Beware the Elephant

Lake County man in the right place for extensive cardiac care at UH Lake West

Mike Zappitello knew just where to go for the best cardiac care in Lake County – and that was even before an elephant landed on his chest.

The 61-year-old Concord Township man was playing pickleball with his wife, Giselle, and another couple. He was sweating more than usual, as he had last fall chopping wood. Pain was radiating down his left arm. He felt like he was choking. In denial, he blew off suggestions that he didn’t look well. He called ‘time out’ to catch his breath.

“That was about the time the elephant sat on my chest,” said Zappitello, who was on the verge of major heart surgery. “Being the forthright guy that I am, I took a couple swigs of water and finished the set.”

Luckily, he lived to tell his story and arrived at the hospital before too much damage occurred. He didn’t mention that elephant to his wife – who had lost multiple loved ones, including both her parents, to heart attacks – until they were in the ER at UH Lake West Medical Center.

University Hospitals Harrington Heart & Vascular Institute has expanded cardiac services in Lake County to ensure immediate access to top-rated care close to home. More cardiovascular experts were added in the community, with prevention and testing services in Concord and Mentor and emergency care at UH Lake West Medical Center in Willoughby. Clinical and surgical suites at UH Lake West Medical Center have also been enhanced with the latest technology so the team can perform advanced interventional and electrophysiology procedures, as well as complex cardiac and vascular surgeries onsite.

Four blocked vessels

A cardiac catheterization found multiple blocked vessels, but Mike’s heart needed time to recover in preparation for surgery. His left anterior descending (LAD) artery was 99% blocked, and several other arteries needed bypass also. A balloon pump was placed to boost blood flow to his heart and keep it pumping steadily until surgery.

Cardiac surgeon Igo Ribeiro, MD, MS, FRCSC, chose to perform Mike’s case off-pump, operating on the beating heart to refrain from putting his patient on the heart-lung bypass machine. Dr. Ribeiro explains that this is beneficial in certain cases, such as when patients are on blood thinners, because surgeons must wait five days to operate on those patients. Instead, this expert with UH Harrington Heart & Vascular Institute was able to bypass Mike’s LAD, two circumflex lesions and a nearly 80 percent blockage in his right coronary artery. Dr. Ribeiro used two arteries, rather than veins, for the grafting.

“This is the best treatment for a patient’s long-term survival,” Dr. Ribeiro said. “We did not stop his heart, decreasing incidence of bleeding after the procedure. The good news for this man is that his heart function was preserved, so we did the procedure at the right time.”

Mike went home four days after surgery. Like many patients, he had a brief episode of atrial fibrillation, which is not uncommon to develop after surgery due to the body’s inflammatory response. He was treated with antiarrhythmic medications and, as usually happens, it resolved.

He later went to cardiac rehabilitation, a medically supervised exercise program, at UH Brunner Sanden Dietrick Wellness Center in Mentor. Three times each week for 13 weeks, Mike was instructed in safely ramping up his activity again.

Be alert to warning signs

Giselle had noticed that her husband of nearly 20 years had less energy than usual. He got winded chopping wood in the back yard last fall. Through the winter, he was sleeping well beyond his usual early morning wake-up.

Friends said he looked tired. Giselle did not disagree. But he wasn’t complaining of any discomfort, so she didn’t push.

“I wish I would have noticed, and I wish I would’ve known to do something, but that light bulb never went off in my head,” said Giselle. “When you live with somebody for so long, you pass off things as normal.”

Yet Mike admits that he would not have headed to the hospital that Friday in February if she had not pressed him to go.

“Giselle saved my life by talking me into going to the hospital,” he said.

Related Links

Learn more about heart and vascular services in Lake County.