HCA Florida Brandon Hospital performs challenging open-heart surgery after high-risk patient experiences double heart attack
The HCA Florida Brandon Hospital cardiovascular team performed a series of life-saving cardiac catheterizations and open-heart surgery to save the life of a patient who is a double-leg amputee from a prior accident. When Debra Shine arrived at the emergency room at Brandon Hospital suffering a heart attack, she underwent an emergency cardiac catheterization during which a stent was placed in her right coronary artery. She was stabilized by the procedure, but doctors determined she would need further care.
Shine had two other arteries with significant blockages. Her left anterior descending artery (LAD) was 95% blocked, and her left circumflex artery (LCX) was 85% blocked. Dr. Umesh Gowda, interventional cardiologist and medical director of the cardiac cath lab and structural heart program and his team decided on a revascularization approach based on Shine’s overall health and the loss of her legs. The team decided that a catheterization procedure to insert two stents was the best approach.
Although Dr. Gowda was confident in the procedure, he shared, “the blockage was a challenging configuration. It changed the whole approach to her care.” Shine then had a second heart attack and Dr. Gowda called for a rapid response from the rescue team. The team intubated the patient and placed the intra-aortic balloon pump until emergency open heart surgery could be performed.
Dr. Kristen Errico, a cardiovascular and thoracic surgeon at Brandon Hospital, prepped and stepped in to perform the surgery. Shine’s heart was weak and stressed, but the team was able to place the bypass. The procedure was complicated by limited vein access due to Shine’s previous amputations.
“Most commonly, we have one surgeon prep an artery in the chest wall called the mammary artery, also known as internal thoracic artery, while another surgeon harvests pieces of veins from the legs to make the bypass. It was much more challenging in this case, because Shine had two leg amputations previously and there was less viable vein to use for the bypass. In the end, we were able to collect enough vein, but it was roughly 40% of what we typically work with.”
“There was a 50/50 chance she might not survive the night,” said Dr. Errico.
Against the odds, Shine endured a challenging recovery and rehabilitation, and today she’s back to living the active life she loves.
Read more about her life-saving care and family who stood by her side in the ‘Patient Stories’ section of the Brandon Hospital website.