Josh has an interesting set of questions regarding keloid scars and sternal wires.

As you can read below, Josh is specifically looking for help from our blog readers. If you can help him, please leave a comment. Here is what Josh writes:

Hey Adam-

Things are going great 5 months after my aortic valve replacement and ascending aortic graft.  Most of the unpleasant sensations have subsided to a very manageable level. However, I do have an issue that I wanted to ask you and the blog members about…

I have two problem areas on my incision site that I saw my surgeon about today.  First, the bottom of my scar has a fairly large raised keloid (shown below) which is very sensitive to the touch.

Second, the top of my scar has a prominent bump that turns out to be part of the sternal wires that were used to fuse the bone that are sticking out.  Most of the time these wires are left in place, but my surgeon said they could do a removal.  He further added that if we were going to remove the wires, he’d have a plastic surgeon consult and help with the re-closure of the incision so as to try to avoid the keloid problem again.

Has anyone had any experiences with one or both of these issues?  My symptoms are not intolerable, but they are fairly uncomfortable.  I’m not looking forward to another surgery, but my understanding is that it’s a fairly simple outpatient procedure.

Thanks and hope all’s well,

Josh

P.S. To leave Josh a comment, please click here.

I just received a fantastic question from Gwen about waking up in the intensive care unit after heart valve surgery.

She writes, “Adam – Thanks so much for all your help. While I’m still anxious, your support has made me feel somewhat ready for my upcoming heart valve operation. I have one more question for you about the intensive care unit. When I wake up from surgery, exactly how many tubes are going to be sticking in/out of me? Keep on tickin! Gwen”

Interestingly enough, this question triggered a very, very, very unique memory for me.

Me (Adam) In The Intensive Care Unit

So you know… My doctors and nurses did not explicitly detail the patient experience within the intensive care unit. Looking back on it, that would have really helped manage my expectation as I came out of general anesthesia.

Read the rest of this entry »

I’m fascinated by the different tools and technologies that help surgeons reconstruct the human heart.

On this point, I just came across an interesting video about the use of extracellular matrix for heart valve repair. In this educational video, Dr. Marc Gerdisch of the St. Francis Heart Center describes extracellular matrix and how it is being used to enhance tissue function in repaired mitral valves.

If you have never heard the term before, extracellular matrix is the extracellular part of animal tissue that usually provides structural support to the animal cells in addition to performing various other important functions. The extracellular matrix is considered one of the defining features of connective tissue in animals.

Thanks to Dr. Gerdisch, a heart valve surgeon from Indianapolis, Indians, for taking the time to create this helpful video!

Keep on tickin!

In case you missed it, there was some pretty big news earlier this week regarding Edwards Lifesciences and their minimally invasive aortic valve replacement technology known as SAPIEN. Here are the details:

Edwards Lifesciences Corporation, the world leader in the science of heart valves, today announced completion of enrollment in its 1,040-patient randomized controlled Investigational Device Exemption (IDE) study of the Edwards SAPIEN transcatheter heart valve.

In addition to completing enrollment in both the surgical and non-surgical arms of the PARTNER Trial, Edwards received U.S. Food and Drug Administration (FDA) IDE approval for non-randomized continued access to the Edwards SAPIEN valve for actively enrolling PARTNER sites.

“It’s exciting that the clinical community will soon have the opportunity to make an informed evaluation of this treatment against conventional therapies that may not be realistic options for high-risk patients with severe aortic stenosis,” said Craig Smith, M.D., interim surgeon-in-chief and chief of cardiothoracic surgery at New York-Presbyterian Hospital/Columbia University Medical Center.

The multi-center PARTNER (Placement of AoRTic traNscathetER valves) Trial assigns patients into one of two arms: a “non-surgical” arm, in which the Edwards SAPIEN valve is compared to non-surgical treatments, and a “surgical” arm, in which the Edwards SAPIEN valve is compared to traditional surgical aortic valve replacement.  The primary endpoint for the PARTNER Trial is based on one-year follow-up of each patient enrolled; this evaluation has been underway and is continuing.

“The PARTNER Trial has brought together multi-disciplinary clinical teams aligned around the mission of addressing the serious problem of aortic stenosis by treating patients with a far less invasive, transcatheter approach,” said Martin B. Leon, M.D., associate director of the Cardiovascular Interventional Therapy (CIVT) Program at NewYork-Presbyterian Hospital/Columbia University Medical Center, professor of medicine at Columbia University College of Physicians and Surgeons, and co-principal investigator for the PARTNER Trial.

Sapien Heart Valve Replacement Device

“These very sick patients need urgent intervention, and we’re extremely pleased that they will continue to have access to this life-saving technology during the follow-up period,” said Larry L. Wood, Edwards’ corporate vice president, transcatheter valve replacement.  “We also applaud the trial’s investigators for their significant efforts in meeting this important milestone.”

Edwards is the only company to have both transfemoral and transapical transcatheter valve delivery systems commercially available in Europe.  The Edwards SAPIEN valve was approved for sale in Europe in late 2007, and has been used in the treatment of thousands of high-risk patients and evaluated as part of nine rigorous scientific studies.  New clinical data on the Edwards SAPIEN valve will be presented at the 21st annual Transcatheter Cardiovascular Therapeutics (TCT) scientific symposium in San Francisco beginning Sept. 21.

Keep on tickin!