URMC Cardiology

Mary Ellen

A story about heart repair

Mary Ellen Mary Ellen Gugliandro lived nearly 55 years before she ever learned she had a hole in her heart.

"I started having palpitations out of nowhere," Mary Ellen recalls. "I was already scheduled to see my gynecologist for a check up, so I asked her about it."

Mary Ellen's gynecologist was aware that she had mitral valve prolapse, a relatively common condition that affects more than 2 percent of the population. In this condition, the valve between two chambers of the heart doesn't close properly. Most people never require any treatment for it.

Because of Mary Ellen's new symptoms, her gynecologist recommended an echocardiogram of her heart, which revealed surprising news. Mary Ellen's cardiologist told her, "I don't see any mitral valve prolapse, but I do see a hole in your heart."

"I was really shocked," Mary Ellen said. "I had gone through labor and delivery with three children and I couldn't believe that I had never had problems before this."

Mary Ellen was referred to another cardiologist of Rochester General Hospital. He told her that the normal procedure to repair a hole like Mary Ellen's would require open heart surgery. "I thought how could this be?'" says Mary Ellen. She couldn't believe that her life had taken such a sudden and unexpected turn.

But then her cardiologist continued. "He told me there was a new procedure that wouldn't require open heart surgery," says Mary Ellen. That procedure, called an atrial septal defect closure, would only require the tiniest of incisions and would allow Mary Ellen to recover much faster.

The procedure could only be performed by one surgeon in the region, Dr. Frederick S. Ling at the University of Rochester Medical Center. Mary Ellen met with Dr. Ling and he explained to her that she would require several tests. They would be used to determine if the hole in her heart was small enough to be treated with this new procedure. She would also need to be free of any blockages in the blood vessels that supplied her heart. If the holes was too big, or if she had any blockages, open heart surgery would be her only option.

After the tests were completed, Mary Ellen received good news: "He said I was a candidate! I was so relieved."

Mary Ellen was told they could schedule the procedure soon. But with her oldest daughter getting married in August, Mary Ellen decided to wait until October to have the procedure. During that time, she continued to struggle with heart palpitations. "It was really disturbing," Mary Ellen says. "My heart would just race. There would be no let up. I'd be on the phone and I'd hear my heart pounding in my ear."

On the morning of October 25, Mary Ellen checked into Strong Memorial Hospital, part of the University of Rochester Medical Center. After being prepped for surgery, she was taken to the Cardiac Catheterization Laboratory, a high-tech room brimming with lights, monitors and robotic surgery equipment.

During the procedure, tiny incisions were made in Mary Ellen's thigh. Small catheters—very thin tubes—were inserted in the incisions and threaded up through the arteries leading to her heart. Then, tiny cameras and surgical instruments were fed up through the catheters. The cameras would give Dr. Ling a three-dimensional view inside Mary Ellen's heart while he precisely manipulated the surgical instruments with the aid of a surgery robot.

Tool The primary instrument used in this procedure was a revolutionary device called an Amplatzer septal occluder. After it was threaded through a catheter, it emerged and opened like two tiny umbrellas within Mary Ellen's heart. The two umbrellas—which opened up on opposite sides of the hole in her heart—were then squeezed together, closing the hole. The device would stay in Mary Ellen's heart, eventually allowing new heart muscle to grow over it.

Mary Ellen's husband, daughters and sister-in-law had accompanied her to the hospital. So after the procedure, Dr. Ling took some time with them.

"He truly is an amazing doctor!" Mary Ellen says of Dr. Ling. "He went out to the waiting area with his laptop and showed my family the whole procedure. My sister-in-law told me later, 'I saw your heart beating!'"

Mary Ellen spent the night in the hospital and then went home the very next day. "I couldn't believe I never even had to take any pain medication."

If she had needed open heart surgery, Mary Ellen would have faced a recovery period of months. As it was, she was only required to be off work for a week, and then to avoid heavy lifting for a few more. Still, she felt great right from the start.

"I was cooking dinner the next day!" she says.

Though the Amplatzer septal occluder will always remain in her heart, it will never hold her back. Within weeks, Mary Ellen was back to working her regular 40 hours a week as the administrator of a 144,000-square-foot facility. "I'm on my feet all day," she says. "I also go to the gym three times a week. I have no restrictions at all. And since I had the procedure done, I haven't had any heart palpitations."

As easy as her surgery turned out to be, Mary Ellen feels overwhelmed at the way things turned out for her. "I've been asked by other doctors how I found out about the hole in my heart," Mary Ellen says. "They'll say, 'Did you have a stroke?' In other words, that's how people usually find out. I could have had a heart attack or stroke because of my condition."

She credits all of her doctors, especially Dr. Ling, for making sure that never happened to her. "He really is a terrific doctor," says Mary Ellen. "He's personable and compassionate, which made me feel he really cared about me."

He's also one of her greatest cheerleaders: "He told me, 'Now go out there and do whatever!'"

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