Thirty-five years ago, former fire captain Howard DeSavino was having what seemed like a typical morning at work in North Bergen Township, New Jersey, when he started to feel ill.
“I walked up the street to get a lottery ticket, and somebody yelled, ‘We got a job!’” recalls Howard, now 86. “I ran back, put on my coat, boots, and helmet, and headed out the door. But the truck had barely made it a block and a half before I suddenly became lightheaded and passed out.”
His colleagues pulled the truck over and called for help. Howard had to be carried to a police car, which transported him to a hospital. After a few hours of observation, he started to feel better, but he knew he wanted to be seen at NewYork-Presbyterian/Columbia University Irving Medical Center, where his older brother’s internist worked.
Once there, he was referred to a young cardiologist named Dr. Allan Schwartz, who is now chief of the division of cardiology at NewYork-Presbyterian/Columbia.
“I was terrified that he was going to tell me that I’d had a heart attack, and that my career in the fire department would be over,” Howard says.
Instead, Dr. Schwartz evaluated him and informed him that he was born with an undersized valve.
“He knew that right away, just from listening to my heart with his stethoscope,” marvels Howard.
More specifically, Howard was born with a bicuspid aortic valve, a common congenital condition in which a person has two flaps in their aortic valve instead of the usual three. The flaps, medically known as leaflets, open and close to send blood from the heart to the main artery of the body, the aorta. Symptoms don’t always present right away, but the condition often progresses as a person ages into their 40s and 50s, according to Dr. Schwartz.
“Howard had the classic symptoms indicating he had developed severe aortic valve stenosis, a narrowing of the valve opening which restricts blood flow into the aorta and through the rest of the body,” says Dr. Schwartz. The heart of those with aortic valve stenosis works harder to pump enough blood through the smaller valve opening, which can lead to chest pain, heart palpitations, fatigue, heart murmur, and possibly heart failure.
Dr. Schwartz informed Howard that he would require an aortic valve replacement, with a tissue valve made from a pig valve. In the early 1980s, this was a relatively new procedure that required full-scale open-heart surgery, says Dr. Schwartz.
Dr. Schwartz’s colleague, Dr. Frederick O. Bowman Jr., who pioneered many of the earliest cardiac repair techniques, performed the surgery to remove his damaged valve and replace it with the tissue valve.
“In those days, it was a little tricky, open-heart surgery,” says Howard. “I was scared out of my mind. I was convinced I was going to die.”
The operation was a success, and Howard spent a week in the hospital recovering. About 10 days after returning home, Howard says, he was able to walk about 3 miles at a stretch.
“Before the surgery, I’d been in pretty good shape, playing full-court basketball with my fire department,” he recalls, “but the recovery still seemed unbelievable.”