How a rare heart surgery helped make music for the NFL

The Eagles have endured plenty of medical setbacks during this unlikely football season, but those are nothing compared with the ordeal of a Levittown man who provided the soundtrack for some key gridiron moments.

Six years ago, Justin Vigile and his mother were making plans for his funeral.

Those discussions turned out to be extremely premature, as Vigile, now 28, underwent a rare heart surgery at the Mayo Clinic — turning him from bedridden invalid back into a promising heavy-metal musician.

After producers at NFL Films heard about his story and listened to the music of his band, Extractus, they invited the group to contribute music during the season for segments on ESPN's NFL Matchup and Showtime's Inside the NFL.

The band's wild guitar solos and relentless beat, with Vigile on drums, are not the usual fare for the league's official production company, which is based in Mount Laurel. But it works — especially for one clip in which athletes, starting with San Diego Chargers running back Austin Ekeler, are playing air guitar.

"The music is dynamic and there is so much passion in it," producer Darrell Campbell Jr.  said.

In the fall of 2011, Vigile was feeling anything but dynamic.

For years, Vigile had no idea that something was wrong with his heart.

Then, just before his 15th birthday, he told his mother he felt light-headed and dizzy when he sat up in bed every morning.

During Vigile's next physical, the primary-care physician who listened to his heart detected an "odd thump" and sent the teenager to Children's Hospital of Philadelphia for tests, recalled his mother, Mary Beth.

He was diagnosed with a form of hypertrophic cardiomyopathy, a condition characterized by an abnormally thick wall in the heart muscle.

Some patients experience irregular heart rhythms, which on rare occasions — typically during strenuous exercise — can lead to cardiac arrest. A standard treatment is to implant a defibrillator, a device that detects whether the heart has stopped and shocks it back into action.

Vigile got one at age 18, and one time it activated while the band was on stage.

"Still finished the gig without stopping," the drummer recalled.

But Vigile's heart held him back in other ways. The abnormal growth of heart muscle occurred in an unusual location — the bottom tip of the left ventricle — and it became thicker with age.

In the spring of 2011, the wall of the ventricle had grown so thick that the chamber was unable to hold enough blood. Vigile often became short of breath, and at his job in retail, he had trouble walking across the store.

"He had no energy, no stamina, and pain in his chest," Mary Beth Vigile said.

He was officially diagnosed with heart failure — a condition that typically strikes people much later in life. Within months, he was so exhausted that he could barely get out of bed, and could not take a shower without help.

By then, frustrated at getting different answers from one doctor and the next, the family had been driving him to Boston periodically to see a cardiologist at Tufts University. That doctor said Vigile likely had just months to live, unless he could get a heart transplant.

Dissatisfied with that choice, Mary Beth came across another option on the internet: an apical myectomy — a surgery that had been developed at the Mayo Clinic, in Rochester, Minn.

On its face, the concept sounded straightforward. The heart muscle was too thick, so surgeons would simply cut away some of the tissue. But in most patients with abnormally thick heart muscle who go on to develop heart failure, the latter condition is caused more by muscle stiffness and scarring — not because the muscle is thick enough to restrict the flow of blood.

In many patients, in other words, removing muscle would not help, said Mayo Clinic cardiac surgeon Hartzell V. Schaff.

"The nuance is figuring out which patients have a small enough ventricle (due to the thickened wall) to contribute to their heart failure," Schaff said.

Schaff performed the first such surgery in 1993, and it also has been performed in Japan. But patients who might benefit from the procedure are so unusual that by the time Vigile came along, in the fall of 2011, Schaff and his Mayo colleagues had performed the operation just a few dozen times.

In a 2010 study, they reported the results of 44 such operations. Two patients did not survive the surgery, but of the 42 who did, all but one experienced improvement in symptoms.

The Vigiles were game, and they flew to Minnesota for the January 2012 procedure. Schaff and his colleagues cracked open Vigile's chest and made a two-inch incision in his heart, enabling them to remove some of the muscle.

Once home in Pennsylvania, the patient took it slowly at first. But before long, he was practicing again with the band, and in December 2012 — 11 months after the surgery — the group played at the Trocadero in Philadelphia.

"I went from being incapacitated completely to performing in front of 500 people," Vigile said. "I have not stopped since then."

Some patients do not fare quite so well, and a few end up needing a heart transplant, after all. Still, the procedure seems to be effective when performed on the right patient, said Pavan Atluri, director of Penn Medicine's Cardiac Transplantation and Mechanical Circulatory Support Program.

So far, the Mayo Clinic is the only U.S. facility to perform the operation, though Atluri said he is working with Schaff to learn the procedure and start performing it at Penn. (Atluri already performs surgery to remove excess muscle from a different part of the heart: the septum.)

Vigile pronounces himself "completely, 150 percent symptom-free," though he still has to avoid high altitudes.

Last year, Campbell, the NFL Films producer, heard about Extractus from his wife, who had met Mary Beth Vigile through a business connection. He was intrigued, and invited the drummer to the studios in Mount Laurel.

Among the songs that producers ended up using was one titled "Rebirth," written by band vocalist Mike Serio. The lyrics are not audible during the NFL video, but they nevertheless hold special meaning for Vigile and his band mates:

Under the knife/It brings new life/This, this heart reborn, it beats, it still beats …

As for the one remaining football game of the NFL season, Vigile's favorite team is not on the field. He is a Steelers fan, due to family roots in Pittsburgh. But because he loathes New England Patriots quarterback Tom Brady, the musician is pulling for an Eagles victory.

Who knows? When the outcome is preserved on film, maybe he will even provide the soundtrack.