Larry and Anna Delahanty of Somers spent the gorgeous day of Monday, March 22, 2021, spring cleaning. Their son and his wife were coming for dinner that evening: spaghetti and turkey meatballs with Anna’s homemade tomato sauce. “She won’t eat anything out of a jar – that’s not happening,” says Larry. Now, house in order, sauce made, Anna, 64 years old, a walker and Zumba dancer, talked Larry into a short walk before dinner.
They started out at 4:45 pm. But when Anna told Larry she “wasn’t feeling right,” they turned back. After 20 steps, Anna was “clutching the center of her chest,” recalls Larry. We’ll call a doctor, he told her. After another 25 steps, Anna stopped again, rubbing her arms. “Are you in pain”? asked Larry. “No – I just feel very uncomfortable,” Anna said. “Do you want me to take you to urgent care?” – this was three minutes away. “No” — they were now at the driveway — “I think it went away.”
Anna went to relax on the deck. Suddenly, from the kitchen, Larry heard “this massive crash behind me – oh my God, Anna….she’d fallen face first in the hallway. She was turning blue-grey. She gasped her last breath in front of me. She had no pulse, no heartbeat, nothing. I knew it was a heart attack.”
Larry flipped his wife over and called 911. Propping his phone beside him, he pumped Anna’s chest. “Her tongue was white, enormous. I held her nose, breathed into her mouth.” While giving Anna CPR, Larry shouted into the phone. “I need help here right now!” As he pumped, “the air puffed right back out – her tongue was so fat it was blocking her throat.” In minutes, a Westchester EMS (WEMS) medic arrived and used a defibrillator to shock Anna’s heart. “There was no pulse – nothing,” recalls Larry. “He hit her again with the charge.” No change. A siren sounded – and more help arrived.
“‘We got it,’” the WEMS medics told Larry – “and they went to work on her. I collapsed, couldn’t catch my breath. After 15 minutes, they had a faint pulse.”
The medics continued working on Anna while feeding information about her condition to the cardiac catheterization lab at The Seema Boesky Heart Center at Northern Westchester Hospital (NWH). Then she was in a Somers volunteer Fire Department ambulance with the WEMS medics, unconscious, en route to NWH. Larry, his son and daughter-in-law, and their pastor and his wife followed.
Larry’s quick, skillful action at the onset of Anna’s heart attack – as his heart broke and he fought panic — was the first link in a chain of events that saved Anna’s life though her chance of survival was almost zero.
Every second counted
In the ambulance Anna was still in the midst of a heart attack and her condition was critical, meaning that her chance of survival was low. The medics worked to get her heart to beat more strongly. In 20 minutes, they were at the cardiac catheterization lab at Northern Westchester Hospital. In this special unit, interventional cardiologists use catheters (thin, flexible tubes) to diagnose and treat a wide range of often-acute heart conditions, including heart attack, ultimately opening up blockages in the heart and its arteries.
Northern Westchester Hospital is the only hospital with a cath lab within 20-30 minutes of the Delahantys’ home. “Anna had suffered a massive heart attack causing heart failure,” notes Dr. Craig L. Basman, the interventional cardiologist who treated Anna at the lab. “Anything greater than 30 minutes without intervention and it was very unlikely Anna was stable enough to survive.”
WEMS’s rapid response and their effective care for Anna was a major factor in her survival. Critically important was that within 20 minutes, Anna was at Northern Westchester Hospital’s state-of-the-art cath lab and under the care of Dr. Basman, an expert interventional cardiologist.
Nearly 100 percent blocked
Upon arriving at the Hospital, Anna was unconscious, her heart pumping extremely weakly, her body blue. She was immediately put on a ventilator. “There was a possibility,” says Dr. Basman, “that Anna’s heart was beyond repair and that even if she did survive, oxygen and blood deprivation had caused brain damage.”
Acting with all possible speed, Dr. Basman performed a coronary angiogram to determine the location of the blockages causing Anna’s heart attack. Feeding catheters through Anna’s groin to her heart, he injected dye into the catheters, then took x-ray pictures of the heart’s arteries. “I saw that the main artery supplying the heart with blood was nearly 100 percent blocked, and that several other arteries supplying the heart were between 95 and 99 percent blocked. It was clear these blockages would require emergency coronary bypass surgery.”
