OMAHA, Neb. — Robert “Tito” Santiago can be described as having the heart of a survivor. The 67-year-old Yankton man, a longtime elementary school custodian who has beaten the odds by enduring six heart attacks during the past two decades, was scheduled to undergo heart transplant surgery Friday evening at the Nebraska Medical Center in Omaha, Nebraska.
Tito’s wife, Lynnette, told the Press & Dakotan Friday afternoon that she had received a phone call at about 8 a.m. that day about his procedure being moved up a day from Saturday.
“I was just shocked,” she said. “I knew it could happen quickly, but I really didn’t think it would happen this quickly. We’re grateful, we’re scared, anxious — just all of the above — so many emotions involved with something like this.
It’s just miraculous how quickly all this has happened.” Friday’s phone call was not the only important one Lynnette received this week, as she and Tito learned on Wednesday that he had been put near the top of a national transplant waiting list to receive a new heart. “They’re told what type of blood type he is and body type,” she said.
“If one becomes available that is similar to what the doctors are looking for, they let them know. Then the team of doctors make the decision whether or not that’s an appropriate heart for that patient. It’s a whole process.
” Thursday brought the news that a healthy heart had been located and accepted for Tito, followed by his surgery scheduled for Friday night, which was quite a quick turnaround. The process to get Tito put on the transplant waiting list took about two years, and he was initially on a much lower tier of priority for a new heart. Tito underwent a scheduled cardiac ablation surgery — a procedure to stop abnormal electrical signals in the heart — on Monday at the Nebraska Medical Center, and that led to him moving up toward the top of the transplant waiting list.
Lynnette said she was told Tito had tachycardia, which is a type of arrhythmia — a problem with the rate or rhythm of the heartbeat — that causes the heart to beat more than 100 times a minute, according to the National Library of Medicine. “The heart is electrified, so to speak,” she said. “His was sending electricity when it shouldn’t be.
He would go out of rhythm, so then his pacemaker would shock him back into rhythm. That’s happened three to four times in the past six months. He just keeps going out of rhythm.
“When that happens, they go in with this little skinny tubular-like device and they look for the area in the heart that is sending that electrode out and they try to burn it or cauterize it,” she said. “That makes that electrode area stop sending those signals, so to speak.” Lynnette said one of Tito’s doctors told her that the team of physicians burned four different areas within his heart.
“Actually, three more (areas) were going off, but they couldn’t get access to (them) because his bottom ventricle is enlarged and squeezing up against the other ventricle, and they needed to get in between the two,” she said. “Because of all this, they weren’t able to successfully finish the surgery like they would have liked to.” Tito’s Monday surgery started at about 9 a.
m. and lasted for approximately 12 hours. “He had been under sedation, and they had a breathing tube through his mouth, but they took that out,” Lynnette said.
Lynnette said Tito was hooked up to an ECMO — extracorporeal membrane oxygenation — pump¬ to help his heart keep beating and working during the procedure. With ECMO, blood is pumped outside of the body to a heart-lung machine, according to the Mayo Clinic. “Because his heart was so weak after the surgery, they left that in him,” she said.
After the Monday surgery, Tito had to lie flat on his back in bed all week. He also ended up being hooked up to two different heart pumps and a pacemaker in addition to a defibrillator he already had going into the Friday procedure, Lynnette said. “He has had two pacemakers prior to all of this,” she said.
“This has been going on since 2005, when he had his first heart attack. He’s had six heart attacks total. He’s had three pacemakers, two of which got infected.
” Lynnette said Tito was infected with MRSA — methicillin-resistant Staphylococcus aureus, a type of bacteria that can cause serious infections in humans, according to the Mayo Clinic — with his first pacemaker. “His kidneys shut down,” she said. “He had to go through dialysis, the whole process there.
” Lynnette could not recall what type of infection Tito had with his second pacemaker. “It’s a step below MRSA — very, very serious, serious infection,” she said. “People die very easily with these infections.
” Tito has amazed Lynnette and his doctors with the way he has bounced back after each heart attack. “The fact that he’s made it through all of this throughout all these years — and he has still got the best attitude and will for life — is absolutely a miracle,” she said. “I’ve been told by so many doctors that the fact that he’s still standing, they just can’t believe it.
” Lynnette said Tito has been living on 10% to 15% heart function for several years. “They’ve been controlling all of this with medication,” she said. “He was taking up to 10 medications a day just to control his heart.
” Lynnette said she is not sure how long Tito will stay at the Nebraska Medical Center to recover from his Friday surgery. “That’s kind of up to the individual and how well they do,” she said. “A nurse told me they’ve had them out of there within a week, but there are others who have to stay longer.
” Tito was employed as a custodian at Webster and Beadle Elementary schools — he was the full-time head custodian at Beadle Elementary for several years — and then later went to work as a part-time custodian and greeter at Walmart in Yankton. He was recognized in 2018 by the Veterans of Foreign Wars (VFW) for the patriotism he inspired by raising the American flag in front of the elementary school during his career there. “He is truly a man of resilience as his goal during cardiac rehab was always to return to work,” said Barb Heithoff, a friend of Tito and Lynnette’s.
“He loved his work, and even more, making the students at his school smile. “His work was interrupted multiple times over the years with ongoing heart issues requiring many heart procedures and hospitalizations, taking a major toll on their lives and finances,” she said. Tito retired from his job as a school custodian in 2020.
He started working at Walmart in February 2023. Barb is a retired registered nurse who worked with Tito, a Puerto Rico native, several times to strengthen his heart in the cardiac rehabilitation program at Avera Sacred Heart Hospital in Yankton. “Over the last 19 years, Tito has had multiple heart attacks and heart procedures requiring cardiac rehab, which is how I met Tito,” she said.
An online GoFundMe fundraiser page was recently set up to assist Tito and Lynnette — who have three adult children and several grandchildren — with extra expenses in addition to medical bills. An account also has been established at Explorers Credit Union for people who want to donate money to the couple. Because his medical team for his heart transplant is in Omaha, this has required Tito and Lynnette, who have lived in Yankton since 2003, to take several overnight trips there for testing, procedures and preparation for his Friday surgery.
“Following the surgery will entail an extended stay in Omaha and then weekly trips to Omaha for ongoing treatment and care,” Barb said. “The expense of these required hotel stays, gas and food are extra expenses they cannot afford.” Lynnette is by Tito’s side as much as she can be, but his surgery and recovery will take her away from her home business as a “reseller” — in which she buys items from garage sales, thrift stores and family members and turns around to sell them online, which pays their monthly bills.
“This beautiful couple have struggled so much over the years with medical bills for Tito’s health,” Barb said. “Can I ask you to please join me in praying for Tito and supporting them on this lifesaving journey to help Tito, who loves his wife and family and the Minnesota Vikings, return to a better quality of life?” While Tito and Lynnette are happy he has received a new heart, they also felt sad for the family who lost a loved one whose organ has been donated for the transplant. With everything he and his heart have been through since 2005, however, Lynnette said Tito is “very deserving” of his new one.
“It’s been a long road for him,” she said. “He’s been sick for so many years — almost 20 years now. I feel like it’s been so long that he doesn’t even know what it feels like to feel good anymore.
” ——— To donate to the online GoFundMe page for Tito and Lynnette, people are encouraged to visit www.gofundme.com/f/help-tito-santiago-get-a-lifesaving-heart-transplant .
As of early Friday evening, more than $2,600 had been contributed toward a goal of $20,000..
