Explained: The heart operation Megan Markle’s father underwent

Explained: The heart operation Megan Markle’s father underwent 8 days after suffering a heart attack

  • Thomas Markle, 73, allegedly suffered a heart attack last week
  • He said he wouldn’t be able to walk his daughter down the aisle as a result
  • On Wednesday he told TMZ he’d had three stents placed to open his arteries
  • Past president of the American Heart Association Dr Sidney Smith explained to Daily Mail Online how the operation works and why some patients need 3 stents

Hours after declaring that he won’t walk his daughter down the aisle on Saturday, Thomas Markle has said he underwent heart surgery on Wednesday morning.

The 73-year-old, who lives in Rosarito, Mexico, allegedly suffered a heart attack last Tuesday.  

Mr Markle told TMZ that doctors implanted three stents in his blood vessels. 

He said doctors planned to ‘go in and clear blockage, repair damage, and put a stent where it is needed’ during the operation. 

Stents hold arteries open to help improve blood flow to the heart and relieve chest pain.

Past president of the American Heart Association, Dr Sidney Smith, MD, told Daily Mail Online how stents work, when they are placed, and why a patient might need three stents at once. 


A stent is a wire mesh tube used to prop open an artery during an angioplasty. Once the balloon is removed, the stent remains to keep the artery open

Thomas Markle has said he underwent heart surgery on Wednesday morning. The 73-year-old, who lives in Rosarito, Mexico, allegedly suffered a heart attack last Tuesday


A stent is a wire mesh tube that props open arteries.

To open the narrowed artery, the surgeon may perform what’s known as an angioplasty.

It involves making a small incision in a patient’s arm or leg, through which a wire with an attached deflated balloon is thread through up to the coronary arteries.

In some cases, this is all that’s needed, to go in and break up the blockage, without putting any permanent artery-openers in place.

However, in some cases surgeons will put in a stent to keep the arteries held open.

The stent surrounds the deflated balloon and expands with it when the balloon is inflated.

After the balloon has been deflated and removed, the stent stays in the artery permanently.


Angioplasties are increasingly common in the United States and Mexico due to rising rates of heart issues.

And stents are becoming increasingly common in angioplasty patients, since it is very common for the arteries to narrow again if nothing is put in place (this is known as restenosis, and happens in about a third of cases).


Yes – depending on what kind of heart attack was suffered.

There are two kinds of blockages – a STEMI (which is a complete blockage) or an NSTEMI (a partial blockage).

STEMI stands for ‘ST-elevation myocardial infarction’, which means the patient has suffered cardiac enzyme changes, and changes to their electrical heart activity, as seen on an EKG scan.

A non-STEMI heart attack, or NSTEMI heart attack, is less urgent. It means they suffered enzyme changes but no changes on their EKG.

‘A STEMI is a very big, severe heart attack where a patient comes into the emergency room and the artery is totally blocked, and needs to be opened up straight away and the stent is placed,’ Dr Smith, Professor of Medicine, Cardiology, University of North Carolina School of Medicine, explained.

‘That’s the patient that goes direct into surgery.’

‘In other cases, the patient may have a non-STEMI. They may have chest pain, and they come into the hospital with enzyme changes but no changes on their EKG [electrical activity of the heart]. The need is not urgent. Stents are placed but it can be days later.’


Meghan Markle, pictured with her father, may be walked down the aisle by her mother on Saturday as Mr Markle said he will be recovering from heart surgery

It depends how many blockages they had, or how many vessels were affected.

‘The decision to place stents in the coronary arteries is based on the number of significant blockages that’s there,’ Dr Smith explained.

‘Three is not out of the ordinary. Sometimes you place just one, sometimes two or three – it completely depends.

‘You places stents where there is a significant blockage. 

‘It could be that there were two or three vessels involved, or three blockages in one vessel. 

‘That would warrant three stents.’

He adds that the amount of blockages has nothing to do with the severity of the heart attack, or whether it would be a STEMI or NSTEMI.


For patients being treated for chest pain, most are usually able to go home the same day of the operation. Patients are often advised to avoid strenuous activities and driving for at least a week.

But Dr Smith said it depends on each patient, and particularly on whether they have other underlying health issues.

‘It depends on how well their heart is pumping,’ Dr Smith said.

‘Patients are often able to go home within 24 hours, usually into cardiac rehabilitation.’

As for the patient taking a trans-Atlantic flight, Dr Smith said that would have to be decided on a case-by-case basis.

‘It depends on how they’re doing, and how long the flight is,’ he said.

  • Any reader who thinks they may be suffering a heart attack, or may have suffered one, should never diagnose themselves. Always call an ambulance if you think you might be having a heart attack. The EMS crew in your ambulance will route you to the right hospital based on your location

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