'Dying saved my life'

To operate on Sophie Clarke, doctors had to bring about her 'death'. She explains how it felt to go under the knife for this terrifying heart surgery

When Sophie Clarke was readying herself for the life-saving open heart surgery she underwent in February, all she could focus on was recovering quickly for her two "boys", husband Pete and son Beau, who is now two-and-a-half. "I knew there were risks," she recalls six months later, "but my worries were for them. It was a choice between not having the surgery, and dying, or having the surgery and getting a chance at life."

What was about to take place in the theatre was too overwhelming to take in. Before work could begin on Clarke's unusual heart defects, her body had to be chilled to 18oC until brain activity ceased, and all the blood drained from her body. To all intents and purposes, she would be dead. And yet these techniques allow the surgery to take place. The surgeon who performed the operation, Professor Stephen Westaby, explains that the complicated techniques he carried out on Clarke were an amalgamation of a string of breakthroughs in cardiac surgery over the past 70 years. "Sophie's operation brought together several procedures that have allowed heart surgery to develop and evolve into an extremely sophisticated speciality," he says. "It wasn't just a heart operation. We replumbed the most critical part of the vascular tree, the aorta, which is the biggest blood vessel in the body and supplies the head and brain. When you stop the circulation to operate on the brain you have only 40 minutes in total before you start getting brain damage."

Clarke's heart has been under medical scrutiny since she was a child. A small hole, which doctors hoped would close of its own accord, was noticed at birth. Aged 10, an ultrasound revealed that her aortic valve was narrowing, and she had to give up her daily swimming training and replace it with therapeutic yoga. "I was a sporty person and upset about not being able to do the things I loved," says Clarke, "but my body had to work harder than everybody else's to keep up."

She knew the valve would probably need replacing at some point in her life, but hoped she would be closer to 40, rather than 30, when that time came. Instead, two years ago and just six months after giving birth to Beau, she began to feel unwell. She had spent much of her pregnancy off work with pneumonia, but was enjoying spending time with her young baby when she began to experience heart palpitations, instances of sweating and undue tiredness. She contacted the John Radcliffe hospital in Oxford and received the news she had been dreading; she was told to prepare herself for the major feat of surgery needed to save her life.

Westaby expedited the five-hour surgery without a hitch, despite the fact he discovered an unexpected complication once he had cut open Clarke's chest. He was expecting to find an aortic aneurism of a very unusual shape, but this aneurism – revealed by an MRI scan – was hiding an extremely rare mutation of the aortic valve itself, known as a mid-arch coarctation. This means the artery was much narrower than it should have been, and consequently the blood supply to Clarke's brain was restricted.

"They didn't know how hazardous it was until they opened me up," she says. "They had to take off the arteries to my brain and sew them back on. Looking back, I can see what my body was up against." Although the operation only took a few hours, Clarke spent eight weeks going in and out of hospital. "After 10 days I was begging to go home," she remembers. "I couldn't sleep and was so uncomfortable – I had to sit upright because of my ribcage, which took six weeks to fuse back together. I went home for a night, sure I would sleep better." Instead, she developed a fever and returned to hospital for another week. She then managed two weeks at home, but realised on her son's birthday she was ill again, and returned to hospital for a further three weeks with what was found to be pleurisy.

Just months after the operation, Clarke looks like any other healthy young woman. The only sign of the surgery is the poker-straight scar where her chest was cut open, peeping out of the top of her T-shirt. But she has only recently been able to go back to caring for her son. "The hardest thing through all of this," she admits, "has been the effect it has had on Beau, and not being able to pick him up and cuddle him. When I was away he started calling his dummy 'Mummy' because he was missing me, and he still does."

The entire course of Clarke's surgery was filmed for an upcoming BBC4 series, Blood & Guts – A History of Surgery. Before entering the operating theatre she had to make a very difficult decision: did she want to replace the narrowing valve that was restricting the blood supply to her brain with a mechanical or tissue replacement? The former would leave her incredibly slim chances of ever having another child, the latter would allow further pregnancies, but would need replacing at some point in the future.

