Heart Patient Turns to Mount Sinai Morningside for “Bloodless” Surgery That Honors His Beliefs
Rolando Perez, who is from the Dominican Republic, noticed that his health was declining in November 2020. At first, he felt as if it was muscular pain, but as the days went on, his fatigue increased. Eventually, he had trouble walking even 10 steps.
When his daughter Lucia saw him, she was alarmed. She urged him to visit a leading cardiologist in the Dominican Republic, Pedro Ureňa Velazquez, MD.
As his health continued to decline, Rolando did not believe he would live to make his appointment. Dr. Ureňa Velazquez started Rolando on a treatment plan that stabilized his condition. Within a few days, Rolando lost 21 pounds as excess fluid was flushed from his body, reducing his blood pressure. He was disoriented, but little by little, he felt better.
Dr. Ureňa Velazquez wanted to do percutaneous coronary intervention, also known as angioplasty, because he believed there was an issue in Rolando’s heart. Doctors thought it would be a simple procedure. However, when they conducted the coronary angiogram, they discovered he had significant obstructions in all of his heart arteries. This condition runs in Rolando’s family. Three of his family members have died from this condition.
Rolando needed coronary bypass surgery, however, he is one of Jehovah’s Witnesses and was not willing to accept a blood transfusion as part of his treatment options. Doctors had to find another solution to help Rolando to survive a surgery. Rolando’s daughters took matters into their own hands and called eight different hospitals, but the nearest appointment they could find was for two months later. They knew there was no time to spare.
Rolando’s daughter Lucia reached out to John Lemond, a fellow Jehovah’s Witness who has helped many patients with similar concerns. With his assistance, the family found a lifeline in the Bloodless Medicine and Surgery Program at Mount Sinai Morningside, managed by Sandra Gilmore. This program is designed to provide transfusion alternatives in the form of surgical procedures, medication, and technologies in order to honor the preferences of patients and their families.
As Rolando was on a plane from Dominican Republic to New York, Ms. Gilmore received a call from the U.S. Branch Office for Jehovah’s Witness and one of Rolando’s daughters, who said he desperately needed to receive care upon his arrival to New York. She reached out to John Puskas, MD, Chairman of the Department of Cardiovascular Surgery at Mount Sinai Morningside, Mount Sinai Downtown, and Mount Sinai West, who agreed to see Rolando the next day.
During testing, Dr. Puskas discovered a blood clot in one of the chambers of Rolando’s heart, caused by the very weak pumping strength of the heart. Rolando was referred to Matthew Tomey, MD, to help treat the blood clot before surgery. Rolando’s daughter Minosky remained hopeful about his future. “When I talked to Dr. Puskas that first day, I felt his confidence and certainty. Other doctors had told us that my dad’s heart function was super low, and he was very likely to have a heart attack any moment—that the chance of him dying in his sleep was high. But when I met Dr. Puskas, his confidence gave me faith.”
Once the blood clot was treated, Dr. Puskas saw that Rolando’s red blood cell count was doing well and agreed to perform the surgery. Dr. Puskas and Omar Lattouf, MD, PhD, performed the complex six-hour surgery. Rolando felt at peace and comfortable when it was time to have surgery, and during the procedure, a member of the surgery team kept Rolando’s daughters informed on how he was doing, which reassured them as well.
Rolando underwent a very sophisticated operation that is performed in very few centers in the world. His triple bypass was performed entirely with artery grafts rather than vein grafts, since artery grafts are known to last longer than vein grafts. His operation did not use the heart-lung machine and avoided manipulation of the aorta, to reduce the risk of both bleeding and stroke. Mr. Perez did extremely well after surgery and was quickly removed from the ventilator. His preferences were strictly respected and he received no blood products of any kind.
Rolando’s condition continued to improve, and he was cleared to leave the hospital eight days after surgery. He is wearing a defibrillator vest to monitor his heart rhythm as he continues to get better. Even Dr. Puskas was surprised at the speed of Rolando’s recovery.
Expressing deep gratitude for her father and her family, Lucia says, “Mount Sinai Morningside was an excellent hospital. We felt so much empathy, talent, professionalism from Dr. Puskas and his team.”