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An Unexpected Journey of the Heart

When it came time for LaTisha (Tish) Smith of Belleville, Ill., to tell her family that she was having surgery, the hardest conversation was with her 9-year-old son, Lee. Just two years earlier Lee and his sister, Leah, age 6, had lost their dad and Tish’s husband.

"I didn't want to give my kids too many details because I didn't want to scare them" Tish said. "I tried to reassure them...I had to let them know I was going to be okay and would be here for them."

Tish underwent a mitral valve replacement surgery at Missouri Baptist Medical Center on Sept. 20 and was indeed okay, but things didn't go quite as she expected.

Path to Diagnosis

Tish, who was 38 at the time, first became suspicious that she might be facing a health concern when she lost weight between her OB/GYN and primary care physician appointments in March and July 2016. She wasn't dieting or trying to lose weight.

"My primary care physician ordered blood work and an X-ray, which showed an enlarged heart," she recalled.  Tish didn't have common symptoms associated with her diagnosis, such as swelling of the ankles and shortness of breath, so it was somewhat of a surprise to her and her doctors. "I really felt fine, but I was told my heart was working at about 40 percent and I would need to have surgery to repair it," said Tish, a human resources professional.

She was referred to Missouri Baptist cardiothoracic surgeon James Scharff, MD, who explained her options of either a mitral valve repair or replacement.

"We always try to repair the mitral valve when we can because it often leads to better outcomes," said Dr. Scharff, who also explained that a replacement would have required Tish to remain on anticoagulation medications for the rest of her life.

Once Tish had prepared her children, her parents and her sister, she was as ready as she could be for her surgery.

"I was scared but I knew I would be in good hands at Missouri Baptist, and I trusted Dr. Scharff," she said. "The plan was that I would have surgery on a Tuesday, be hospitalized for a few days and go home."

While her mitral valve repair surgery went well, her heart was unfortunately too weak to pump blood on its own and Tish required life-saving ECMO (extracorporeal membrane oxygenation), a temporary support system used to assist with heart and lung function for patients.

Dr. Scharff's colleague, Missouri Baptist cardiothoracic surgeon and ECMO specialist Joshua Baker, MD, joined him in caring for Tish. She remained sedated and on a ventilator for four days in the ICU.

"ECMO allowed her heart to rest and strengthen so it could effectively pump blood like it should," Dr. Scharff said. "If it weren't for our ability to provide her with life-saving ECMO, she might not have survived."

Road to recovery

Tish came out of sedation and was removed from the ventilator on the Saturday after her surgery. She said during this time her parents and sister stayed by her side with her kids, trying to give them as much normalcy as possible.

"I'm feeling blessed. Although it was a little rough at first, I am doing well," Tish said. "I owe so much to the doctors and especially the ICU nurses, who were awesome." Tish recalls how nurses went above and beyond to help her reach out to her children.

"The ICU nurses found an iPhone and helped me FaceTime with my kids and reassure them," she said.  "I couldn't talk because the tube had just been removed from my throat, but they could see for themselves that I was fine. It meant so much to me that the nurses took the time and effort to do this."

Although Tish's maternal grandparents both passed away from heart attacks, she said no one could tell her for sure why this occurred.

“Today her prognosis is excellent, and her heart muscle has strengthened quite nicely” said Dr. Scharff.

"I can't thank everyone enough for what they did, especially the ICU nurses. They made me feel like I was the only one on the floor," she said. "When I went back to visit a few weeks later, they all were so happy to see me doing well. They not only took care of me, but also my family."

Tish said there is no doubt that Missouri Baptist was where she needed to be; she thanks everyone who cared for her and ensured she would be there for her kids for years to come.

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