Dr. Basman immediately turned to the next issue: Because Anna’s heart was too weak to pump by itself, she wasn’t getting enough blood flow to survive. Again using a catheter, he placed a pump in her heart’s left ventricle to work as an artificial heart. This relatively new procedure is used with advanced heart failure. “Without timely insertion of this device,” says Dr. Basman, “her heart wouldn’t have been able to support her vital organs and she would have quickly gone into multi-organ failure and died.” After two hours of emergency care, Dr. Basman went out to her family.
A lifesaving partnership
In the family room waited Larry, his son and daughter-in-law, and their pastor, Don Foster, and his wife, Rose, of the Yorktown Assembly of God’s Church. Larry remembers Dr. Basman saying “she was very ill, with the worst blockages he’d ever seen, that she had a pulse but wasn’t doing anything on her own, and they needed to get her more stable.”
At these words, “I started crying,” says Larry. “I couldn’t believe what I was hearing. How is this possible? How could it be so desperate? When Dr. Basman went back to Anna, we all prayed. I prayed God wouldn’t take Anna.”
Says Dr. Basman, “No cath lab performs triple bypass surgery. I wanted to make sure she had someone who could perform it at the highest level. I called my partner, Dr. Nirav Patel, a cardiac surgeon at Lenox Hill Hospital in Manhattan” – Northern Westchester Hospital’s cath lab is an extension of Lenox Hill’s nationally renowned cardiac services department; both hospitals are part of Northwell Health. “I told him I was bringing in a patient who needed emergency triple bypass surgery. Many surgeons would have turned down such a critically ill patient because of the high chance of mortality – yes, surgeons can turn down a patient who they deem too sick for surgery. But I knew of Dr. Patel’s specialty and knew he was Anna’s best option.”
Dr. Basman explains: “Dr. Patel can perform bypass surgery without putting the patient on a heart-lung machine normally used in such cases. The machine stops the heart and takes over for it. I told Dr. Patel, ‘If you stop Anna’s heart, it won’t recover even with bypass surgery.’ Dr. Patel agreed to perform Anna’s surgery according to my plan and to treat her immediately.”
Anna’s bypass surgery was successful. Right afterwards, her heart’s pumping function was good. She left Lenox Hill Hospital on April 1, 2021 and was recovering so well, she was allowed to go directly home.
Because of the close relationship between the Northern Westchester Hospital cath lab and Lenox Hill Hospital and the high level of trust between colleagues Dr. Basman and Dr. Patel, Dr. Patel unquestioningly accepted Dr. Basman’s assessment of the best surgical plan for Anna – saving precious time. Because of their connection, Dr. Basman knew of Dr. Patel’s specialty, which gave Anna a fighting chance. The link between the two hospitals meant Dr. Basman was at Lenox Hill during Anna’s post-op recovery, including when it was time to remove the heart pump he had installed. One of Dr. Basman’s specialties is removing the device without injury to the blood vessel.
A remarkable recovery
Anna continues to astonish everyone with her rapid recovery. She attends cardiac rehabilitation at the Chappaqua Crossing facility — also part of Northwell Health — where Dr. Basman sees her. He in turn communicates regularly with Dr. Patel about her progress.
Notes Dr. Basman: The continuity of high-quality care Anna experienced was essential to her survival, starting with Westchester EMS, whose medics stabilized her, also ensuring that she survived the trip to Northern Westchester Hospital and to Lenox Hill Hospital. The fact that Anna had access to first-rate interventional cardiologists at the Northern Westchester cath lab who partner with top cardiac surgeons at Lenox Hill, as well as Chappaqua Crossing practitioners who specialize in recovery all within the same Northwell Health system, was essential for first-rate clinical care.”
Says Larry: “It’s not a matter of words, it’s a matter of caring. How the WEMS medics who came to the house worked on her non-stop; how Dr. Basman used all his talent to stabilize her, telling me ‘This woman is going to come home’; Dr. Patel’s unbelievable skill; the incredibly caring visiting nurse and physical therapist from Northwell. I couldn’t be more thankful for the grace of all the people I encountered. There’s not enough words to express our gratitude to everybody.”
Learn more about lifesaving cardiac care in Westchester, visit nwh.northwell.edu/heart