BY EMILY KULKUS
Chris Diaz is no stranger to fear or pain.
Diaz, 35, spent four years in the Army, including nearly a year in Iraq from 2009 to 2010. When you’re in the Army, if something hurts, you drink water and press on.
That’s what Diaz tried to do on Nov. 28, 2017, when he felt a surge of pain snake up his left arm and into his chest. Diaz was studying mechanical engineering at Clarkson University at the time, and finals were looming. He figured the pain was related to anxiety or stress because of his exams.
“Honestly it felt like razor blades up my veins,” he says. “It felt like something I’d never had before — a crushing sensation around my heart.”
He drank water, but the pain got worse. His fiancée, a certified nurse assistant, said he looked pale and was sweating. She insisted he see a doctor. She drove him to the emergency room at Canton-Potsdam Hospital in nearby Potsdam. There, they listened to his chest and detected a murmur. An ultrasound revealed a much more serious condition: Diaz had an aortic dissection, which is when the large blood vessel of the heart tears. The surging blood can continue to tear the aorta, causing blood that should flow through the heart to spill into the body. In more than 50 percent of cases, the injury is fatal within 24 hours. Without surgery, up to 75 percent of cases are fatal within two weeks.
Diaz needed surgery immediately.
That’s when his memory of that day gets blurry. He remembers doctors starting pain medicine and telling him he was going to be airlifted to Upstate University Hospital in Syracuse. He remembers the ambulance but not the helicopter. He remembers the airport but not his arrival.
He definitely remembers what he was thinking at the time: “I’m going to miss my finals because of this. I was just really mad this was going on,” he said
G. Randall Green, MD, chief of cardiac surgery at Upstate, was waiting for Diaz. He asked him if he wanted a mechanical valve or a tissue valve to replace the one that was tearing. Diaz chose mechanical. He woke up many hours later in the recovery room.
It wasn’t until later that doctors told Diaz how dire his situation had been. “My cardiologist said, ‘We weren’t expecting to see you again,’” Diaz recalls. His surgeon told him that if he’d arrived in Syracuse 30 minutes later, he probably would have died.
Green says Diaz’s case is memorable and remarkable.
“We were doing chest compressions when he came into the operating room. He had no heart rate, no blood pressure. He was basically not with us anymore,” Green said. “All of us looked at him and said we’ll do our best for this guy.
“It’s just unbelievable what the human body and the human spirit are capable of living through.”
Diaz spent eight days at Upstate, followed by a rigorous course of physical therapy to regain his strength. He took his finals from the fall semester the following March. Two months later, Diaz graduated from Clarkson with a degree in mechanical engineering. During the graduation ceremony, President Anthony Collins told Diaz’s stor and thanked him for his service.
No one knows why Diaz suffered the aortic dissection, something that normally occurs in much older patients. Diaz thinks it might be genetic, since his mother has a heart murmur. Chest trauma from serving in Iraq may have also contributed, he says.
More than a year later, Diaz feels like his old self. “I feel great,” he says. Medicine regulates his heartbeat and prevents blood clots, and he exercises every day. He and his fiancée have settled in Milford, outside of Oneonta, and are planning a summer 2019 wedding.
Which valve would be best for you?
If you need a heart valve replacement, you may be asked to choose between a mechanical valve (left) or one made of tissue (at right).
Generally, people younger than 60 have been apt to choose a mechanical valve because of its durability. But a mechanical valve, made from materials such as titanium and carbon, comes with a lifelong requirement to take a medication that reduces the risk of blood clots by thinning the blood. It may not be right for some people, including women of childbearing age.
People who choose a tissue valve may face the prospect of needing a second valve replacement operation years later. That’s because tissue valves, made from pig valves or cardiac tissue from cows, last only 10 to 20 years. Tissue valves are more popular with people over age 70 who don’t want to have to take a blood thinner, says G. Randall Green, MD, Upstate’s chief of cardiac surgery.
He said options changed about six years ago with the development of the transcatheter aortic valve replacement. This is a procedure in which a doctor inserts a catheter — a thin tube — into the patient’s groin and threads it into the heart. There, a stent is deployed with a tissue valve that takes the place of the diseased valve. TAVR, as it’s known medically, is only used for aortic valves that have stenosis, or a narrowing of the valve that restricts blood flow.
Green says doctors aren’t sure how long the transcatheter valves will last. The procedure is less taxing than an open surgery, so patients who want to avoid taking blood thinners may be OK with the idea that they may require a redo years later
This article appears in the winter 2019 issue of Upstate Health magazine.