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Blocked Arteries, Heart Bypass Surgery

Dimarzio 620

If you were to meet 88-year-old Mary DiMarzio, you couldn't help but see her as a role model for aging gracefully. Her petite frame exudes a positive spirit and a contagious enthusiasm. She shares stories about her four children, grown grandchildren, and one-year-old great-granddaughter. She lives independently in the same house she and her husband bought in 1956, seven blocks from The Chester County Hospital. She is a member of the Hospital's Women's Auxiliary and works in the Hospital's Gift Shop twice a week.

Mary's ties to The Chester County Hospital reach back to 1939, when she came to train as a nurse and then built a 25-year career here, often working part-time while raising her children. Mary remembers with a laugh that colleagues called her "Tiny," a nickname coined for her by the head of surgery at the time.

Mary left nursing in 1967 to open a small grocery store on Biddle Street in West Chester -- a store she and her husband naturally named Tiny's. "Everyone knew Tiny's," Mary says with a smile, and the DiMarzios ran the store for 17 years. Mary's ties to The Chester County Hospital were still strong, as it remained a trusted source of healthcare for her family.

Those ties became even stronger in March 2009, when "Tiny" Mary DiMarzio earned a new nickname, "Miracle Mary," given to her by her cardiologist, W. Clay Warnick, MD. She beat incredible odds by surviving and thriving after multi-vessel heart bypass surgery -- a risky procedure for anyone, but extremely high-risk for Mary.

Mary first started feeling poorly in late 2008, but she attributed it to holiday stress and the recent tragic death of her 26-year-old granddaughter. "I felt like I had the flu and bad indigestion," she says. Her symptoms worsened in the New Year, so on February 23rd she went to the Emergency Department at The Chester County Hospital. By that afternoon, she was in the cardiac catheterization lab, where cardiologist Timothy Boyek, M.D., discovered that her three main coronary arteries were blocked.

Soon came more bad news from cardiovascular surgeon Martin LeBoutillier, MD: her heart's ejection fraction was only 12 percent, much lower than the normal 50-55 percent, and blood was backing up into her mitral valve. Surgery to bypass the blocked vessels was possible but very risky, given her age and other health conditions, including diabetes and some abnormalities in kidney function. For the time being, her condition could be managed with medications and an intra-aortic balloon pump doctors had implanted. But Mary and her children now had to decide whether the risks of surgery were justified.

"It was a difficult few days," Mary recalls, "but eventually I said, 'Let's go for it. I can't live like this. If I don't make it, at least I know I tried.'"

Fate ultimately made the decision for her: on March 3rd, Mary started having a heart attack and was taken in for emergency surgery. Dr. LeBoutillier performed a beating heart or "off-pump" four-vessel bypass surgery. She spent a rather uncertain nine days under sedation with a breathing tube. Once she woke up, she started back on the road to recovery. Mary left the Hospital at the end of March, completed several weeks of inpatient rehabilitation, and was back home by the end of May.

"Two weeks later, I fired all of my help," Mary jokes, referring to her visiting nurses and the son who had been living with her. Her ejection fraction was now up to 45 percent -- leading Dr. Warnick to call her "Miracle Mary" -- and she completed 26 sessions of cardiac rehabilitation.

"I was so glad I could have such a complex procedure here, close to home and family, and not go into the city," Mary says. "The care here was phenomenal and I especially credit my nurses, who are such a dedicated bunch."

Nurse practitioner Jen Law, CRNP, agrees that Mary's recovery has been nothing short of miraculous. She notes that, according to the Society of Thoracic Surgery's online risk modeler, Mary's risk of dying during surgery was greater than 80 percent and her combined risk of dying and having long-term complications was 96 percent. "You really can't get much higher than that," Jen marvels. "For her to come through without any major organ damage and to be living on her own again is amazing."

Mary is back to work at the Gift Shop and recently celebrated the first anniversary of her surgery with a month-long trip to Florida.

By Kristine M. Conner

Mary's Doctor

William Clay Warnick, MD

Medical Director of Cardiovascular Service Line Chester County Hospital

Dr. Warnick completed his undergraduate training in Biochemistry at Rutgers University, New Brunswick, New Jersey. He received his medical degree and completed a fellowship in Cardiovascular Medicine at Hahnemann University School of Medicine in Philadelphia. Dr. Warnick regularly lectures on multiple topics in Cardiology. He is the, Medical Director of the Congestive Heart Failure Clinic at Chester County Cardiology Associates; the Medical Director of Cardiac Rehabilitation and Co-Medical Director of the Heart Failure Program at Chester County Hospital. He has expertise in transthoracic, transesophageal echocardiography, and nuclear cardiology. Dr. Warnick is a partner at Chester County Cardiology Associates and sees patients at their West Chester and Kennett Square offices.

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