March 4th, 2014
The response to our webinar, “What Can Heart Valve Surgery Patients Expect?”, has been extraordinary. Hosted by Dr. Luis Castro and myself, this 60-minute session connected over 100 attendees in real-time to discuss patient expectations before, during and after heart surgery.
In case you missed the webinar, I just posted a free 53-page eBook and video playback of the event. If you are preparing or recovering from surgery, I really encourage you, your family and your friends to read this eBook or watch the webinar video.
If you were unable to attend the webinar, I have created two ways that you can access the information shared during this online event with Dr. Castro and myself. You can:
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March 6th, 2014
As we have learned together, there is no “perfect” valve replacement for patients who cannot have their own valves repaired. That said, as patients, we must weigh the pros and cons of each valve type – pig, cow, horse and mechanical – to determine which device is best for us given factors including age and lifestyle.
The mechanical valve replacement is an interesting choice for patients. It’s been around for over 40 years. It’s the most durable valve comprised primarily of a special form of carbon— pyrolytic carbon—that can last more than 100 years with the pressures inside the heart. And, there is some research, which suggests that patients who receive mechanical valves have lower complications over a 25-year period.
However, there are two disadvantages for mechanical valve recipients. First, some patients complain that mechanical valves “click” loudly inside the body – which can be annoying. Second, all patients who receive a mechanical valve must take anticoagulants (blood thinners) to prevent the risk of blood clots forming on the valve – for the rest of their lives.
For some patients, the thought of permanently being on blood thinners is just too much handle. As a result, some patients choose a tissue valve and risk the possibility of a future re-operation when their pig, cow or horse valve fails. But mechanical valves sometimes need to be removed from rare incidences of infection or clots.
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March 5th, 2014
If you didn’t know, there are physician guidelines for the management and treatment of heart valve disease. These guidelines, which were created by the American Heart Association and the American College of Cardiology, are used by your cardiologist and heart surgeon to determine the best approach for the treatment of valvular disorders including aortic stenosis and mitral regurgitation.
The big news of the week is that the 2014 guidelines have just been released. To help you learn why these guidelines are so important, here is a video with Dr. Robert Bonow, a leading cardiologist at Northwestern Medicine, who has been working on these guidelines for many years.
March 3rd, 2014
The world’s very first heart surgery was said to have taken place only a little more than a century ago. Today, it’s almost common place, with millions undergoing surgeries like cardiac catheterizations, coronary artery bypass grafts and valve related procedures.
Back in 1893, medical textbooks stated that operating on a human heart was too dangerous, but a physician by the name of Dr. Daniel Hale Williams decided to take the risk without the benefit of X-rays, antibiotics, proper anesthesia or other modern surgery tools. His patient survived and was discharged almost two months later; the operation is now widely considered to be the first successful open-heart surgery.
Since that time, there have been many advances in heart surgery.
The introduction of a heart-lung machine in 1953 was a major milestone in heart surgery, but it was still considered extremely risky with only 1 out of 5 patients surviving at the time. Since then, the machine has significantly improved, developing into the sophisticated piece of equipment we know today. For over three decades, the heart had to be stopped during bypass surgery but in more recent years new pieces of equipment that stabilize the heart have been created, allowing surgery on a heart that is still beating.
Photo by Jorg Schulze via Flickr
February 24th, 2014
I received an interesting question from Dorata about breast implants, echocardiograms and minimally invasive heart valve surgery. In her email, Dorata writes, “Hi Adam, I’m expecting a mitral valve repair surgery in a few years. I’m considering having breast implants now. I am wondering if breast implants interfere with the echocardiographic examination and minimally invasive surgeries?”
To help Dorata answer this question, I contacted Dr. Allan Stewart, Director of Aortic Surgery and Co-Director of the Heart Valve Center of Mount Sinai Hospital. So you know, Dr. Stewart has successfully treated many patients in our community as you can see by clicking here.
In his response to Dorata’s question, Dr. Stewart noted the following:
Breast implants have the potential to alter the approach of heart valve surgery. It is important to tell your surgeon about implants during the pre-operative consultation so damage does not occur. Depending on the type and size of the implant, a heart surgeon may decide to involve a plastic surgeon in the procedure.
In my practice, I will still proceed with minimally invasive surgery, but will involve a plastic surgeon to care for the implant. Specifically, I mean that the implant is temporarily removed at the start of the procedure and placed in a sterile container. The heart surgery procedure will be performed as planned. Once I am satisfied that the procedure was successful, the chest is closed and the breast implant is replaced. The presence of breast implants should not eliminate the possibility for a minimally invasive procedure on the heart.
I hope this helped Dorata (and perhaps you) learn more about breast implants and heart surgery. Many thanks to Dorata for her question and a special thanks to Dr. Stewart for sharing his clinical expertise with our community.
Keep on tickin!