need answers

My father went in on May 15 to have a pacemaker put in because he had a few drops in his heartrate. He had a history of bypass and stents but a catherization done six weeks prior to the pacemaker showed his arteries were clear. He had the procedure done, was in recovery and doing well and suddenly suffered a massive heart attack from which he never recovered. He died on May 17. I apologize if this post is disturbing to those of you with pacemakers but I am desperately trying to find some answers. The surgeon told us that he believed there was a problem during the surgery with an "old stent" and that a blood clot dislodged and completely blocked an artery. How is this possible if he was watching the procedure as he did it...would he not know if he encountered a blood clot and especially not know if he dislodged it? A pulmonogist was also called in and we don't know why. he was put on a ventilator within two hours after surgery. I am so distraught because this was supposed to be a routine surgery and my dad's quality of life was excellent. Obviously this was extremely rare and again, I almost didn't post this but I am seeking answers anywhere I can. Thank you in advance for any thoughts.

4 Comments

Loss of your Dad to Myo

by donr - 2012-06-05 01:06:22

Suzi: My condolences to you on such an unexpected death.

I've said it several times in here - there are TWO kinds of heart problems - Plumbing & Electrical. Stents & bypasses take care of the Plumbing problems & Meds, Ablations & PM/ICD's take care of the Electrical. They are, unfortunately, sorta like North & South - Ne'er the twain meet.

Generally speaking, when you have an Electrical problem, you see an EP - Electrophysiologist - the equivalent of an electrician for your house. He's an interventionalist cardio who specializes in the electrical functions of the heart.

When you have a Plumbing problem - valves, coronary arteries, etc, you see a regular cardiologist or for interventional procedures, a Cardiac surgeon. These Dr's are like plumbers for your house.

The two breeds speak two separate languages & perform two completely different kinds of procedures.

The reason for this long intro -

When an EP does a PM implant, he/she goes into the sub clavian vein, right under the collar bone. The leads are threaded down into the upper chamber of the heart & one is usually implanted like a harpoon in the flank of a whale. If a second lead is used, it is then guided down through the valve into the lower chamber & implanted in the wall of that chamber.

At no time does the EP really see the coronary arteries. That's where the heart attacks take place. They are on the outer surface of the heart, whereas the EP is working on the inner chambers of it.

The EP works w/ big fluoroscope panels so he can watch where the leads are going in the veins & where he is going to implant the ends.

You are really asking a mal-practice/ competency question. That's a tough one that we will be hard pressed to answer well. Because of the real division between the two specialties, your EP would not be seeing what happens in the coronary arteries. You say your Dad made it into recovery - that means that the fatal event took place AFTER the EP was finished & satisfied that all had gone well during his procedure. Your Dad had been turned over to the folks who monitor recoveries at that time.

There is a good chance that he would not know if a blood clot was dislodged - it would not likely show up on the screen.

I hope this gives you a start on your investigation. You should talk to some specialists for more exacting info.

Don

I'm so sorry to hear

by Jax - 2012-06-05 07:06:03

Of yr dads passing. My condolences.

My condolences as well.

by Pookie - 2012-06-06 02:06:10

Don gave a pretty good description of what type of doctor is responsible for what issue when it comes to the heart.

I'm not quite sure how it works other than here in Canada, but before we go for any type of surgery, we meet with the Anaesthesiologist and they go over all of the risks associated with any type of surgery and have the patient sign saying they have read such information and understand it fully. I remember reading all the risks and most of them were things like infection, punctured lung, etc. but I also remember reading where it said death can occur but the % was so low I didn't give it a 2nd thought. Just wondering if your Dad had to sign anything like that...perhaps you should get a copy of his medical file.

I know you want answers and by golly you deserve them; is there anyway the family can meet with the doctors who did the surgery so they can explain in detail step by step what happened and why. Not that this will bring your Dad back, but I'm thinking it may give you a better understanding of exactly what went wrong and why.

I lost my Dad just 9 months ago today - massive heart attack, he was 79. It's been extremely difficult, but with each day that passes it is getting a bit easier to deal with.

My heart truly goes out to you.

Pookie

Thank you

by suzilks1 - 2012-06-06 10:06:44

Thank you all for your input. I am not considering a malpractice suit. My dad would not want that and as pookie said it won't bring him back. We are just trying to understand exactly what went wrong. There was some mention right after Daddy came out of surgery that there could be a problem with his lung but that they didn't think it was serious but we keeping watch. About a half hour later he suffered the heart attack. We are planning on meeting with the surgeon just to try to understand the sequence of events. I think it would be so helpful to us to move on if we could just understand what happened.

Again, thank you all for your comments. They were helpful to me.

Suzi

You know you're wired when...

You always have something close to your heart.

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