“The way I was treated, I would do it again,” she declares. “For me, that’s just how simple a procedure this was. The care I received, not just from Dr. Chakhtoura but from the nurses and technicians, was incredible.”
An Inventive Approach to Unblocking Arteries has Given Sandra G a New Lease on Life
For Sandra Gaudiosi, her third experience with a serious medical issue over the past few years proved the most difficult. The special education teacher had recently had a colostomy, and then a bout with anal cancer, before a surprise episode brought her to the Emergency Department at Clara Maass Medical Center (CMMC). “All of a sudden I got a pain in my breastbone area that went immediately toward my back and I said, ‘Oh my God, this is not right,’” Sandra recalls. “With that, we called 911 for an ambulance.” After conducting an examination and tests, the physicians at CMMC informed Sandra that she needed to have a percutaneous coronary intervention, or PCI—a treatment that uses dye and a flexible tube or catheter to unblock narrowed coronary arteries and insert a stent to restore vital blood flow to the heart. “When I was told I had to have this procedure, that really shook me up,” Sandra says. “I was able to face having a colostomy and I was able to find the strength to get through a cancer diagnosis, but knowing that it was my heart this time—that really set me back.” A devoted wife of 52 years to her high school sweetheart, proud mother of two daughters, and doting grandmother to a 16-year-old “football superstar,” Sandra drew strength from both her family and her dedication to her job to move forward on this frightening and unexpected journey. “I had to get back to my family, my students and my school. I wanted to get back to work and make it to graduation. That was my goal.”
An Atypical Approach
Traditionally, a PCI is done by inserting a cardiac catheter through the femoral artery in the groin. But Sandra qualified for a “transradial approach PCI,” a less-invasive technique in which the catheter is inserted in the patient’s radial artery at the wrist. The procedure has several advantages, which include a lower risk of complications from bleeding, early ambulation and early discharge. “When we intervene to fix a blood vessel, because of the blood thinners that the patient is on, there is a risk of bleeding when the catheters are removed at the end of the procedure,” explains Elie Chakhtoura, MD, interventional cardiologist, Director of the Cardiac Catheterization Laboratory at CMMC and member of Barnabas Health Medical Group. “When you perform the procedure through the groin, there is more bleeding and it’s harder to control in that area — so much so that a blood transfusion is sometimes necessary.” In men with prostate disease, the femoral approach can lead to problems in urinating after a prolonged period of post-procedure bed rest. “With the wrist, we can compress the artery with a simple compression device. The patient is able to ambulate immediately, and often can be discharged the same day,” Dr. Chakhtoura explains.
Energy Returns
Despite her fear of the worst, Sandra says her experience couldn’t have gone better. “The way I was treated, I would do it again,” she declares. “For me, that’s just how simple a procedure this was. The care I received, not just from Dr. Chakhtoura but from the nurses and technicians, was incredible. They explained everything to me, step by step, and kept me feeling at ease. They didn’t put me under general anesthesia, so I was awake the entire time, but with the medicine they gave me for the pain I felt nothing.” Sandra was kept overnight for observation and went home the following day. Her only restriction? “For a few days I wasn’t supposed to pick up anything over 10 pounds with that hand. After that, I was fine.” “The patient is treated mechanically with the catheter and stent to improve blood flow to the affected area, and with medications to lower cholesterol and thin the blood to prevent a recurrence,” explains Dr. Chakhtoura. “Step three is cardiac rehabilitation to improve stamina, strength and cardiovascular outcomes.” With proper arterial blood flow now restored by the insertion of the stent, Sandra started on a course of cardiac rehabilitation, six weeks after the procedure. Looking back, Sandra realizes just how much her daily life used to be affected by her condition. “Once my blood pressure came down after the procedure, I could immediately feel my overall energy levels begin to rise,” she says. “All I can say is, ‘Listen to your body!’ I think maybe if I were more in tune with myself, I could have caught this a lot earlier—you never think something like this is going to happen to you.” As she ponders her upcoming birthday, the soon-to-be-73-year-old, now retired, resolves to enjoy her new lease on life by picking up an old hobby. “I used to play softball, and I used to volunteer as a coach,” she says. “It’s my favorite sport. Once I finish my cardiac rehabilitation program, I’m going to get involved in it again.”
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