An Amazing Surgery

Two years ago, Jean Magazzu began having trouble breathing. Her doctor thought it could be allergy-related — or perhaps a case of bronchitis. 

But multiple rounds of antibiotics didn’t help, and her breathing worsened to the point where she couldn’t even walk across a room without sitting down. An X-ray revealed the frightening truth: Her lungs were filled with blood clots and scar tissue, a symptom of pulmonary hypertension (PH). She was immediately transferred to Allegheny General Hospital, where cardiologist Dr. Raymond Benza diagnosed her. “Pulmonary hypertension is a rare disease, affecting only 15 people in 1 million,” says Dr. Benza, a nationally recognized leader in the treatment of PH. “It’s also rapidly progressing and deadly — probably as mortal as any cancer we treat.” Jean’s form of PH — related to the chronic clots in her lungs — was even more rare. 


The disease is characterized by high blood pressure in the lung’s pulmonary artery, which forces the heart to essentially work itself to death. “When she came to us, she was already in the throes of severe heart failure,” says Dr. Benza. Along with his team, he determined that Jean needed to undergo an extremely delicate and difficult surgery to remove the clots and scar tissue. The procedure can take 12 hours, and requires stopping the heart and deep-chilling the body and brain; it’s performed in only a handful of U.S. institutions. 

 Fortunately, AGH recently joined that exclusive club. Dr. Benza had arranged for AGH cardiothoracic surgeon Dr. Robert Moraca to receive the months-long training necessary to perform the procedure, which took Dr. Moraca to hospitals in San Diego, Canada and Alabama. Jean was the first person to undergo this procedure at AGH, but she says Dr. Benza’s manner helped lessen her fears. “He understood this was scary, but he explained things so I could understand them — and told me, matter-of-factly, what they were going to do,” she says. “I really wanted to know, so I appreciated that. His and Dr. Moraca’s confidence really helped.” Jean’s surgery required a bypass machine to produce total circulatory arrest. “You can’t have any blood going through the lungs because that’s where we were operating,” Dr. Benza explains. 

After her body and brain were chilled, lead surgeon Dr. Moraca opened up all the blood vessels in her lungs and carefully teased away the clots from the vessels. “Deciding what’s real tissue and abnormal tissue inside the vessels is one of the real challenges here,” explains Dr. Benza. “And if you make a mistake and puncture a blood vessel, that’s usually fatal.” The positive results of Jean’s surgery were apparent immediately — the high pressure in her lungs dropped to normal, and her circulation responded in kind. “Although I was weak from the surgery, I remember sitting up and taking a breath and thinking, Wow, a real improvement!” Jean says. “I was only in the hospital a week, and back to normal quickly.”