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North Texas Man Survives 17 Mini-Strokes and Endocarditis

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Texas Health Alliance | Image by Texas Health Resources

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A North Texas man is recovering quite well after suffering a series of strokes, thanks to a less invasive surgical technique performed at Texas Health Dallas.

A few days before having 17 mini-strokes that led to heart valve surgery, retired Marine Ralph Marmolejo was enjoying the 75 acres at his cousin’s home. He told The Dallas Express they did a lot of walking and “stayed busy the entire time.”


“There were no signs of me feeling ill or anything,” Marmolejo said.

His health took a significant turn for the worse after returning home from his visit. On the Saturday of Martin Luther King weekend, he remembers his family gathering for a barbecue. However, he cannot recall anything else from the day’s events.

For the remainder of the week, Ralph stayed in bed, thinking he had COVID-19 after a home test came out positive.

A visit to the ER at Texas Health Alliance proved that was not the case.

“There was bacteria that had formed on my valve that was preventing it from functioning correctly,” said Marmolejo.

Doctors did a CAT scan, which revealed Marmolejo was having strokes. He was transferred to Texas Health Dallas, where it was determined he needed surgery to stop the strokes from continuing.

Dr. Mark Pool, a cardiac and thoracic surgeon at Texas Health Dallas, said Marmolejo developed bacteria in the bloodstream, which formed vegetation — abnormal growths made up of bacteria clumped with cells and other materials from the blood — on his heart valve.

A normally functioning heart valve constantly opens and shuts, which, in this case, allowed the bacteria to spread to the brain.

“He had several pieces break off of the vegetation [that] lodged and clogged up one of his arteries in his brain, and that caused the stroke, but that happened to him several times,” Dr. Pool said to The Dallas Express.

The vegetation developed into endocarditis, an infection inside the heart. Dr. Pool used a rare technique for Marmolejo’s heart surgery so he would not be as physically restricted in rehab.

“I used robotic technique to replace the valve and perform the operation,”  Dr. Pool explained.

He said patients do not need to be as cautious with their movements after surgery with the robotic technique. Specifically, Marmolejo could push harder to recover during rehab because he had this type of heart surgery.

Despite having 17 mini-strokes, Marmolejo did not suffer any lingering complications. However, the surgery did change the way he looks at his health: he is taking it seriously now.

“If anything came out of that surgery, it’s the fact I’m getting back in better shape,” he told The Dallas Express

He is currently participating in cardiac rehab at Texas Health Fort Worth. At home, his granddaughter keeps him active during their evening walks.

Doctors are amazed that the strokes did not result in lasting damage for Marmolejo. According to the Centers for Disease Control and Prevention (CDC), someone dies from a stroke every 3.5 minutes. Dr. Pool said seeking help when odd symptoms appear is vital to surviving a stroke.

“If a patient or a family member thinks a person may be having a stroke, seek medical attention,” he cautioned.

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