Boston Globe sports columnist Dan Shaughnessy reflects on lifesaving heart surgery at the Brigham

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Feb. 6 started out like any other day for Boston Globe sports columnist Dan Shaughnessy. It ended in a way he never anticipated.

That Tuesday morning, Shaughnessy, 70, stepped out of his Newton home to complete a one-mile jog around his neighborhood, a practice he has maintained with monk-like discipline for the past 40 years. Later that day, he and his wife, Marilou, planned to drive into Boston for an elective cardiac catheterization at Brigham and Women’s Hospital to investigate the cause of some recent symptoms.

“I figured maybe I would leave with just some medicine and a stent. It’d be a brief day,” he said. “I remember talking to the valet, Jimmy, when we got there. He said, ‘How long are you going to be?’ I said, ‘I don’t know, three or four hours.’”

Shaughnessy was discharged from the Brigham 11 days later, following emergency quadruple-bypass surgery.

“What we discovered on the cath was extremely surprising: He had a near-total occlusion of the artery that feeds the left side of the heart,” said George Tolis Jr., MD, section chief of Coronary Surgery and General Cardiac Surgery at the Brigham, who led the multidisciplinary surgical team that performed the bypass. “When I saw him, I didn’t want to scare him, but I wanted to make 100% sure he stayed in the hospital. I was not planning to do any surgeries the next day, but I cleared the schedule to get him in because he really needed it.”

Also known as a coronary angiogram, the exam Shaughnessy initially underwent at the Brigham had been the latest in a series of doctor visits that were occupying his time with increased urgency over the past few months.

Back in October, during one of his daily jogs, Shaughnessy noticed some unusual symptoms: numbing in his elbows and tightness in his chest. That’s new, he thought.

Knowing he had an annual physical exam coming up in December with his primary care provider, Michael Levin, MD, of Newton-Wellesley Hospital, Shaughnessy made a mental note to mention it then. In the back of his mind, though, he had a hunch something was amiss. He had a family history of cardiovascular disease — his father died of a heart attack at 64 — and, by his own admission, he often found himself following “the sportswriter diet,” which rarely includes a kale salad.

During the appointment with his PCP, Shaughnessy shared his recent symptoms with Levin, who recommended a stress echocardiogram — a test that monitors how well a person’s heart and blood vessels function during exercise.

He returned to Newton-Wellesley in January for the stress echo. Cardiologist Giulia Sheftel, MD, didn’t like what she saw in the results. After discussing them with Shaughnessy, she ordered an angiogram at the Brigham’s Cardiac Catheterization Lab for a more detailed look at his coronary arteries.

The procedure was scheduled for Feb. 6. His bypass surgery took place the next morning.

“It was so fast,” Shaughnessy said. “I wasn’t in any position to argue, but there was just no warning for how life-changing this was going to be.”

Despite the uncertainty, Shaughnessy said he always felt that he was in the most capable hands during his time at the Brigham.

“I see team execution all the time in my job, and I know you’ve got to have a ‘team above self’ concept. I had a sense of that the whole time I was at the Brigham. Everybody knew what was going on with my care,” he said. “The professionalism and skill level — I notice stuff like that. It’s one of the blessings of living where we live. That’s why people come from all over the world to be at the Brigham.”

During a coronary artery bypass grafting, or CABG, surgeons create a new path for blood to flow into the heart. To form this detour around the blockage, they repurpose healthy blood vessels from other parts of the body, usually the chest or arm.

For Shaughnessy’s procedure, Tolis opted to use the internal thoracic arteries, also known as internal mammary arteries, from each side of his chest. It is a more complex procedure with higher risk of complications but has considerably improved outcomes. As a result, it is typically used in younger patients.

“A bilateral mammary adds years of life post-bypass, but it’s a more complicated operation. We don’t often use them in older patients, but I thought he would do very well with it because he’s otherwise in such good shape and very active,” Tolis said. “I told him he would miss the Red Sox’s spring training, but he would be there for the season opener.”

Nationally, bilateral mammary arteries are used in about 6% to 7% of coronary cases, Tolis said. In his practice, he uses them for about 50% of eligible surgeries.

“It’s something I’ve worked on for a long time over the past 15 years, and I think it is the only thing that makes a great operation — a coronary bypass — even better in terms of longevity,” he said.

Tolis emphasized that so many interprofessional colleagues are essential to achieving such outcomes.

“While using the bilateral mammary arteries can be associated with more complications, we have such a good track record at the Brigham because of the team approach that I don’t fear using this technique in older patients,” he said. “It’s not just about the surgeon at the table. It’s the operating room staff who maintain a sterile field. It’s the Environmental Services staff who clean the operating room. It’s the quality of wound care our nurses deliver postoperatively and much more beyond that.”

In collaboration with cardiac anesthesiologist Dirk Varelmann, MD, the team opted to use an intra-aortic balloon pump during Shaughnessy’s procedure to maximize safety. Inserted into the body’s largest artery through a small catheter in the leg, the mechanical device helps a weakened heart pump more blood with less effort.

“His blockage was so severe that I didn’t think his heart could tolerate the stress of anesthesia without further support,” Tolis explained.

The picture today looks very different, he added. “From my perspective, he has a clean bill of health. He’ll never need another bypass operation, and I’d be very surprised if he ever needs stents,” Tolis said. “You have someone who was basically running on borrowed time to someone who should never hear from his heart again.”

Reflecting on his care at the Brigham, Shaughnessy said the attentiveness and compassion he and his family experienced left a lasting impression.

“I grew up in a small town, and my mom was a nurse, and this felt like that. It did not feel like ‘the big city.’ I saw Dr. Tolis every day, and I thought everybody had a gentle touch,” he said. “People were patient with me. Even knowing how hard their jobs are, I was struck by the fact that they never let it down for a second. I felt very comfortable, safe, and secure the whole time.”

When asked what message he would like to convey to his care team, Shaughnessy said it was one of extraordinary gratitude.

“Thank you for your caring, professionalism, and skill level. I know it took years of study and practice, and they’re still bringing it every day,” he said. “In the time you’re being cared for, you are the most important person to them in that moment.”

Now, about four months out from surgery, Shaughnessy continues to regain his strength and feels a little better every day — even well enough to write an occasional column.

“I think of this as a gift,” he said. “I dodged a bullet and didn’t have a catastrophic event, so now it’s on me to run with that and stay on the right side of healthy living.”