In the end she followed the guidance of Professor Westaby. His preference was for the mechanical valve, which means Clarke will always have to take an anti-coagulant, which increases the risks of complications during pregnancy. "Most people don't want to face another heart operation if they can avoid it," says Westaby.

"I guess my perspective on life has changed slightly," says Clarke, who is currently taking time out from her job as a primary school teacher. "When my husband suggested I take the year off I was really grateful, because it means I will get all this quality time with Beau when he is small. This is time we will never get back."

The precision with which Westaby was able to operate on Clarke, and his success rate, may be novel, but the thinking behind cooling a patient's body to enable them to survive the surgery goes back years. Even before the heart and lung machine (which allows the heart to be stopped before the operation takes place) was developed in the 1950s doctors carried out cardiac operations by bringing down the body's temperature with ice packs laid on the surface of the skin, before embarking on "smash and grab" procedures, desperately working against the clock to fix the faults before the heart stopped for good.

Clarke loves programmes about surgery but has never before been able to watch anything about hearts. This time, she has managed it. "I got emotional at the end because you see all the risks these surgeons have taken in the past 50 years," she says. "All those lives have been lost on the operating table, so that I could have my surgery successfully. I just felt so humble. It really hammered home the point that heart surgery has come so far."



Blood & Guts – A History of Surgery begins on Wednesday 20, at 9pm on BBC4. Heart surgery is explored in episode two.

A history of heart surgery

*130-200 AD

Galen, the private physician to Emperor Marcus Aurelius, makes important discoveries including identifying valves and ventricles and the differences between veins and arteries.



*1628

William Harvey describes the idea of circulation and how blood is pumped through the body by the heart, revolutionising the way we think about the human body.



*1810-1820

The first heart operations are carried out by doctors including Dominique Jean Larrey, Napoleon's surgeon, and Francisco Romero, though most patients die.



*1890s

Stab wounds to the heart are successfully operated on for the first time, although there is still a 90 per cent mortality rate during the course of the surgery.



*1938

The first major operation on the heart vessels to repair a pulmonary artery defect is successful, signalling the beginning of modern cardiac surgery.



*1950s

After various wartime breakthroughs, surgeons experiment with lowering a patient's body temperature, which allows for the first successful open heart surgery in 1952. The heart-lung machine is then developed, which takes over the functions of the body's vital organs, giving the surgeon more time to operate. Cardiac surgeons such as Denton Cooley become celebrities in their field.



*1967

South African Christian Barnard performs the first ever heart transplant. The procedure becomes so successful and widespread during the 1970s that there is a shortage of donor hearts.



*1990s

Surgeons had been experimenting with artificial heart transplants since the 1950s, but it is not until the end of the 20th century that battery-powered heart transplants prove successful. The artificial hearts give the patient time to recover or wait for a donor heart to be found, though it is hoped they may soon be long-term solutions to heart defects.

Suggested Topics
Voices
Barn owls are among species that could be affected
charity appeal
News
Sarah Silverman (middle) with sister Reform Rabbi Susan Silverman (right) and sister actress Laura Silverman (left) at Jerusalem's Western Wall for feminist Hanuka candle-lighting ceremony
peopleControversial comedian stages pro-equality Hanukkah lighting during a protest at Jerusalem's Wailing Wall
Arts and Entertainment
The Bach Choir has been crowned the inaugural winner of Sky Arts’ show The Great Culture Quiz
arts + ents140-year-old choir declared winner of Sky Arts' 'The Great Culture Quiz'
Sport
After another poor series in Sri Lanka, Alastair Cook claimed all players go through a lean period
cricketEoin Morgan reportedly to take over ODI captaincy
PROMOTED VIDEO
Have you tried new the Independent Digital Edition apps?
Life and Style
ebookNow available in paperback
Life and Style
ebooksA superb mix of recipes serving up the freshest of local produce in a delicious range of styles
Latest stories from i100
Have you tried new the Independent Digital Edition apps?
Independent Dating
and  

By clicking 'Search' you
are agreeing to our
Terms of Use.

