Gravely Ill A Week Before the Wedding, Did This Patient See His Granddaughter Get Married?

There are some family milestones that you don’t want to miss, like when your granddaughter gets married. That certainly was the case with Burns Rutty, the 91-year-old patriarch of a very prominent Cayman Islands family.

Mr. Rutty’s health took a serious downturn as the wedding day approached, however. A week before the big event, it was unclear if he would get to see his granddaughter walk down the aisle.

Feeling dizzy and short of breath, Mr. Rutty sought help at a hospital on Grand Cayman, where his daughter, Judy Rutty Wight, says he underwent a thorough evaluation “from head to toe.” The conclusion: Mr. Rutty’s aortic valve was not functioning as it should and needed to be replaced. Immediately.

Although the local hospital had a newly established program to perform minimally invasive procedures, doctors there were not confident that Mr. Rutty was a good candidate because he had a narrowed femoral artery, which is used to access the heart. The alternative, open heart surgery, was risky.

Worried and uncertain how to proceed, Mr. Rutty’s family consulted an old friend, Mark Dylewski, M.D., Baptist Health’s chairman of thoracic surgery. Dr. Dylewski had attended the University of Florida with Mr. Rutty’s son, the father of the bride. Immediately recognizing the gravity of the situation, Dr. Dylewski referred the family to interventional cardiologist, and medical director of the structural heart program, Nish Patel, M.D., of Baptist Health Miami Cardiac & Vascular Institute.

“I looked at the CT scan, I spoke with the family and I told them that they could transfer Mr. Rutty over here and we would take care of him,” Dr. Patel says. Very soon after, Mr. Rutty was on a private jet to Miami.

Time Crunch

Time was of the essence — no longer because of the wedding, but because Mr. Rutty was gravely ill. “He was in cardiogenic shock, a life-threatening condition in which your heart can't pump enough blood to meet your body's needs,” Dr. Patel says. “It's often deadly if not treated immediately.”

Burns Rutty, 91, was able to attend the nuptials of his granddaughter Hannah.

Mr. Rutty was rushed to Baptist Hospital in Miami, where Dr. Patel and his team were on standby. The transfer was facilitated with logistical support from Baptist Health International, which helps bring patients to Baptist Health from throughout the world, especially the Caribbean and Latin America.

“At that point, the family didn't care if he would be missing out on the wedding,” Dr. Patel says. “They just wanted to make sure that he was taken care of.”

Nish Patel, M.D., interventional cardiologist at Baptist Health Miami Cardiac & Vascular Institute.

Mr. Rutty arrived on a Thursday afternoon and was immediately admitted through the Emergency Department. On Friday morning, he underwent preoperative testing and a cardiac catherization to make sure he had no blockages. On Monday morning, Dr. Patel performed a minimally invasive transcatheter aortic valve replacement, also known as TAVR.

Mr. Rutty was discharged the next day and was on his way home to Cayman Islands two days later. And, yes, he made it to his granddaughter’s wedding, which he described as “quite an elaborate occasion.”

“The fact that he was able to make it to the wedding was icing on the cake,” Dr. Patel says.

Somewhat similar to placing a stent in an artery, the TAVR approach delivers a fully collapsible replacement valve through a catheter without having to open the patient’s chest.

“It is fantastic — fantastic! — that they could do that,” says Mr. Rutty, who served two terms as the Cayman Islands Minister of Social Services, which included the department of health. “This is a great development.”

Understanding TAVR

The heart has four valves, and blood flows through each one in sequence. Aortic stenosis is the narrowing and stiffening of the last valve, the aortic valve, through which blood is pumped from the heart to the rest of the body.

When the aortic valve is no longer able to open and close properly due to plaque and calcium deposits, this results in the most common — and most serious — heart valve problem, affecting about 2.5 million people. By impeding the flow of blood, the problem forces the heart to work harder to compensate. That can lead to long-term damage to the heart muscle and eventual heart failure.

During the minimally invasive TAVR procedure, a new folded-up valve is inserted without removing the old, damaged valve. Starting at an artery in the groin, a catheter is used to thread the new valve to the heart. Once it is expanded, it pushes the old valve leaflets out of the way and takes over the job of regulating blood flow.

Research has shown that this method is usually safer and has either similar or better outcomes than traditional aortic valve replacement surgery as long as it is performed in a high-volume center like Miami Cardiac & Vascular Institute that is highly experienced in this procedure.

Great Result

Mr. Rutty was thrilled with how quickly he was treated, the procedure’s success and that he was able to be present for the nuptials of his granddaughter, Hannah. “Everything was perfect,” he says. He’s also very pleased that he has been able to resume his very active life, which includes socializing with friends, traveling, swimming, boating and fishing.

“We can't keep up with him,” says his daughter, Judy.

Mr. Rutty appreciates the attention he received at Baptist Hospital — and he knows a thing or two about royal treatment. As a government official, he once took Great Britain’s Prince Philip on a fishing excursion when the queen’s husband visited Grand Cayman. A few years later, he met Queen Elizabeth at a government reception in Jamaica and was delighted when the monarch chatted with him about the outing, while others waited in the receiving line.

An avid outdoorsman, he’d like to give Dr. Patel the same royal treatment if he ever visits the Cayman Islands. Dr. Patel is now considered a friend and part of the family, and they’ve recommended him to several acquaintances who need cardiac care.

“The man is fantastic,” Mr. Rutty says. “Not only is he a great surgeon, but he is a very, very kind person. He takes an interest and talks to his patients.”

Having to travel to Miami for first-class care at Baptist Health would not have been Mr. Rutty’s first choice, especially under the circumstances, but he’s glad the option was there.

“I did the right thing by coming to Dr. Patel, coming to Baptist Hospital,” Mr. Rutty says. “I would have liked to stay at home, but I did what was best for me.”