Billie Findlay

As someone whose life has been guided by her deep faith in a higher power, Billie Findlay was only a little surprised when a recent health scare took her on a journey that seemed to be sprinkled with drops of divine intervention.

In 2015, the 85-year-old resident of Tyler, Texas, was told she had a heart condition that could only be treated with open heart surgery – a procedure that is not without risks of its own, especially at her age.

Just as Findlay began to comprehend the gravity of her situation, she found herself traveling to Tulane Medical Center in the neighboring state of Louisiana. There she underwent an innovative new procedure that successfully reversed her condition – and has given her a new lease on life.

No stranger to heart disease

In summer 2015, Findlay was enjoying her retirement. The Michigan native spent her days soaking up the Texas sunshine, playing with her grandkids and spending time with Douglas, her husband of 56 years.

“During this time I kept experiencing shortness of breath and swelling in my ankles,” says Findlay. “It was more annoying than anything, but I didn’t want my symptoms to get worse and slow me down.”

As a former nurse and someone with a long history of heart problems – including living with a biventricular pacemaker – she knew she should see her doctor.

In Sept. 2015, Findlay was diagnosed with a condition called chronic total occlusion, or CTO. Her right coronary artery was fully blocked, and the left coronary artery contained calcified blockages that significantly reduced blood flow to her heart.

In December of that same year, doctors tried to reopen Findlay’s left coronary artery using a minimally invasive procedure called coronary angioplasty and stenting. Unfortunately, due to the amount of calcium built up in her arteries, they were not able to place the stents.

Findlay says that’s when she learned she was virtually out of options. Although her doctors recommended she have open heart surgery, Findlay had no interest in undergoing such an invasive procedure – or putting herself through such a long and difficult recovery.

An unexpected turn of events

“As we headed into 2016, I actually began preparing for the end of life,” says Findlay. “But then life handed me one of those mysterious opportunities that seem to pop up when you least expect them, but most need them.”

While telling family members about her situation, Findlay discovered something interesting. Although she knew her daughter-in-law’s sister is married to an employee at Tulane Medical Center, she was surprised to learn that the hospital happens to be one of the few hospitals in the United States offering a highly successful, but relatively uncommon, procedure to treat people with CTO.

“Thanks to this distant family connection, I found an interventional cardiologist from Tulane named Dr. Nidal Abi Rafeh, who reviewed my case and said he could help me,” Findlay explains. “The next thing I knew, I was scheduled to have minimally invasive surgery in New Orleans on Feb. 4, 2016.”

A viable and successful option

As the city around her was preparing for Mardi Gras, inside Tulane Medical Center Findlay was preparing to undergo a complex procedure with an equally complicated name: chronic total occlusion percutaneous coronary intervention, or CTO PCI.

Findlay says Dr. Abi Rafeh took the time to explain the procedure, so she felt comfortable heading into the operating room.

“While it was reassuring to hear him say the success rate of this procedure is nearly 90 percent, what made the most difference was when he told me to remember that God is in control,” Findlay adds. “I felt at peace then.”

During the procedure, Dr. Abi Rafeh looked at both of Findlay’s coronary arteries in real time, using advanced imaging procedures including dual injection angiography and intravascular ultrasound. These diagnostic techniques helped him evaluate blood flow through the arteries, and see precisely where the blockages had formed.

He then spent the next several hours reopening Findlay’s blocked arteries. Using special guide wires, catheters and a set of advanced techniques that allowed him to work around the blockage instead of tunneling through it, he placed one stent in her right coronary artery, three stents in the left circumflex artery and an additional stent in the main artery down the front of her heart.

Later that day, Findlay woke up to wonderful news – her arteries had successfully been propped open, and the stents would allow normal blood flow from the arteries to her heart.

The benefits of modern medicine

Among all of the interventional cardiologists in the U.S., approximately two percent – including Dr. Abi Rafeh and his Tulane colleague Owen Mogabgab, MD – are qualified to perform the full range of CTO PCI procedures.

In the past, treatment options for CTO were limited to medication (to relieve symptoms), conventional angioplasty and stenting or an open surgical procedure called coronary artery bypass grafting (CABG). Fortunately, the field of interventional cardiology is rapidly evolving, and physicians like Dr. Abi Rafeh – who has pursued advanced training in promising new diagnostic tools, surgical devices and minimally invasive techniques – are able to offer safer and more effective options to patients with hard-to-treat conditions.

“Although Mrs. Findlay may have lived for a couple more years without surgical treatment, the quality of her life would have steadily and permanently diminished,” says Dr. Abi Rafeh. “She likely would have found herself in the hospital repeatedly for chest pain and other signs of heart failure, and as a result she would have become less and less functional.

“I firmly believe that quality of life is just as important as quantity of life,” Dr. Abi Rafeh adds. “I feel grateful to have given Mrs. Findlay the chance to enjoy her retirement, free of pain and other debilitating symptoms.”

Home sweet home

Today, Findlay is back to doing what she loves most, spending time with family and living a full, productive life. Perhaps more importantly, she is symptom-free. Findlay reports that she has no more shortness of breath or ankle swelling.

“It is so good to be able to take a deep breath again,” says Findlay. “What a difference Dr. Abi Rafeh has made in my life.”

Findlay adds that she has simple advice for anyone else who has been diagnosed with CTO and told they don’t have any options.

“Go to Tulane,” she says. “I’m living proof that they are the best.”