ES Rentals

    iJobs Job Widget
    iJobs General

    Recruitment Genius: Finance Director

    £65000 - £80000 per annum: Recruitment Genius: Finance Director required to jo...

    Recruitment Genius: Medico-Legal Assistant

    £15000 - £25000 per annum: Recruitment Genius: This is a unique opportunity fo...

    Ashdown Group: (PHP / Python) - Global Media firm

    £50000 per annum + 26 days holiday,pension: Ashdown Group: A highly successful...

    The Jenrick Group: Quality Inspector

    £27000 per annum + pension + holidays: The Jenrick Group: A Quality Technician...

    Day In a Page

    Homeless Veterans appeal: 'You look for someone who's an inspiration and try to be like them'

    Homeless Veterans appeal

    In 2010, Sgt Gary Jamieson stepped on an IED in Afghanistan and lost his legs and an arm. He reveals what, and who, helped him to make a remarkable recovery
    Could cannabis oil reverse the effects of cancer?

    Could cannabis oil reverse effects of cancer?

    As a film following six patients receiving the controversial treatment is released, Kate Hilpern uncovers a very slippery issue
    The Interview movie review: You can't see Seth Rogen and James Franco's Kim Jong Un assassination film, but you can read about it here

    The Interview movie review

    You can't see Seth Rogen and James Franco's Kim Jong Un assassination film, but you can read about it here
    Serial mania has propelled podcasts into the cultural mainstream

    How podcasts became mainstream

    People have consumed gripping armchair investigation Serial with a relish typically reserved for box-set binges
    Jesus Christ has become an unlikely pin-up for hipster marketing companies

    Jesus Christ has become an unlikely pin-up

    Kevin Lee Light, aka "Jesus", is the newest client of creative agency Mother while rival agency Anomaly has launched Sexy Jesus, depicting the Messiah in a series of Athena-style poses
    Rosetta space mission voted most important scientific breakthrough of 2014

    A memorable year for science – if not for mice

    The most important scientific breakthroughs of 2014
    Christmas cocktails to make you merry: From eggnog to Brown Betty and Rum Bumpo

    Christmas cocktails to make you merry

    Mulled wine is an essential seasonal treat. But now drinkers are rediscovering other traditional festive tipples. Angela Clutton raises a glass to Christmas cocktails
    5 best activity trackers

    Fitness technology: 5 best activity trackers

    Up the ante in your regimen and change the habits of a lifetime with this wearable tech
    Paul Scholes column: It's a little-known fact, but I have played one of the seven dwarves

    Paul Scholes column

    It's a little-known fact, but I have played one of the seven dwarves
    Fifa's travelling circus once again steals limelight from real stars

    Fifa's travelling circus once again steals limelight from real stars

    Club World Cup kicked into the long grass by the continued farce surrounding Blatter, Garcia, Russia and Qatar
    Frank Warren column: 2014 – boxing is back and winning new fans

    Frank Warren: Boxing is back and winning new fans

    2014 proves it's now one of sport's biggest hitters again
    Jeb Bush vs Hillary Clinton: The power dynamics of the two first families

    Jeb Bush vs Hillary Clinton

    Karen Tumulty explores the power dynamics of the two first families
    Stockholm is rivalling Silicon Valley with a hotbed of technology start-ups

    Stockholm is rivalling Silicon Valley

    The Swedish capital is home to two of the most popular video games in the world, as well as thousands of technology start-ups worth hundreds of millions of pounds – and it's all happened since 2009
    Did Japanese workers really get their symbols mixed up and display Santa on a crucifix?

    Crucified Santa: Urban myth refuses to die

    The story goes that Japanese store workers created a life-size effigy of a smiling "Father Kurisumasu" attached to a facsimile of Our Lord's final instrument of torture
    Jennifer Saunders and Kate Moss join David Walliams on set for TV adaptation of The Boy in the Dress

    The Boy in the Dress: On set with the stars

    Walliams' story about a boy who goes to school in a dress will be shown this Christmas