Cardiologists experience “MacGyver moment” during rare procedure

Sarah Schertzer is on a solid road to recovery, thanks to two resourceful and quick-thinking physicians, Hattiesburg Clinic cardiologists Arthur Martin, M.D., and Randel Smith, M.D.

Schertzer, an 85-year-old retired nurse from Lumberton, Miss., underwent heart bypass surgery at Forrest General two years ago. In June 2008, she was admitted to Forrest General with an infection, which in turn caused a small heart attack. She had a heart catheterization which showed that it was only a small heart attack, and after confirming that everything looked fine she was discharged to go home. However, after spending a week or so at home, she began to notice shortness of breath and felt like something just wasn’t right. Schertzer went back to the hospital to check things out and physicians discovered a myocardial rupture, or a hole in Schertzer’s heart. Myocardial ruptures are a rare complication of heart attacks, and are usually instantly fatal. However, in Schertzer’s case, she had more than the average amount of good fortune on her side.

Schertzer’s life was saved by a combination of things, one stemming from her previous heart surgery two years ago. After that surgery, Schertzer’s body formed a layer of scar tissue around the outside of her heart. When muscles in the front left wall of her heart ruptured, the scar tissue contained the blood and kept it from leaking into her chest cavity, which would’ve been instantly fatal. Schertzer also counts the quick work of two outstanding cardiologists as one of the reasons she is still here today.

Usually, a ruptured heart is treated with open heart surgery, which is risky for anyone, much less an 85-year-old who has had previous heart surgery. The physicians had to do some quick thinking about the optimal procedure that could save Schertzer’s life, as with every passing moment her chances of surviving the surgery decreased. Schertzer’s heart had ruptured on the lower left ventricle. As the patient was in such unstable condition, Drs. Martin and Smith re-evaluated the situation. In a moment of ingenuity only comparable with resourceful television hero MacGyver, they determined the best way to proceed would be to patch the hole in her heart with a CardioSEAL patch. They had performed a myocardial patch procedure numerous times to cover holes due to congenital birth defects or strokes but had never used a patch to cover a hole as large as the one in Schertzer’s heart muscle. They saw the opportunity to try this risky but possibly effective procedure, and took the chance, with Schertzer and her family’s permission, in hopes of saving Schertzer’s life. The myocardial patch is actually a small device about the size of a quarter that is shaped like a tiny umbrella. Instead of using open heart surgery to insert the device, the patch is dispatched to the heart in its closed position through an artery. Then, once the device reaches the heart, it is opened and left in place. In this case, a double-umbrella was used, one placed outside the heart and one placed on the inside to patch up the hole.

“When all was said and done, we covered the hole with the patch and she is doing well,” said Arthur Martin, M.D., one of the cardiologists who performed the procedure. “Mrs. Schertzer really put her faith in this procedure, and did not want to go through another open heart procedure. There is no question that this procedure saved her life.”

When asked about this risky but life-saving surgery, Schertzer says, “I’m glad [the physicians] did it. We all have so much to be thankful for.” In Schertzer’s case, she does have a lot to be thankful for. Thanks to medical technology and good old-fashioned human brain power on the part of her physicians, Schertzer will be around to spend time with her three children and watch her 26 grandchildren grow. With so much potential yet to be attained in those 26 young children, perhaps one of them will grow up to save lives through a career in medicine, inspired by the miracle procedure that saved their grandmother’s life.