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Community Hospital's first two open heart surgery patients


No one in his family had reported heart trouble. And at 69, he too was enjoying a healthy life, competing in a bowling league, playing quite a bit of golf, and getting in a walk whenever he could. But suddenly, it seemed, his heart wasn't doing exactly what it was supposed to; it wasn't pumping exactly as it should.

His doctor, Salinas cardiologist Dr. Anthony Sintetos, began closely watching Flores' heart, giving him a stress test every six months. The disease progressed slowly. But this past August, after six years of vigilance, the waiting and watching was over. He needed a valve replacement.

Joe Flores had become a candidate for open-heart surgery.

"Oh, man; that was a lot to think about," says Flores, now 75. "My doctor wanted me to go up to Redwood City for the surgery, but that's a long ways from Salinas. And I wanted my family near me. I'd heard that Community Hospital was opening up a new heart surgery program, so I asked my doctor how long I could wait. He gave me six months."

The first time Flores called Community Hospital, they estimated November 15 for the first heart surgeries. Then December. Then January. The clock was ticking.

"I just kept calling," he says. "Finally, I went over to the hospital and
talked with Dr. (Bill) Reed. He told me February 13, which was right up against my deadline. And that's the day it happened. I was the very first patient to have open-heart surgery at Community Hospital. I was even a celebrity for a little while; they wrote it up in The (Salinas) Californian and The (Monterey County) Herald (newspapers)."

Today, Flores has gone back to bowling and is getting in a regular game of golf, plus a lot of walking. "Three months ago," he says, "I had a five-day stay in ICU. Looking at me now, you'd never know it. I'm just a little bit sore in my chest yet, but Dr. Sintetos says I'm looking good."

Richard Elster

It all began some 15 years ago while he was working in Washington, D.C., in a civilian capacity at the Pentagon. Richard Elster experienced his first atrial fibrillation, an abnormal heart rhythm characterized by disorganized, rapid electrical impulses that result in irregular heartbeats. And he experienced fear.

From then on, Elster took solace in routine heart monitoring through regular visits to a cardiologist in Arlington, Virginia. But on the Monterey Peninsula a few years later, local internist Dr. Walter Holz identified the sound of a leaking heart valve. He referred Elster to Dr. Terrance Moran, a local cardiologist who prescribed statin drugs to mitigate the problem and monitored Elster's condition. This past fall, Moran retired from private practice and referred the case to cardiologist Dr. Riaz Ahmed.

"Although ideally no blood pumping out of the heart should flow back in," says Elster, "about a third of mine was seeping back in. So, after monitoring the 'ejection volume,' as well as the dimensions of my heart, Dr. Ahmed said I should prepare for surgery to replace the aortic valve and do a Maze procedure intended to reduce or eliminate the problem of atrial fibrillation."

Part of Elster's preparation was an internet search to check out the condition, the surgical procedure, and the surgeon who would resolve his heart disease. Yet he never imagined his research would provide him a virtual practice run.

"I used the internet to check out Dr. Vincent Gaudiani, who performed this kind of surgery in Redwood City," says Elster. "And the data was very good. Then I happened across a streaming video of him performing an aortic valve replacement. I watched it several times. Although technically difficult, it looked like he knew what he was doing, and he had good interaction with his colleagues, which was comforting. I settled on Dr. Gaudiani for my surgery. And when I discovered he was coming to Community Hospital's new Tyler Heart Institute, I decided to wait."

Elster really wanted to be the very first open-heart surgery patient at Community Hospital. He came close, settling for second patient on the first day of heart surgery.

"I have great confidence in these two surgeons (Gaudiani and Reed)," says Elster. "I'm 67, and when I go to cardiac rehab at the Hartnell Professional Center, I feel like a spring chicken. I feel terrific. And I'm so glad to have this truly convenient, sparkling new facility right in my backyard. A major point I'd like to make is that, from check-in to check-out, everyone was terrific; what a wonderful group of people."

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