Surgery for Pulmonary Embolism Gives “Second Chance” to a Patient Who Had Put His Health on Hold
One day in December 2021, Benjamin Henderson, then 56 years old, couldn’t catch his breath for hours. He figured the problem would pass as it usually did. Hours passed, but not his breathing difficulty. Then Benjamin started to sweat profusely. His cousin made him laugh, and that wore him out. “I was tired, exhausted,” says Benjamin. “I mean it felt like I ran three marathons.” He tried to relax by watching the news. Then he went to sleep. At 1:30 am, Benjamin woke to searing pain, and he called an ambulance that took him to the Emergency Department at Mount Sinai Morningside.
This is how a successful journey to better heart health began for Benjamin, who received life-saving surgery for a pulmonary embolism—a clot in his lung—from Omar Lattouf, MD, PhD, a renowned cardiovascular surgeon. Benjamin’s story highlights many of the heart health risks faced by African Americans, who are 40 percent more likely to have high blood pressure and 30 percent more likely to die from heart disease than non-Hispanic whites, according to the U.S. Department of Health and Human Services.
A pulmonary embolism occurs when blood clots form in the deep veins of the legs (deep vein thrombosis or DVT), travel through the body and get stuck in the artery leading to the lungs, which can lead to cardiac arrest and stroke. Symptoms may include sudden shortness of breath, sweating, chest pain, lightheadedness, and coughing. The condition requires emergency intervention including blood thinners or clot busters.
Studies have shown an increase of DVT since the start of the pandemic, and Mount Sinai cardiologists and cardiovascular surgeons have seen an increase of emergency cases.
“The last two years of the pandemic, the rate of serious clots going to the lungs that were nearly fatal has increased tenfold,” Dr. Lattouf says, “People stopped going to see their doctor to follow their blood pressure, or their diabetes, or their general health. Putting your general health on hold, not exercising, is very dangerous.”
Benjamin had many of these complicating factors. He had spent years faithfully taking care of his mother, who had dementia and passed away in June 2021, and he had not focused on maintaining his own health with diet and exercise. He was obese and had evidence of vascular problems and poor circulation, says Dr. Lattouf, Professor of Cardiovascular Surgery, Icahn School of Medicine at Mount Sinai.
On December 3, the day of his life-changing surgery, Benjamin says, “My chest and stomach were tight. I couldn’t breathe. It was like something was tying a knot in my stomach and in my chest.” At the ED, providers ordered blood work and imaging tests, and diagnosed an acute pulmonary embolism. This means the artery leading to his lung was completely blocked. They called Dr. Lattouf, who says he only needed one look at Benjamin to know the patient was in trouble.
“His oxygen level was quite low. And what impressed me upon examination was that he had evidence of venous disease in his legs, which pointed to an immediate problem,” says Dr. Lattouf. “That meant he was at very high risk of a clot formation in his lower extremities, which could go into his lungs.”
An ultrasound showed that the right side of Benjamin’s heart was very large and was barely contracting. “That's a very bad sign,” the cardiologist explains. It means the right side of the heart is working very hard because of poor circulation, and without treatment, the heart ultimately will fail. “Left alone, he would not have survived,” says Dr. Lattouf. It was time for emergency surgery.
Benjamin says that normally he is wary of medical procedures. “I’m a scaredy cat. I’m scared of needles; I don’t like doctors.” But he felt calm and comfortable with Dr. Lattouf. “He commands a room with his voice alone,” says Benjamin. “And I trusted him.” Within a half-hour of meeting the surgeon, Benjamin was being prepped to go into the operating room. “That’s really quite drastic,” says the cardiologist.
Dr. Lattouf performed an open-heart procedure called a surgical pulmonary embolectomy to remove the clots and restore the blood flow. He opened up Benjamin’s chest, then went into the blood vessel. Using forceps, he removed a foot-long clot, which was unusually large, as well as some smaller clots. Throughout the four-hour procedure, Dr. Lattouf supported Benjamin’s heart with a heart-lung machine.
While pulmonary embolectomies are generally considered safe, factors including Benjamin’s weight made the procedure more risky, explains Dr. Lattouf. Often patients with this severe a condition and this many risk factors would go right into heart failure. But Benjamin was in good hands; Dr. Lattouf has been performing complex pulmonary embolectomies for more than a decade. Benjamin says, “All I remember is getting anesthesia in the OR and waking up two days later.”
Benjamin says his health had declined partly because of the demands of being a caregiver to his mother. “Dementia is really hard,” says Benjamin. “The mood swings, the attitude, the time.” But Benjamin knew he couldn’t give up on his mother. “It was really, really difficult for years. But I wouldn't change it for anything in the world,” he says. Benjamin was worried about taking the COVID-19 vaccine, but he is now vaccinated, after learning that because he is in several high risk groups—as an older African American man who is overweight, and has a heart condition—vaccination is important to keep him and his loved ones safe from serious illness.
Benjamin expressed deep gratitude to Dr. Lattouf and the team at Mount Sinai Morningside. “I'm lucky. I feel like a miracle,” he says. Since his surgery he says he has been determined to “do what’s right for me and my body.“ He has lost 40 pounds and exercises regularly.
Benjamin hopes his story will inspire people to make healthy lifestyle changes and to get vaccinated against COVID-19. “I just want to live” he says. “I’ve got a second chance, and I want to take advantage of it.”