Sandra Guiter poses for a photo and smiles.Sandra Guiter was not just an adult with a heart issue. She was an adult who had grown up with a congenital heart condition from birth. She needed a different type of heart care.

Fifty years ago, when she was 5 years old, Sandra had her first open heart surgery. She had been born with tetralogy of Fallot, a combination of four heart defects that affect the structure of the heart and cause oxygen-poor blood to flow out of the heart and through the body.

As she grew, her lack of oxygen prevented her from participating in sports or other more strenuous activities. She eventually had another open heart surgery, but was left with residual heart problems. By age 40, she had a pacemaker and heart valve replacement surgery. After a sudden collapse, a defibrillator was implanted under her skin, an electronic device that shocked her heart into action when it became too slow or stopped beating.

“In 2012, the swelling increased and I had shortness of breath,” Sandra said. Fluid retention became a big problem, causing her abdomen and legs to swell.

Sandra’s doctors at another Michigan center did what they could, but eventually told her they could do no more. Diuretics were not enough to rid her of the fluid she was retaining, and her heart was giving out from the strain.

“They pretty much told me to get my affairs in order,” she said.

But Sandra was not ready to give up. She had a life to live. Sandra’s sister drove her to see the congenital heart specialists at Spectrum Health, where she knew they specialized in diagnosing and treating all congenital heart conditions.

“When Sandra came to us, she was in a wheelchair and on oxygen,” said Samuel Lacina, MD, a pediatric cardiologist who also specializes in adult congenital care. Dr. Lacina was honest with Sandra about her options. “She was in a critical state,” he said. “Her options were to choose hospice care or take an aggressive approach. I told her that she was too young for me to give up on her.” He referred her to his colleagues, cardiovascular surgeon Marcus Haw, MS, FRCS, and congenital cardiologist Joseph Vettukattil, MD, who specializes in interventional cardiology and 3-D echocardiography.

Sandra was ready for the fight; she was admitted to Spectrum Health the same day.

Her tricuspid and mitral valves were leaking and obstructed. She was taken to cardiac surgery, where Dr. Haw replaced the leaking tricuspid, pulmonary and mitral valves. She also had a biventricular defibrillator implanted. She received complex, post-op intensive care, with aggressive support.

After spending five weeks in the hospital and three weeks in a cardiac rehabilitation program, she is feeling strong and healthy again and no longer needs diuretics. Her wheelchair has been set aside; she’s back on her feet, walking and living independently.

“When I compare the care I received at Spectrum Health,” Sandra says, “it’s the whole team approach. Rather than a doctor here and a doctor there, and sometimes feeling like they weren’t all communicating with each other, I had a team working together with me. Dr. Haw would say, ‘Sandra, you look better than yesterday!’” Sandra said as she smiled. “I liked that. It was uplifting.”

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