Tamboli knew time was pressing. Finally, he found a clot.
The cardiologist carefully fed the catheter through the blocked artery. Attached was a suction device that Tamboli planned to use to vacuum the clot.
He planned to then insert and inflate a miniature balloon to open the artery, followed by a mesh metal tube known as a stent that would keep the artery open and the blood flowing.
Then Sosa’s heart stopped.
A dozen medical staffers hastened to the lab. This was a “code blue” — Sosa needed resuscitation.
A critical care doctor directed the responders. They intubated Sosa to keep him breathing, hooking a tube to a ventilator and inserting it down his throat. They injected him with medication to increase his heart’s output. With a defibrillator, he was shocked his heart.
Three medics took turns performing CPR.
In the midst of this “organized chaos,” Tamboli was still trying to open Sosa’s blocked artery. X-ray images showed his stopped heart.
“He’s dying on me, literally dying on me,” Tamboli remembered.
Under ideal conditions, steering a catheter wire through arteries toward the heart is a tricky procedure, a series of delicate, minute movements and adjustments.
Tamboli was trying to perform it on a body being jolted by defibrillators and pounded by chest compressions.
“It’s like trying to fix an engine with the engine running,” he said.
Tamboli told those performing CPR that he needed them to pause for 10-second intervals. Four times, CPR was halted.
Knowing he had little time left and only a rough idea of where the clot was, Tamboli asked a nurse for the longest stent they had. Then he fitted the 1¼-inch-long mesh tube inside Sosa’s right coronary artery.
With the stent in place, doctors were able to restart Sosa’s heart. For about a minute, he had been clinically dead.
Sosa was alive, but barely.
His blood pressure was “in the toilet” and no one in the room was confident he would survive.
“The critical care doctor tells me, ‘You know, I think he’s gone. Maybe we should go and talk to his wife,’ ” Tamboli said.
Tamboli knew it made medical sense to stop. But something inside told him to persevere. He knew Sosa was relatively young and, other than high blood pressure, had been in good health.
As a last resort, he made the decision to install a tiny heart pump inside Sosa known as the Impella. The device does much of the work of the heart, pushing out healthy blood to the organs. He hoped that it would reduce the strain on Sosa’s heart muscles, allowing them to recover.
The device was inserted through the same femoral artery. But even with the pump, Sosa’s heartbeat remained weak.
There wasn’t much more doctors could do. They took Sosa to intensive care and placed him in a medically induced coma. He was given IV drips of medication called inotropes, which makes the heart squeeze harder.
His body temperature was lowered to about 36 degrees to give his brain the best chance of surviving undamaged.
“I told his wife and the family to pray hard for divine help as we had done what we could,” the doctor said.
Sosa had not improved when Tamboli returned to the hospital the next day.
Three days later, doctors started to thaw Sosa out, slowly warming his body. Tamboli kept calling for updates.
On the fourth day, the nurse’s report gave Tamboli hope. Sosa’s medications had been reduced and he was not as reliant on a ventilator.
When Tamboli made his rounds, he examined Sosa himself. An echocardiogram showed a stronger heartbeat. Sosa occasionally opened his eyes. Standing next to their unconscious patient, doctor and nurse hugged and cried. They didn’t know Sosa but they knew how hard the medical team had worked to save him. They knew how close he had been to death.
On Sept. 28, five days after his heart attack, Sosa’s doctors removed the heart pump.
It was another two days before Sosa regained consciousness.
He woke to find his arms and legs restrained to the hospital bed, a precaution against movements that could disconnect IV drips and sensors monitoring his vital signs.
There were dark marks on his arm. His whole body felt beat up.
He thought it had been a day since the ER nurse cut open his shirt. A nurse explained he had been unconscious for a week.
He was sitting up when Tamboli entered his room. The doctor gaped.
“He was so amazed,” Sosa said. “It’s like when you see a dead person.”
Tamboli cannot say with certainty that Sosa’s COVID-19 infection caused the blood clot and his heart attack.
Normally, clots appear alongside plaque, a telltale sign of high cholesterol issues, the doctor said. To see a clot in an artery with no plaque was unusual.
Sosa had never had heart issues before. Never smoked. Never drink.
Those who’ve caught the virus seem to have higher clotting tendencies, in Tamboli’s experience. Many of his patients who are discharged after an infection end up on blood thinners, he said.
Tamboli can’t explain why Sosa survived. In his 35 years treating cardiac patients, no patient has been so close to death and lived. In cases like this he believes a higher power intervenes, be it fate or providence or God.
“That’s the law of the universe,” he said. “There’s something higher than us. There’s a bandmaster ahead.”
Sosa, who turned 59 in January, says he feels in good health but gets tired more easily.
He’s on a daily regimen of 12 pills that includes blood thinners. Every three months, he must see a heart specialist.
In the five months since his heart attack, he’s experienced many of the same emotions — relief, gratitude, an increased closeness to God and a newfound joy in life — as others who have suffered near-death experiences.
He hopes his experience will be a warning to others not to ignore symptoms that could signal heart trouble.
Sosa still exercises, but gently. He still takes on handyman jobs around the house, but no longer works through the evening.
He makes more time to be with his wife, children and three grandchildren, to walk on the beach, to enjoy life a little more.
“I know how fragile we are,” he said.
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