Steve Sarkisian details emergency heart surgery that saved his life while on Alabama's staff

Three years before this moment — with Steve Sarkisian poised to lead Texas into a massive road game against Alabama — the Longhorns head coach was the Crimson Tide offensive coordinator going through an intensive physical. It turned up a troubling reality.

A heart defect was discovered, revealing to Sarkisian that his aortic valve wasn’t working properly. Sarkisian, according to a Yahoo Sports story from Ross Dellenger detailing his health scare, needed emergency surgery around a month prior to 2020 fall camp.

“The comment from the doctor was that he would have dropped dead one day out on the field,” Jeff Banks, a friend of Sarkisian and assistant coach at Texas, said to Yahoo.

Sarkisian’s aortic valve had two flaps instead of three, a congenital defect that occurs in around one in every 100 people. This bicuspid valve was causing particular problems, constricting blood flow to the aorta — the main artery that feeds the body with oxygenated blood — and allowing blood to leak back into the heart chambers. It also can lead to inflammation of the aorta.

Sarkisian was at significant risk of suffering a ruptured aorta — his was inflamed to 6.5 centimeters — that would’ve likely killed him where he stood. With the discovery, emergency surgery was ordered.

To safely work on Sarkisian’s heart, doctors effectively turned his body off by cooling his internal temperature to around 80 degrees, slowing his heartbeat and sending his body into a hibernation-like state. They replaced the valve with a bioprosthetic valve from a pig. And like any major chest surgery, Sarkisian has the scar to show off from having his ribcage sawed open and wired back shut.

But before he got to show off his scar to colleagues, Sarkisian had to be thawed out. It was a process his wife, Loreal, recalled to Yahoo.

“They come out and say, ‘We have to let his body warm up. Like, come back to life,'” Loreal said. “That was scary. It’s like, ‘What if he doesn’t come back?'”

Sarkisian did, but still needed plenty of rest before he could be back on the sideline. After getting comfortable with the most basic of human functions — talking, reading, walking and so on — Sarkisian graduated to short walks around the house, with help, setting more ambitious goals with each benchmark getting set. He completed lung and heart exercises.

Eventually, he began coaching his offensive personnel over Zoom around two weeks after his emergency surgery (allowed due to pandemic restrictions in place at the time). He started going back to work, but unable to drive he was taken to and from by Loreal early each morning.

On the eve of camp, Sarkisian was cleared to come back. His offense would go on to lead Alabama to a national championship while producing a Heisman winning receiver that season.

“I was cleared to coach — miraculously at Alabama! — the night before camp,” Sarkisian said to Yahoo. “At Alabama, we always joke, ‘Just send them to Birmingham and they’ll get you fixed!’ Well, they did.”

It was a miraculous ordeal that relied on a number of factors to ultimately discover Sarkisian’s potential heart trouble.

For one, doctors made clear that putting the surgery off with football season so close wasn’t an option, as Sarkisian could’ve been dead in a matter of weeks with his bicuspid valve.

And there’s the physical itself, a measure that Alabama head coach Nick Saban has his staff go through regularly after experiencing it himself early in his tenure. It’s not a routine physical and takes several hours, but it may have saved Sarkisian’s life.

“These guys are in high-stressed positions, so we want to make sure they are good,” Jeff Allen, Alabama’s associate athletic director for sports medicine, said to Yahoo. “We’ve picked up on a lot of things over the years with our coaches, but this one was the most serious. It wasn’t even close.”

Read the full Yahoo feature here.