Retired Pulmonologist Turned Heart Patient
Complex care for advanced heart and vascular disease
Nov. 3, 2025
4 minute read
Complex care for advanced heart and vascular disease
After 50 years of treating patients, retired pulmonologist Mehboob Qureshi, MD, of Menomonee Falls, has always taken his health seriously. As he approached 90 years old, he swam daily at his local YMCA.
In July 2024, Mehboob finished his usual breaststroke and backstroke laps with no problems. But after he returned home, he developed shortness of breath.
“I knew something was wrong,” he said. “It wasn’t the kind of symptom I’ve ever had before. I just couldn’t get enough air. It was like I had run a race and was taking deep breaths.”
He arrived at Froedtert Hospital, the academic medical center of the Froedtert & the Medical College of Wisconsin health network, in critical condition. He had severe coronary disease and severe stenosis of his heart valve.
A decade before, tests had revealed abnormalities with his heart, but his regular echocardiograms were stable, and he had no symptoms.
“Sometimes advanced heart disease shows up with seemingly no warning signs,” said Mina Iskander, MD, cardiologist and MCW faculty member. “If you’re a marathon runner or a swimmer for a long time, your body will sometimes only manifest heart symptoms later, when things are more critical or advanced.”
Mehboob’s main cardiac issues included critical coronary disease (severe narrowing of arteries supplying blood to the heart) and aortic stenosis (narrowing of the aortic valve), which impaired blood flow and added strain on the heart. He also had peripheral artery disease, complicating standard treatment options.
“Traditionally, younger patients would be treated with coronary artery bypass surgery,” Dr. Iskander said. “However, given Mehboob’s age and condition, conventional open-heart surgery posed excessive risk. Coronary artery disease is seen frequently in the older population, but significant left main stenosis is relatively uncommon.”
Instead, the heart team, including Dr. Iskander and Paul Pearson, MD, PhD, cardiothoracic surgeon and MCW faculty member, recommended a stent to open the main artery of Mehboob’s heart and a transcatheter aortic valve replacement (TAVR) procedure to treat the aortic stenosis. Both procedures could be done in the cardiac catheterization lab, where a less invasive approach allows doctors to place the stent and new tissue valve via an artery.
“Managing these complex cases requires preparation and precision, or mechanical circulatory support,” Dr. Iskander said. “Mehboob’s anatomy and co-existing conditions made traditional mechanical support impossible. We determined the safest approach was to stabilize his heart with a stent first, and then proceed with the TAVR procedure.”
Dr. Iskander first placed the stent and then did the TAVR procedure, along with Dr. Pearson, a couple of days later. But that procedure was also more complicated than usual — there are only a few published cases of a TAVR procedure immediately following a stent in the left main artery. The care team used a technique called kissing balloon inflation, which involved positioning a balloon to protect the stent from getting crushed by the balloon used to expand the valve.
While the TAVR placement was successful, Mehboob went into ventricular tachycardia, an abnormally fast heart rhythm likely due to his advanced coronary artery disease. He also developed heart block, a type of rhythm problem that occurs when the heart’s electrical signals are disrupted and unable to get through.
“Heart block can occur after TAVR procedures, especially in older patients,” Dr. Iskander said.
His team was prepared to address these complications, and that same week, Mehboob had a third cardiac procedure to implant a pacemaker to address the heart block and a defibrillator to treat ventricular tachycardia.
The high level of expertise within the Froedtert & MCW Heart and Vascular Program made it possible for Mehboob to receive this trio of cardiac procedures quickly and efficiently. He is grateful he was able to have less invasive procedures.
“The valve replacement procedure was less stressful or painful than going to a dentist,” he said. “It’s amazing with this new technology — just threading through the vein with no pain. In a short time, the valve is replaced. From my perspective, the treatment is miraculous.”
The Froedtert & MCW Heart and Vascular Program offers a complete range of specialized programs to diagnose and treat common and complex scenarios, as well as access to the latest in surgical and nonsurgical options. Call 414-777-7700 for an appointment. Learn more at froedtert.com/heart.
