Tall and thin, Mark Malecky has the strength and physique of a track and field athlete. But in 2019, while hospitalized for an unrelated problem, UPMC doctors discovered a mass the size of a tennis ball on Mark’s heart — like a ticking time bomb in his chest. In December 2019, Mark had open heart surgery at UPMC Shadyside to remove the life-threatening coronary artery aneurysm and repair his heart.
The Problem: Coronary Artery Aneurysm
All his life, Mark Malecky has been active and athletic. He specialized in short distance races and the long jump as a member of the Butler Area High School track and field team. Mark hoped to continue his track and field activities after starting college in the fall of 2012.
But the mechanical engineering major’s college sports were soon sidelined by surgery for two separate spontaneous lung collapses — a fairly common occurrence in people who are tall and thin, especially men. Although he eventually returned to run track and field his junior year, Mark was told he would always be at risk.
Three years after graduating, Mark experienced another small lung collapse. But imaging results also revealed the 25-year-old had a mass the size of a tennis ball on his heart — a life-threatening coronary artery aneurysm.
“It’s amazing that they found it,” Mark says. “It’s almost never found when you’re alive.”
The Path to the UPMC Heart and Vascular Institute
When the 7-centimeter mass was found, doctors at UPMC Shadyside called in Ibrahim Sultan, MD, director of the UPMC Center for Thoracic Aortic Disease and a cardiothoracic surgeon with the UPMC Heart and Vascular Institute.
Additional scans and tests confirmed Mark had a dangerous bulge in a coronary artery. Without surgery, the aneurysm could rupture — and he could die.
While it was tough to hear that he would need open heart surgery, Mark says he wasn’t worried.
“I had total faith in the doctors because I met with them a lot before the surgery. I trusted them with my life. I knew Dr. Sultan and the people he was consulting with on my case are some of the best in the world.”
The Solution
Because Mark’s case was so unusual, Dr. Sultan and his surgical team carefully outlined three methods to remove the aneurysm. Their preferred option — and the safest for the long term — was to remove the entire aneurysm through open heart surgery.
On Dec. 20, 2019, Dr. Sultan performed a coronary artery aneurysm resection. Because Mark’s body had adapted over the years to the slow-growing aneurysm — creating other arteries to keep blood flowing to his heart — the team did not have to perform any bypasses.
Three days later, Mark was released from UPMC Shadyside and spent the next two months recovering at his parents’ home in Butler, Pa.
“I owe my parents a lot,” he says. “Those first few months were difficult. It helped that my dad could take a few weeks off from work to be there for me.”
Although he knew the initial goal of cardiac rehab was just to get his muscles moving again, Mark found the slow pace to be frustrating. Still, he looked forward to the rehab sessions at UPMC Center for Rehab Services in Green Tree.
“The therapists had to keep me from pushing myself too hard at first, but it felt good to do things again,” says Mark. Within a month and a half, he was jogging on the treadmill and working out on the stationary bike.
“I always believed that I would get back, and I’m probably stronger now than I’ve ever been.”
The Results
By March, Mark had recovered well enough to leave his parents’ home and return to his apartment in Pittsburgh’s Mount Washington neighborhood.
When the COVID-19 shutdown hit and in-person rehab was cancelled, he continued following a rehab program at home. The many trails that wrap around Mount Washington’s hilly terrain provided him with plenty of opportunities for walking and hiking.
“I took it slow, but I made sure to do something every day. And being outdoors was great for me.”
Mark says he really began to feel like himself again six months after the surgery. An avid hiker and rock climber, Mark celebrated with a backpacking trip to Colorado in June 2020 for some altitude hiking.
“My chest muscles are definitely weaker than any other muscle group, so I’m very careful not to jolt my chest,” he says. “I definitely have to take more precautions when I’m hiking and rock climbing now, but it lets me have some sense of normalcy.”
Overall, Mark has few restrictions and can still enjoy his favorite activities.
“I’m not allowed to scuba dive, which I really want to do. But if that’s the only restriction, I can live with it!”
Mark’s' treatment and results may not be representative of similar cases.
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