Patient Gets a Second Chance at an Active Life After Heart Attack While Running

Verissimo Costa’s life was saved in 2018 by a Mount Sinai surgeon after he collapsed during a jog. On November 7, 2021, he and the renowned surgeon—John Puskas, MD, Chair of Cardiovascular Surgery at Mount Sinai Morningside, Mount Sinai Beth Israel, and Mount Sinai West—celebrated that new lease on life by running the New York City Marathon together.

Verissimo had always considered himself to be in good shape. On a near daily basis, he would go for long-distance runs throughout New York City. But he received a frightening wake-up call during one of those jogs, in October 2018. While he was running on his favorite path along the Hudson River, his heart stopped as he dropped on the ground, unconscious and pulseless. “I was clinically dead for a few minutes, like five minutes,” Verissimo says. Thankfully, two cyclists in the park saw him collapse and proceeded to perform CPR. Paramedics responded to the scene and rushed Verissimo to Mount Sinai Morningside.

When Verissimo arrived at the hospital, Dr. Puskas, a world leader in coronary artery bypass surgery, took over his care. The first priority was cooling Verissimo’s body temperature to help brain healing. Then Dr. Puskas performed an innovative heart bypass.  "We performed a highly unique procedure, one in which we do not use any veins, rather only employ arteries for the bypass," Dr. Puskas said in a WABC news report on Verissimo’s care.

The procedure, known as all-arterial, no-aortic-touch, off-pump coronary artery bypass, uses only arteries rather than veins for bypass grafts and avoids any manipulation of the aorta or use of the heart-lung machine. In this novel procedure, the heart continues to beat throughout the surgery, and risk of stroke is greatly reduced. 

This was particularly important for Verissimo, who had already suffered a prolonged period of confusion caused by his cardiac arrest. Moreover, for such a young patient, the use of only arterial grafts ensured that his coronary bypass surgery would have a longer benefit than the conventional operation performed elsewhere, in which most grafts are veins taken from the patient’s legs. Approximately 50 percent of vein grafts are known to close within 10 years of coronary bypass surgery, while arterial grafts have a 90 percent likelihood of being open beyond 10 years, Dr.  Puskas says.

According to medical experts, most people die after a heart attack like the one Verissimo experienced. Fortunately, Verissimo made a full physical recovery. However, he had to get past the fear of a repeat heart attack while running. With the support of Dr. Puskas, who joined him on a number of his runs, Verissimo pushed through.

This year, Dr. Puskas and Verissimo decided to run the New York City marathon together. Verissimo told the New York Daily News, “I don’t think I was even thinking about that, how my life was going to be after the surgery. Here I am, and I’m running the marathon. I’m very excited, half-terrified. It’s my first time.”

In an interview with ABC News, Dr. Puskas said Verissimo was more than ready for the marathon "We did 15 miles together a couple of weekends ago. We ran from here all the way down to the Battery and back and he's going to be just fine," Dr. Puskas said.

Another grateful patient, John Garlepp, 84, helped with the training.  John is a former world-class marathoner who finished six in the 1971 New York City Marathon. In 2019, Dr. Puskas performed bypass surgery on John, who no longer runs but remains a popular coach. “He was one of the best athletes on the planet in 1967,” Dr. Puskas explained. “Fifty years later, he’s coaching his surgeon and a patient to run that marathon.”

Verissimo never believed he would be hospitalized because of a heart issue. He was 42 years old, a vegan, and had annual physicals. But there was a history of heart disease in his family. His advice for people who believe their healthy habits are enough?  “No matter how young or healthy,” he says, “there’s still danger if you have a family history of heart disease. You cannot take your health for granted.”