana, took me to the emergency department at The Miriam Hospital, which is about a half a block away from where we live.” At the time, the 81-year-old would have no way of knowing that the accident was the first step in what would become a months-long fight for survival. “As soon as we arrived at the emergency room, I noticed my grandfather was really having difficulty breathing and his fingertips were blue,” Chana explains. Sometimes, this can be a sign of heart failure, and tests quickly confirmed Allan had had a heart attack. It was likely a massive silent one and occurred maybe a week or more earlier. Even more concerning was the discovery of a large hole in the wall separating the two lower chambers of Allan’s heart. Allan needed an advanced level of care, and he needed it quickly. An intra-aortic balloon pump was inserted in Allan’s heart at The Miriam to control his blood flow—a measure taken to stabilize him enough for his transfer to Rhode Island Hospital. At this point, Allan’s prospects for a successful outcome were still very much in doubt. “We had a long discussion with Mr. Shapiro when he arrived about how complicated his problem was,” says Neel Sodha, MD, Director of Cardiothoracic Intensive Care Unit at Rhode Island Hospital. “Oftentimes when patients have this issue, they die no matter what we do. This meant whatever path we chose would be high risk. But Mr. Shapiro wanted
Allan with his wife Marilyn and their grandchildren
aggressive care and his family was onboard with going down whatever road was necessary.” The first thing Dr. Sodha and team would do is replace the intra-aortic balloon pump Allan had with a left ventricular assist device (L-VAD), which allowed Allan’s heart to flow more blood to his body and less to the side where the hole had formed. Surprisingly, he survived. After almost two weeks of stabilization on the L-VAD to minimize the surgical risk, Allan underwent open heart surgery. During the complex procedure, Dr. Sodha and team addressed three separate issues: the blockages in Allan’s arteries, for which they performed a two-vessel coronary artery bypass; the hole or ventricular septal defect separating the two lower chambers, for which they created a series of patches to restore continuity; and the ruptured outside portion of his heart, which they repaired as well. (continued on page 2)