Mount Sinai Offered Timely and Life-Saving Surgery for Lung Clots
Doug Robertson, age 59, was having a hard time breathing—and had been short of breath for several days. Since Doug’s symptoms had not improved, his wife checked his blood oxygen saturation level and found cause for concern. It was in the 70s, the normal level is 95 or above. When the oxygen saturation, as measured by a finger-tip measuring device called a pulse-oximeter, dips below 88 it requires immediate medical intervention. Doug’s wife called an ambulance, which arrived at their Upper West Side home within 15 minutes.
At the Emergency Department, providers immediately administered oxygen. While there was some concern about Doug’s COVID-19 status, he was fully vaccinated and had tested negative several times in recent days.
Imaging tests showed blood clotting in his legs and lungs, which required assessment from heart specialists who treat clots that could go to the lungs. These clots can create a life-or-death situation. As a result, health care workers transferred Doug to Mount Sinai Morningside and placed him under the care of Dr. Lattouf, Professor of Cardiovascular Surgery, Icahn School of Medicine at Mount Sinai. Dr. Lattouf reviewed the computed tomography (CT) angiogram imaging and confirmed that Doug had a very large clot in his lung arteries, with blood backing up into his right heart and unable to cross into the lungs due to the obstruction imposed by the clots.
When the clots are very large, as in Doug’s case, they can lead to cardiac arrest and death, if not managed correctly and in a timely way. Symptoms may include sudden shortness of breath, sweating, chest pain, lightheadedness, and coughing. Occasionally, patients may cough up a streak of blood if the condition goes unattended and causes lung tissue damage. Once diagnosed, patients usually receive blood thinners as the initial line of treatment along with supplemental oxygen, and then may receive clot busters or suctioning of clots with specialized catheters under the direction of expert interventional radiologists.
Doug was evaluated by Dr. Lattouf, who recommended surgical pulmonary embolectomy to remove the clot in his lung. This open-heart procedure involves making an eight to 10-inch incision in the chest, and placing the patient on the heart-lung machine. While the heart is still beating, the clots are removed using specialized forceps and scopes that can reach deep into the lung arteries to ensure all the clots are cleaned out and allow blood to again flow freely into and through the lungs.
Once Doug and his family learned of the seriousness of the condition and the available option, they proceeded with Dr. Lattouf’s recommended plan. In a successful and uneventful procedure, all of the clots were removed in a five-hour operation. Doug then spent six days in the intensive care unit and one more in a private room. He went home in very stable condition, Dr. Lattouf says, and returned for follow-up in excellent condition without any physical limitations.
“The nurses, aides, and transporters were all very helpful and supportive,” Doug recalls.
And the surgeon? “Dr. Lattouf saved my life,” Doug says. “I appreciate his demeanor and felt comfortable with him leading the surgery. I would strongly recommend him. He was very knowledgeable and experienced. His bedside manner was top-notch, especially in such a scary time for my family and me.”
Doug is working hard at his recovery. A few weeks after the procedure, he was back to walking three and a half miles a day. He happily celebrated his birthday on February 8, a milestone he wasn’t sure he’d reach less than a month earlier.