Duluth football coach undergoes complex heart surgery after going in for checkup

When he exercised, Mark Nachtsheim tried to ignore the tightness he felt in his throat and the difficulty he had breathing.

At 47, the Gnesen Township man knew he was in good condition. He ran five miles four times a week. He lifted weights. A volunteer on the coaching staff of Duluth East High School’s football team for more than a decade, he was studying for a new career as a strength and conditioning specialist. He never smoked. His family had no history of heart disease. He had high cholesterol, but given his overall health his doctor didn’t see it as a major concern.

But that tightness didn’t let go.

“I kind of worked through it for about a month and a half and finally decided I’d go see my doctor and say: This isn’t right,” Nachtsheim related. “And he agreed.”

Routine tests — an EKG, chest X-ray and blood work — turned up nothing abnormal. But to be certain, his physician, Dr. John Ryden, also ordered a stress test.

Nachtsheim arrived at Essentia Health Heart & Vascular Center at 7 a.m. July 12 expecting nothing dramatic, perhaps a diagnosis of an upper respiratory illness. “I had been sick,” he said. “I thought I was just clinging on to an infection.”

But after just three minutes, the technicians stopped the stress test. Nachtsheim was introduced to Dr. Nizar Saleh, a cardiologist, who told him he probably needed a stent or two but it wouldn’t be certain until his heart was open. Given a chance to have the surgery done that day, Nachtsheim took it.

When he came out of that surgery, Nachtsheim learned he needed much more than a stent. His arteries were blocked, and he needed a quadruple bypass.

Nachtsheim’s family had gathered. Remarried a year ago, he has two children and three stepchildren, ages 12 through 21, “My wife was crying and my daughter was crying her eyes out,” he said. “And I’m going, ‘Hey, let’s get this done with. It’s all right. Don’t worry about it.’”

That’s when Nachtsheim was introduced to Dr. Antonio Laudito, a well-traveled cardiothoracic surgeon who had begun his tenure with Essentia Health a week earlier.

Nachtsheim, who built the youth football program that feeds into East, said Laudito’s manner of talking with him and his family reminded him of the way a good coach inspires his team.

“I’ll never forget his words,” Nachtsheim said. “‘You’re not getting the jeans-and-T-shirt surgery. You’re getting the tuxedo surgery. This is going to be so great. They’re going to want to show it on CNN.’ He had me excited.”

Laudito, who like Nachtsheim is 47, said he uses the “tuxedo” analogy when he envisions a particularly challenging surgery. He would be performing his first operation in Duluth that night.

“Because of the age of the patient, at a dramatically young age with coronary disease, I felt that we could not compromise the quality of the outcome because of the time of the day,” said Laudito, whose voice carries the strong accent of his native Italy.

Laudito said that Dr. Wilson Ginete, a cardiologist, alerted him to the need to act quickly in Nachtsheim’s case.

“From a cardiac surgeon’s point of view you found what you were looking for,” Laudito said of Ginete’s face-to-face communication. “It means: I’m not going to sleep on this patient. I’m going to take him right away.”

Laudito chose to perform what’s known as a double mammary arterial reconstruction, a technically demanding, time-consuming surgery so delicate that he compares it to neonatal surgery. He was working in a place, and with people, where he had never worked before. It turned out to be a fantastic team, he said.

“That was the first time that I met these people was in the operating room,” Laudito said. “They provided the help that I was able to do a very complex surgery.”

Laudito had Nachtsheim’s heart stopped during the surgery – a normal part of the procedure. When it came time to restart the heart, nothing happened.

“You expect the heart to come back with a bang, and you realize it’s not coming back at all,” Laudito said. “Not even when we shocked it was it responding.”

Laudito finally turned to a procedure known as the “hot shot,” arresting the heart again with a combination of cold blood and potassium, replenishing the blood and raising the temperature. Doing so added another 15 minutes to an already lengthy procedure.

“By that time, it was 3 o’clock in the morning,” Laudito said. “People were tired. It was a long surgery, very technically demanding, so keeping the team together was important. That’s why I’m extremely grateful to the fantastic performance of the people in the operating room.”

The difficulty restarting the heart also confirmed that Nachtsheim had been in “a really critical situation,” Laudito said. “His heart was starved for oxygen.”

The surgery was finished about 5 a.m. — 22 hours after Nachtsheim arrived for his stress test.

It was easy for him, Nachtsheim said; he slept through it. It was much harder for family members, including his wife, his children, a stepdaughter, his parents, his brothers and his sister. “They were all pacing and sleeping on the furniture,” he said. “They had a tough day.”

The parents of one of the East football players brought in dinner from Coney Island. “They knew everyone was not going to leave,” Nachtsheim said.

He went home the following Tuesday evening. His heart isn’t damaged, but he has been told recovery will take about six months. He reports for one-hour cardiac rehabilitation sessions three days a week at Essentia, a regimen that will last 12 weeks. He can’t lift things. He has to watch his activities. But he’ll be with the team when practice starts on Monday, in a limited role.

“I’m not very soft-spoken when it comes to football,” Nachtsheim said. “But I’m going to have to be this year. One of the players visited me in the hospital and he said, ‘Are you going to be able to coach?’ And I said, ‘Yeah, I’ll be able to coach. I just won’t be able to yell as much as I usually do.’ And he said, ‘Ah, don’t worry about that. You don’t need to do that. All you need to do is get that look and we get it.’”

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