MIAMI – Kathy Ritvo watched the 2008 Kentucky Derby on television with her cardiologist in the critical care unit of Jackson Memorial Hospital in Miami. Suffering from cardiomyopathy, or a severe deterioration of the heart muscle, Ritvo was in the first month of an interminable wait for a donor. She spent the next six months hooked up to an intravenous machine that provided medication to keep her heart functioning, uncertain whether she would live to see another Derby. Much of that time, she was confined to Jackson Memorial as the search for a donor continued. Finally, on Nov. 13, 2008, a donor was found. She underwent surgery for 17 hours to replace a heart that had been so damaged, her surgeon told her she might not have survived the week. “I’m as tough as they come,” said Ritvo, 41. “But I had suffered so much for so long, even I had gotten to the point where I was prepared to die. When my surgeons examined my heart after the operation, they told me I wouldn’t have lasted much longer. The fact a donor was found at that time was a miracle.” So, too, was the fact that within six months after her surgery, Ritvo was back at the track working with the horses again. Now, with some luck and a little help from a promising 3-year-old named Mucho Macho Man, she might just end up watching the 2011 Derby with her doctor from one of the trainers’ boxes at Churchill Downs. “During those last several months in the hospital, as sick as I was, I never thought I’d be able to have a normal life again even if I did survive,” Ritvo said. “But here I am, working at the track every day almost as if nothing ever happened. I still have to take anti-rejection medication and will for the rest of my life, but my two-year tests all came back fine, and to tell you the truth, I don’t think I’ve ever felt better in my whole life than I do right now.” DRF WEEKEND: Handicapping roundups | Q&A with Eclipse Awards emcee Kenny Rice MORE: The Factor the latest smart buy for pinhooker Kim Valerio Ritvo has been training since 1987, when she took out her trainer’s license at Suffolk Downs at age 18, but she comes from a racing family and has been around the track for most of her life. She is the daughter of Peter Petro, a long-time owner who died of a heart ailment in 2007 at age 73, and she is the younger sister of Michael Petro, a veteran trainer now competing on the Delaware-Maryland circuit; jockey Nick Petro; and Louis Petro, a former jockey who died in 1996 at age 38 from complications caused by cardiomyopathy. Ritvo’s husband, Tim, is a former trainer who earlier this fall became the director of East Coast racing for MI Developments. The couple married in 1990, the year they left Boston and relocated permanently in south Florida to race on the Calder/Gulfstream Park circuit. Kathy Ritvo won 150 races from 1990 through 1998, including seven stakes. Her best horse in those years was Liberada, who finished eighth in the 1992 Breeders’ Cup Juvenile Fillies but came back two years later to capture the $157,000 Calder Breeders’ Cup. “Tim was responsible for the majority of the stable when we got down here, but I had a small division of my own that I trained pretty much on a regular basis until I was forced to take a break due to my illness about 10 years ago,” Ritvo said. Ritvo first discovered the severity of her condition in January 2001, when she lost what would have been the couple’s third child six months into her pregnancy. “I began feeling sick and tired all the time a couple of years earlier, and nobody knew why,” she said. “That’s why I had to stop training the first time. I got sick with what the doctors believed to be the flu during my pregnancy, and they put me on antibiotics. On Dec. 22, 2000, I went to the emergency room at Memorial West Hospital, and they told me I had a blood clot on my lung. I was immediately transferred to Jackson Memorial and stayed there until Jan. 11, and that’s when doctors discovered it was my heart that had been causing my problems all along, that I had a degenerative heart disease, and it was only a matter of time before my heart would give out.” Once doctors had determined her heart condition, Ritvo said, they advised that it would be in the best interest of her health to terminate her pregnancy. The Ritvos’ two other children, Michael and Dominique, were 8 and 9 at the time. Ritvo spent the next seven years in and out of hospitals, but she returned to training on a limited basis in 2003 and 2004 and started one horse in 2005 before she had to stop training again. Her condition reached a stage in the summer of 2008 where living at home was no longer an option. She became a permanent resident at Jackson Memorial, hooked up to her life-saving machinery as the search for a heart donor continued. “When she came to us she was very, very sick,” said Dr. Joseph Bauerlein, who has been Ritvo’s cardiologist since 2008. “Her symptoms were pretty severe. On the scale of one to four we use to rate the seriousness of a person’s heart disease, with one being the least and four the worst, she was a class 3 or 4. And there was absolutely no doubt at that point she needed a transplant.” Ritvo said her illness was extremely difficult for her family. “She’s really an amazing woman to endure what she had to endure all those years, especially the last several months, when she’d gotten so sick that there were times after she’d gone to bed at night that I really didn’t know whether to expect her to wake up the next morning,” Tim Ritvo said. “But she had so much will to live. It was all because of her kids. She was determined to survive for them.” “She’s unbelievable,” Michael Petro said. “To be honest, the condition she was in during those last months before the surgery, I really didn’t think