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Cardiac Rehab Puts Utah Man Back on the Hiking Trail after 2nd Open Heart Surgery


Welster Santos couldn't figure out why he was feeling so sluggish. He was an active 68-year-old guy who loved going on extensive three-day hikes with a group of buddies, a few his age and a few "youngins in their 50s." He'd tromp through the Southern Utah wilderness and photograph his adventures along the way—but, lately, Welster had been feeling run down and winded after even mild exertion. When had walking become so hard?

It didn't help that he'd recently fallen off a ladder and broken his hip, requiring surgery. For some reason, he wasn't bouncing back from his injury as fast as he expected. There was something else going on—in addition to the hip accident—that was holding him back.

Medical imaging tests revealed the problem was in his heart—he had a defective aortic valve. It wasn't allowing blood to flow properly through the main artery in Welster's body, causing a condition called aortic stenosis. Common symptoms include shortness of breath especially when exercising, fatigue, and chest pain or tightness.

Here we go again, he thought.

15 years earlier, Welster—who was born with two of his three aortic valve leaflets fused together—needed open-heart surgery to implant into his chest a porcine (pig tissue) valve, which typically lasts about 10 years, according to Jason Glotzbach, MD, a cardiothoracic surgeon at University of Utah Health. Welster was fortunate—his prosthetic valve had lasted five years longer than the average. Still, he remembered everything involved with the first surgery, and it was the last thing he wanted to go through again. He'd had a difficult recovery—and he was quite a bit younger then too.

While Welster faced a 10 percent chance of a major complication, he had a much greater shot at feeling better than he'd felt in years after he recovered from the open-heart surgery, said Glotzbach, especially if Welster was willing to follow through with U of U Health's cardiac rehab program, which is typically a three-times-a-week, three-month fitness and strength-training program.

Instead of merely being told to go to a gym, patients' workout routines are led by a team that includes a cardiologist, exercise therapist or physiologist, nurse, and a clinical dietitian.

"Cardiac rehab is a really crucial part of this whole process," Glotzbach said. "We do these big operations on people's hearts, and we kind of have to hurt them to make them better. Open-heart surgery takes a pretty significant toll on your body even if you're healthy coming in. People get run down and tired, and it's important to get that strength back."

Jason Glotzbach, MD

Welster's surgery was a success. This time, a bovine valve was used. Welster needed to recover for four days in the ICU followed by a few more days as an inpatient. He thought his stay was a bit different from his first time around 15 years ago.

"The thing I'm seeing is they are listening to the patient more," Welster said. "If one has apprehensions, they can address everything if we're willing to ask it. Before leaving my room, the last words were always 'Is there anything else I can do for you?' That's what I got out of my experience at the U—and that positive attitude translates into better recuperation."

Welster soon became a model cardiac rehab patient dedicated to his workout program.

For people recovering from heart surgery, figuring out the right balance of how much and how hard to exercise can be extremely difficult, said Natalie Holdaway, a certified exercise physiologist who worked with Welster. Hitting the treadmill can bring up a lot of anxieties as patients wonder if their rapid heartbeat is normal or if they should take it easy or go another mile.

"We help by pushing them harder in rehab before they push harder in real life," said Holdaway, who tracks her patients' vital signs as they exert themselves. "It's an awesome preventative thing, and it's rewarding to see people gain confidence to go out and do the things they love to do."

Plus, three months of exercise helps people to not just recover from surgery but to get into shape and form a habit of exercising regularly.

Glotzbach expects Welster to make a full recovery and predicts he'll be out hiking with his friends again soon.