I just received a great question from Jenny about sleep after heart valve surgery.

Jenny writes, “Adam, I had mitral valve replacement seven days ago for regurgitation. I’m struggling a bit as I deal with the some of the post-operative challenges you address in your book. I’m really having an issue getting a good night of sleep. Sleeping at the hospital was tough enough. But, it’s gotten worse since I came home. I feel like a Zombie. And, the night sweats continue. Is this common? Thanks, Jenny”

Over the years, I have spoke many patients – especially tummy sleepers – that have expressed several sleep problems following heart valve surgery. Some of those problems include:

• Inconsistent sleep, waking up often
• Insomnia
• Night sweats
• Discomfort getting in and out of bed
• Heart pounding noises
• Mechanical valve replacement clicking

Finally, some patients may have an adverse reaction to medication intended to enhance sleep. Personally, I had a very, very, very strange reaction to Ambien. One night, after taking a 10mg Ambien pill, Robyn (my wife) found me sleepwalking through our house. When Robyn approached me, I responded to her as if I was a character in a book that I was reading. When I woke up the next morning, I had no memory of the episode. Needless to say, that was the last time I took Ambien.

As many former patients read this blog, maybe they can share their thoughts on this topic. Did you experience any problems sleeping after heart valve surgery? If so, please click here to leave a comment.

I hope this helps Jenny (and perhaps you) learn more about sleep after heart surgery.

Keep on tickin!

As you may have seen, the recent post, Did You Travel For Heart Valve Surgery?, has generated a lot of interest and response – as over 25 patients and caregivers have commented.

I have also received several emails from patients wanting to know more about traveling to The Cleveland Clinic for heart valve repair and heart valve replacement surgery.

That said, I called The Cleveland Clinic on Monday to better understand the scale and scope of patients traveling to the world’s number one cardiac care center. I learned three great factoids (from their patient education team) that you might find interesting. For 2008:

• More than 50% of Cleveland Clinic patients reside outside the state of Ohio;
• Patients from 89 countries came to The Cleveland Clinic for cardiovascular care; and
• Patients from all 50 states came to The Cleveland Clinic for cardiac surgery.

I hope this information helps you learn more about the patient profile at The Cleveland Clinic. To get direct patient feedback about surgeons at The Cleveland Clinic, please visit our Heart Surgeon Database.

Simply type “Cleveland” into the city search field. The search results will share actual patient experiences with the following cardiothoracic surgeons – Lytle, Svensson, Roselli, Gillinov, Mihaljevic, Smedira, Sabik and Pettersson.

Keep on tickin!

I guess this patient success story would classify as ironic.

According to The Scottish Sun, a vegetarian teenager from Scotland, who was suffering from a rare cardiac condition, is now being kept alive by a pig heart valve replacement.

Robyn Cairney, 18, of Ruckazie, Glasgow was diagnosed with aortic stenosis and regurgitation after she collapsed at the gym. Over time, the condition caused her aorta to narrow, which allowed blood to dangerously flow back to her heart. The most common symptom is shortness of breath with exertion, resulting in some patients feeling “out of shape,” according to the American Heart Association.

Robyn Cairney – Heart Valve Replacement Patient

“It came totally out of the blue,” Cairney told The Sun. “I was at the gym and became unwell during a mile run. I couldn’t breathe and wouldn’t stop coughing. Then my lips started turning blue and I knew that something was seriously wrong.”

When the aortic valve becomes excessively obstructed or leaky, the valve must be repaired or replaced.

“The doctors told me that I would need to have a valve taken out and replaced by one from a pig,” Cairney said. “It was a bit of a shock being a vegetarian, but I realized it was a life or death choice. Obviously everyone is going to pick life, so now I’m a vegetarian being kept alive by a pig.”

Medtronic Mosaic Pig Valve Replacement

Cairney was fitted with the pig’s valve during open heart surgery at the Golden Jubilee Hospital near Glasgow. The pig valve replacement could last for 20 years. Cairney may have to undergo surgery in the future to have a mechanical valve fitted.

“I’m just glad I can get on with my life now and am determined to make the most of everything I do,” she added.

Keep on tickin’ Robyn!

I just received a great question from Carol about traveling for heart valve surgery.

She writes, “I have concerns about choosing a hospital that is highly regarded for heart valve replacement surgery but out of town. Have any of your readers traveled significant distances for their surgeries? Were there any problems? How did they handle follow-ups? Thanks, Carol”

Carol raises a very good point. In fact, her email reminded me of my gut reaction when I was diagnosed with severe aortic stenosis and told I needed surgery.