she could make it. Now you look at her, and she seems like she’s in perfect health. In fact, to me, she seems to be in better health now than when she was a kid.” Petro also remembered what it was like to watch his brother Louie’s health decline up until his death in 1996. “Louie was never really sick that I could remember,” Petro said. “Then one afternoon we were playing softball up at Rockingham Park, he slid into second base and didn’t get up. He was always kidding around and playing jokes, and I thought he was just doing it again, so I went over and started kicking him and told him to stop clowning around and get up. But he couldn’t. He had suffered his first stroke. The whole right side of his body was numb. He was never the same again.” Unlike his father, brother, and sister, Petro said neither he nor Nick have ever had any heart problems. “With our family history, it’s always in the back of your mind that it could happen to you, but fortunately, Nick and I have both been fine,” Petro said. “When we were in the hospital visiting Kathy, the doctors asked us if they could take some blood to do some kind of study into our families genes. I figured if it might help, why not, although we’ve never gotten any results or heard another word about it.” To this day, Ritvo does not know the identity of the person whose heart saved her life. Hospital regulations require that six months pass after surgery before a patient can make a formal request to learn the donor’s name. Once the time elapsed, Ritvo wrote a letter that was delivered by the hospital to the donor’s family. The family has yet to reply. Bauerlein said that several months after her surgery, when Ritvo came to him with the news she intended to return to training, he spent a long time discussing the situation and advising her of the risks involved. “It’s reasonable for her to be working again as long as she takes the precautions that are necessary to avoid further problems with her health,” Bauerlein said. “But she does face serious risks of contracting an infection from dust, molds, or bacteria, and probably more so being around the stables, certainly more so than the average person, because she is on medications that suppress her immune system and always will be because there is still the risk of rejection. There will always be the chance her body could still reject the new heart.” But Bauerlein also said the long-term prognosis for Ritvo is a good one. “The advantage she has is that she’s still young, in good physical condition, she’s intelligent and motivated,” he said. “And if she makes it to the Kentucky Derby this spring, I’ve already told her I will definitely be there to cheer her on.” Earlier this fall, Ritvo took charge of the entire family stable after Tim accepted his position with MI  Developments. Mucho Macho Man joined the Ritvo family this summer after Tim’s owner Dean Reeves purchased a 70 percent interest in the colt from the Dream Team Racing Stable following his career debut at Calder on July 17. A son of Macho Uno, Mucho Macho Man finished second that day behind no less an opponent than Gourmet Dinner, who went on to win the $1 million Delta Jackpot and punch his ticket to the 2011 Derby. Mucho Macho Man has improved steadily ever since, making his biggest strides once stretched out to distances of a mile and beyond. After the colt won his maiden going a mile and 70 yards at Monmouth Park while still trained by Tim Ritvo on Sept. 19, Kathy Ritvo took Mucho Macho Man to Aqueduct, where he twice finished second to trainer Bill Mott’s To Honor and Serve: by four lengths in the Grade 2 Nashua and by two lengths in the Grade 2 Remsen, in which he earned a career-best 99 Beyer. To Honor and Serve is generally considered the second-best member of the 3-year-old crop behind only division leader Uncle Mo. “We got a lot closer to Mott’s horse the second time,” Kathy Ritvo said. “He even made the rider take the stick out that day. The best thing about the Remsen is that my horse wasn’t even blowing when he came back, and I believe he can only get better the farther he goes.” Mucho Macho Man is an imposing colt, standing nearly 17 hands tall with perhaps some more growing to do, considering he was a June 15 foal. “He’s both tall and long,” Ritvo said. “He’s so big I had to stand on my tippy toes in my high-heel boots just to put the saddle on him in the Nashua, and by the time we got to the Remsen he’d grown even taller. I could barely get up high enough to saddle him that day. And remember, he was a late foal. It’s amazing he’s run this well this soon, because he’s still immature. But he’s improved and learned more with each start. He’s raced in blinkers in all five of his starts, but we’ve been taking them back a little farther each time he runs, and eventually, I think it will get to the point where he won’t need them at all.” After the Remsen, Ritvo, with the help of her husband, mapped out a plan that called for backing off on Mucho Macho Man following his return to Gulfstream. “The Holy Bull is our first goal this winter,” Ritvo said, referring to the Grade  3, one-mile stakes to be run Jan. 30. “We feel he has enough speed that cutting him back to a mile shouldn’t be a problem. And I think he’ll really like the Gulfstream track.” And what does Ritvo think about the pressure-packed road that lays ahead should Mucho Macho Man make it into the starting gate for the Kentucky Derby? “The doctors advised me not to return to working at the track at all following my surgery,” Ritvo said while gazing up at Mucho Macho Man. “But I figured I was already so close to dying that every day I’m alive now is a bonus, and I’m going to do what makes me happy. And besides, it does the heart good to have a horse like him.”