An Innovative Technique Combining Bypass Surgery with an Implantable Heart Pump Saves a Man’s Life & Restores His Quality of Life
When Tak Yuen, 62, arrived at the Emergency Department at NYU Langone Hospital—Brooklyn in November 2022, his son and wife had to help him walk. Just days before, he had reported for duty as a sergeant in the Triborough Bridge and Tunnel Authority. But ever since, he had grown weaker and weaker. Finally, at his wife’s urging, he went to the hospital.
“They were putting needles in me, and I felt nothing,” says Yuen. “People around me were talking, and I could hear them, but it was like I wasn’t really there mentally. I thought I was dying.”
Yuen presented a challenging case for George Fernaine, MD, chief of cardiology at NYU Langone Hospital—Brooklyn. A CT scan showed that he had a life-threatening blood clot in his lung, known as a pulmonary embolism. He also had diabetes, high blood pressure, high cholesterol, chronic kidney disease, and heart failure, likely due to blocked arteries.
“He was extremely ill and had two very serious problems at the same time: an acute pulmonary embolism and heart failure,” says Dr. Fernaine. The challenge was to devise a strategy that would manage the heart failure while also dissolving the blood clot in his lung, all while avoiding the risk of heart attack.
Dr. Fernaine’s step-by-step plan for Yuen unfolded over several months. Yuen continued on blood thinners and medications for heart failure until February 2023, when the clot finally dissolved. Then, he had an angiogram, a test that uses a special dye and X-ray imaging to visualize how well blood is moving through the coronary arteries. As Dr. Fernaine predicted, multiple arteries were completely blocked and would require coronary artery bypass surgery to open.
Yuen was referred to cardiothoracic surgeon Elias A. Zias, MD, director of NYU Langone’s Coronary Artery Bypass Program, who specializes in complex cases like Yuen’s. Supported by a cardiac surgery team with a three-star rating from the Society of Thoracic Surgeons for coronary artery bypass grafts—the highest rating possible—Dr. Zias delivered a jolt of hope to the Yuen family.
The surgical excellence and high safety standards at the Coronary Artery Bypass Program often result in patients being able to get up and walk within hours of surgery, which translates to faster recovery times.
“Here at NYU Langone Hospital—Brooklyn, we collaborate with our top-ranked cardiac surgeons so that when our patients need surgical care, they are able to go to Manhattan and get it, but then come back to their community for follow-up care,” says Dr. Fernaine. “This truly makes us unique compared to other health systems.”
Yuen’s bypass would reroute five arteries. In addition, the pumping capacity of his heart was severely compromised, making the surgery particularly high risk. So risky, in fact, that many people with Yuen’s condition are told they are not candidates for a bypass. “Every surgery has risk, but Tak’s risk with traditional bypass was higher than average,” says Dr. Zias.
Fortunately, Dr. Zias had a plan to ensure a successful outcome. He specializes in an innovative technique that combines bypass surgery with an implantable heart pump called a temporary transvalvular ventricular assist device. “The pump takes over the job of pumping blood through the body and allows the heart to do minimal work as it recovers from the surgery,” says Dr. Zias.
On February 28, Yuen had bypass surgery that included having a tube graft sewn to his aorta. A small pump the size of a pencil was then threaded through the tube to lie inside his heart. Within a day after the surgery, thanks to the pump helping to move blood through his heart, Yuen was strong enough to walk—a crucial indicator of a successful recovery. “For every week you spend immobile, you’ll need a month of rehabilitation,” says Dr. Zias. “The heart pump allows a person to get up and move around sooner, and that makes a huge difference in their overall recovery.”
After 10 days, the pump was removed during a bedside procedure that required no additional anesthesia or surgery. On March 10, Yuen returned to his home in Bay Ridge, Brooklyn. His recovery continues with cardiac rehabilitation at NYU Langone Hospital—Brooklyn to help improve his heart health and overall fitness, and he still sees Dr. Zias and Dr. Fernaine for checkups. But all indications suggest a bright future.
This summer, Yuen took his daughter to see Taylor Swift. “I admit it. I’m a Swiftie, too,” he says. He also traveled to Florida with his wife and son for a vacation. This fall, he hopes to return to work. “I can’t wait to go back to work because that means that I’m well,” says Yuen. “And being well is better than anything that money can buy.”