“Even though I live in California, I’m going to The Cleveland Clinic or The Mayo Clinic!” I thought to myself. “No messing around… I want the best surgeon… That surgeon must be in Ohio or Minnesota.”

So you know, that is a very, very, very common thought among many of the patients and caregivers I have spoken with over the years. Interestingly enough, that thought often turns into reality for some patients. So you know, I recently learned that over 50% of heart surgery patients at The Cleveland Clinic are not residents of Ohio (e.g. Robin Williams).

However, when I took the time to research and evaluate surgeons for the procedure I wanted, I found some heart valve gurus right in my own backyard. As I live in Los Angeles, I located several, highly regarded surgeons within 10 miles from my home – including Dr. Starnes (USC), Dr. Trento (Cedars) and Dr. Shemin (UCLA).

I admit, I was lucky. This is often not the case for many, many, many, patients out there. As a result, patients must travel – by car, by plane – to have surgery done.

Mary Billings – Heart Valve Surgery Patient
(Traveled From Fiji To Los Angeles)

In fact, I know patients from Fiji, Trinidad, Somalia, The Philippines and Malaysia that have traveled to the United States for surgery. Recently, I featured a story about Patrick’s journey to The Cleveland Clinic from Brazil.

The points I am trying to make are two-fold.

• First, each patient case is unique. Please take the time to evaluate your surgical needs. Then, research the surgeons and hospital that provide the best care for you.
• Second, traveling for heart valve surgery does occur – and, quite frequently. That said, many hospitals have services to make your pre- and post-operative time very manageable.

I believe several of our readers did, in fact, travel for their heart surgery. If you are one of them, can you help Carol? Simply click here to leave a comment. We would love to read about your experience.

Keep on tickin!

If you ever wanted to learn more about the Ross Procedure, this is the place to do it. The second-annual Ross Procedure Summit kicks off in Atlanta today. Here are the details:

Elite cardiovascular surgeons from around the world will travel to suburban Atlanta this week for the two-day Ross Procedure Summit to review and discuss current peer-reviewed data relating to the survival advantage of the Ross Procedure and to practice the technical nuances required to perform this heart surgery successfully.

The Ross Procedure is a type of specialized aortic valve surgery in which the patient’s diseased aortic valve is replaced with his or her own pulmonary valve. The pulmonary valve can then be replaced with a cryopreserved human pulmonary valve.

Nine peer-reviewed articles regarding the Ross Procedure representing individual series from eight different countries, comprising a total of 2,234 patients have appeared in major medical journals over the past four years and report that:

• The Ross Procedure is associated with excellent long-term survival;
• Late survival with the Ross Procedure is comparable to that of the age-matched general population; and
• There is an excellent propensity-adjusted survival with the Ross Procedure in a pediatric patient population study compared to the excess mortality demonstrated with using a mechanical valve (as reported by one of the nine reports).

Led by Professor Sir Magdi Yacoub, FRS, FRCS, of Imperial College’s Heart Science Center in London in tandem with William F. Northrup III, MD, vice president of physician relations and education at CryoLife, the Ross Summit will have a faculty of more than 30 world-renowned cardiovascular surgeons and cardiologists, who will present clinical data on heart reconstruction surgery at their respective clinics.

The Ross Procedure is performed on up to 1,500 individuals globally each year — a number that is expected to increase as survival data become more widely known.

“In children, young adults and in active older adults, the Ross Procedure offers several advantages over other traditional aortic valve replacement options,” said Dr. Northrup. “The most important advantage is growing evidence of improved long-term survival over other valve replacement options. The procedure is also attractive because patients do not have to take long-term, blood-thinning medications after surgery as they would with mechanical valves. This is particularly appealing to women of child-bearing age, athletes and active adults.”

Dr. Vaughn Starnes – My Ross Procedure Surgeon

“The Ross Procedure requires very specific surgical expertise to achieve predictable, long-lasting results, and The Ross Summit was created to foster data exchange to provide a well-rounded point of view in addition to offering critical procedural training,” noted Steven G. Anderson, chairman, president and CEO of CryoLife.

A live webcast of the Ross Summit can be viewed at http://www.TheRossCommunity.org.

As many of you know, Dr. Vaughn Starnes performed the Ross Procedure on me several years ago. If you have any questions or would like to learn more about the Ross Procedure, feel free to email me.

Keep on tickin!