Once told he was out of options, Sergio is now taking 15,000 steps per day
Sergio was in a wheelchair due to a heart condition and difficult-to-control heart rhythm. The 58-year-old wore a life vest, which is a defibrillator worn like a jacket, to monitor his heart rhythm and shock him if it was abnormal.
Sergio has Takotsubo syndrome cardiomyopathy, which involves a weakened left ventricle. He also was born with sinus venosus atrial septal defect, which is a hole between the upper heart chambers that allows blood to pass into his lungs. Walking even 2,000 steps per day was difficult.
“I would be dead tired and had to sleep until the next day, or I would trigger some type of event and end up in the emergency room,” he said.
Sergio saw Jessica Silveri, APRN, CNP, a cardiology practitioner in Fargo, who referred him to cardiologist Jamie Lohr, MD, in the adult congenital heart disease program with M Health Fairview. Lohr is also an associate professor at the University of Minnesota Medical School.
In September 2024, Lohr and her team brought in Varun Aggarwal, MD, a pediatric interventional cardiologist with M Health Fairview and the University of Minnesota Medical School, who treats children with sinus venosus atrial septal defect. At that time, Sergio’s heart failure was so bad that his only chance at survival was getting care from an experienced research institution and compassionate use approval from the FDA for a special device.
"Sergio was essentially living on a life vest, and he was so scared because it would shock him at random times, but he couldn’t get out of the vest,” Aggarwal said. “The problem is that life vests are not as accurate as an implanted defibrillator, so there's a lot of false shocks.”
Aggarwal and his team delivered Sergio’s wish to get out of that vest. Sergio was walking 12,000 to 15,000 steps just days after surgery. Now, he said he is feeling more energetic than he has in years.
A complex medical history
Sergio’s congenital condition led to biventricular dysfunction, which affects both sides of the heart. Neither side pumps blood effectively, which leads to heart failure. Sergio also had severe right ventricle enlargement that left him with irregular heart rhythm. He also had a stroke.
Usually, sinus venosus atrial septal defects are diagnosed in children, but Sergio’s wasn’t found until he was in adulthood. The defect is difficult to see on an echocardiogram, which makes it easy to miss, Aggarwal said.
If that wasn't enough, Sergio was also treated for cancer, which is now in remission, and his cardiomyopathy left his heart function low.
Doctors presented Sergio for a heart transplant, but Sergio was denied due to his other health conditions. The M Health Fairview team also considered Sergio for open-heart surgery, but surgeons didn’t feel confident it would be successful due to his low heart function and additional health conditions.
But Aggarwal and his team didn’t give up. They got FDA approval for compassionate use of a custom-made stent and were able to close Sergio’s sinus venosus atrial septal defects. Usually, commercially available stents are up to six centimeters long, which is too short for adult patients and has been shown to embolize, or block the blood vessel, more often. So, Aggarwal and his team had a 10-centimeter stent specially tailored for Sergio’s anatomy.
The type of procedure was first done about 10 years ago in London and has only been done in a handful of heart centers. After getting special approval to do the procedure, Aggarwal and his team placed the stent in a transcatheter procedure in May 2025. Sergio also had a pacemaker and defibrillator implanted to help with his heart rhythm.
Because this type of procedure is usually done on pediatric patients, Aggarwal had both the pediatric team and the adult team there.
“I don't do these procedures alone,” Aggarwal said. “Sergio’s success would not have been possible without the outstanding teamwork and expertise of everyone involved, starting with Jessica Silveri, who referred Sergio to M Health Fairview for further evaluation, Dr. Lohr, and the entire research and heart team at M Health Fairview for their dedication, skill, and seamless coordination throughout the process.”
From end of life to becoming a runner
When Aggarwal first met Sergio, Sergio was in a wheelchair and essentially at the end of his life. About a month after the procedure Aggarwal called to check on Sergio, who reported that he was running a mile or a mile and a half every day.
“His transformation has been remarkable,” Aggarwal said. “It’s deeply rewarding to witness.”
Sergio did have some hiccups in his recovery. He was briefly hospitalized for bleeding from the pacemaker pocket and concern for infection. He also experienced vertigo as his body got used to his new heart function.
“I refused to give up,” Sergio said. “I figured I'd rather have vertigo than how I was doing before the surgery.”
Sergio said he started by walking laps on the hospital floor but progressed to walking the University of Minnesota campus near the hospital.
"I'd run into many students and share my story. They'd give me the confidence to keep going,” he said. “I also want to say that all my staff from my doctors to my nurses and assistant nurses, and the students I'd meet during my stay and walks, were incredibly nice and beyond professional. They made me feel like a loved relative. In some way they all should get credit for going above and beyond.”
Aggarwal saw Sergio’s heart function improve significantly just a day after the procedure. He expects Sergio to have a good long-term outcome. He shares credit with a large team of congenital heart researchers and clinicians.
“This case was truly a testament to the power of multidisciplinary collaboration within our cardiology group,” Aggarwal said. “Moments like these remind us of the impact we can make when we work together."
