November 29, 2021 by John Fernandez
Runner, 67, has Bypass Surgery at Miami Cardiac & Vascular Institute, Finishes Boston Marathon 5 Months Later
You have to be physically fit and free of health issues to complete 16 marathons (26.2 miles each) over eight years. That was the case for John Regan at the age of 67 in May of this year — until the moment he was training for yet another long-distance run and he suddenly felt a tingling sensation in his right arm and right leg.
The West Kendall retiree was feeling the symptoms of a TIA (transient ischemic attack), which is often called a “mini-stroke.”
“I was almost finished with 10 miles when I just stopped on a dime right there because falling on asphalt is not a lot of fun, but the tingling didn’t go away,” recalls Mr. Regan, who had no underlying health issue that he knew about at the time. “I could still feel it. I went to talk to the person I was running with, my girlfriend Lily Medel, and in what I thought was a very clear voice, I said: ‘I think I’m having a stroke.’ Later, she said that all she had heard from me was unintelligible mumbling.”
From that moment, Mr. Regan would take a different type of course like no other he had endured as a runner. This one would include various cardiac imaging and screening tests, and a minimally invasive bypass surgery at Miami Cardiac & Vascular Institute, performed by Joseph McGinn Jr., M.D., the chief of cardiac surgery, who happens to have pioneered the very same procedure known as the “McGinn Technique.”
A ‘Lucky TIA (Mini-Stroke)’
The diagnosis: Mr. Regan had almost complete blockage (95 percent) of his left anterior descending (LAD) artery, which carries fresh blood into the heart, providing the oxygen it needs to pump properly. Complete blockage of the LAD can cause what is known as the “widow-maker” heart attack.
Recalls Mr. Regan: “That’s when Dr. McGinn’s staff came in and referred to me as having a ‘lucky TIA’. They said that if I didn’t have it, I would just keep running and go about my everyday life — and likely drop dead from a heart attack.”
His bypass surgery at the Institute was performed on May 12. Flash forward five months to this past Oct. 11 when the heart patient ran the Boston Marathon for the 6th time. And he’s shooting for a faster Boston Marathon next year because he intentionally slowed down for his first post-surgery, 26.2-mile run as a precaution.
“I never worried at all during the marathon,” he recalls. “I pretty much took it easy from the start. I had a good idea of what I wasn’t capable of doing yet. So, I just laid out a plan in my head. I started out a little too quick anyway, so I intentionally kept trying to slow down.”
Getting Heart Patients ‘Back to Normal Living’
Dr. McGinn cites Mr. Regan’s case as yet another ideal outcome of diagnosing severe coronary artery disease and following up with “minimally invasive cardiac surgery coronary artery bypass graft,” or MICS CABG. The surgery involves an incision, about 2 to 3 inches long, made in the chest between two ribs, avoiding muscle and the need to break any bones. It is the growing alternative to traditional “open heart surgery,” which potentially involves more complications and a much longer recovery.
“It’s great,” says Dr. McGinn, referring to Mr. Regan’s Boston Marathon performance. “It really is emblematic of what we’re trying to do. We’re trying to get patients who have really life-threatening, critical heart disease back to normalcy in the shortest period of time. He’s just one of many examples of people going back to what they do, whether it’s running, back to work, back to golfing — back to normal living.”
The Road to Mr. Regan’s Diagnosis, Surgery
The day of his mini-stroke, or TIA, Mr. Regan first received emergency department care at West Kendall Baptist Hospital, and then was taken for more comprehensive cardiac testing at Miami Cardiac & Vascular Institute. His vital signs were quite normal, including blood pressure. He underwent an echocardiogram, a noninvasive procedure that checks the heart’s function and structures using sound waves that are sent to a computer and create a moving image. That test came back normal.
He then underwent a coronary calcium scan that measures the amount of calcium in the arteries. The presence of calcium deposits in an artery represents plaque that has accumulated. The results are given as a calcium score, with a score of 100 to 300 representing moderate plaque deposits. The scan can help predict your risk of having a heart attack, even before symptoms appear. Dr. McGinn said Mr. Regan’s calcium score was an alarming 1,017.
The team at the Institute’s Cardiac Catheterization Lab referred Mr. Regan to Dr. McGinn. A “cardiac cath” is an invasive diagnostic procedure to determine if blockages exist in the arteries that bring blood to the heart muscle, as well as the location and severity of these blockages. Marcus St. John, M.D., an interventional cardiologist, is medical director of the Cardiac Catheterization Lab.
“Next thing I know, Dr. St. John was going to put a stent in the next day,” recalls Mr. Regan. “He then said it wasn’t going to work because the artery was between 90 and a 100 percent blocked.”
Heart Surgery and a Swift Recovery
On May 12, Mr. Regan had the MICS CABG surgery by a team led by Dr. McGinn.
“The whole system really worked for him because he came in, and they made sure they flipped over every rock to find out what was going on,” says Dr. McGinn. “They found something that was critical before it caused a major heart attack. He did not know he had 95 percent blockage in the artery that could have killed him.”
Mr. Regan remembers waking up from the surgery and being asked how he felt.
“I said I felt like I got hit by a truck and they said that sounds about right,” he recalls. “But, they had me out of bed the next day. I have not a single complaint with anything that went on at Baptist Health, out at West Kendall or the Institute. I found everybody to be nice as can be and extremely helpful.”
His recovery went very well. After surgery on a Wednesday, he left the hospital the following Saturday, three days later. On that Monday, just five days after surgery, he walked a mile — a slow mile. Nonetheless, he would pick up his pace slowly. By July, he was already training for the Boston Marathon.
“When we saw him in the office for a follow-up visit, he was doing great, and we gave him the go-ahead to return to full activity,” said Dr. McGinn. “Usually, with the MICs CABG, you can go back to activity almost immediately. We saw him on May 21st. So, that was nine days after his surgery, and we gave him the green light to go back to running and doing what he wants to do.”
Mr. Regan has returned to his love of long-distance running with a still-determined, but a bit more cautious attitude. His next marathon will be the Boston event again, which in 2022 will return to its pre-pandemic April date — just six months away.
“I can get back to where I’m supposed to be by next April,” he says. “If not, I’ll have an idea of what I’ll be able to do going forward. But, my mindset is: I’m going to go right back to where I was.”