I just received a very interesting question from Bernie about the pericardium and heart valve surgery.

Bernie writes, “Hi Adam – At 51 years old, I need an aortic valve replacement surgery due to a stenotic bicuspid valve. I’m curious to know about the pericardium. I know the sac has to be opened. But, then what? Do they stitch-up the pericardium after the valve is fixed? Or, is it left open? Thanks, Bernie.”

Interestingly… I had this exact same question prior to my heart valve surgery. However, before we answer Bernie’s question, I want to make sure we all know what the pericardium is.

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Robyn, Ethan and I want to wish everybody a very happy and very safe Halloween!

For his 2nd Halloween, Ethan is dressing up as “DJ Lance Rock” from the hit television show Yo Gabba Gabba.  The show has become a morning staple for Ethan as he gulps down his first glass of milk. Ethan loves running around, screaming “Yoooooooo” as waves his hands in the air like DJ Lance Rock.

The popularity of DJ Lance Rock (played by 45-year old Lance Robertson) can not be understated — as shown in the picture below.

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As many of you know, I’m fascinated with technology.

That said, when I’m invited to see a clinical application of a new heart valve technology, I jump at the opportunity. So, last week, I found myself in a hybrid catheterization laboratory / operating suite at the University of Virginia in Charlottesville, Virginia. Dr. Scott Lim, Associate Professor of Pediatrics and Medicine, Division of Cardiology, was performing a MitraClip procedure.

Dr. Scott Lim, M.D. And Me (Adam)

“We’ve been investigating the MitraClip therapy in select patients as an alternative, less-invasive therapy for mitral regurgitation,” Dr. Lim shared with me. “By clipping the mitral leaflets into a double-orifice configuration we can reduce leakage across the valve – without inducing stenosis.”

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I just received a very interesting question from Joseph about the different types of tissue heart valve replacements.

Joseph writes, “Have you ever heard of any surgeon using equine tissue valves for aortic valve replacement? In the 10 months of researching my aortic valve disease, I’ve not heard of EQUINE valves being implanted — not once. Can you provide some insight? Thanks, Joseph”

ATS 3F Bioprosthetic Aortic Valve – Equine Tissue Valve

As Joseph suggests in his question, most discussions about tissue valve replacements focus on pig valves (porcine) or cow valves (bovine). However, an interesting fact is that equine tissue valves do exist. I recently learned a lot about horse valve replacements during a tour of a Medtronic assembly facility in Irvine, California. Medtronic manufactures an equine valve replacement known as the ATS 3f Aortic Biprosthesis valve replacement (shown above).

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Considering our recent discussion about heart valve re-operations, often referred to as “Re-Dos”, I wanted to wish Bob Uecker a very successful surgery today. If you didn’t know, Bob Uecker — who was anointed  “Mr. Baseball” by Johnny Carson — will undergo his second heart valve surgery during the past six months.

Bob Uecker – Heart Valve Surgery Patient

According to reports, a pseudoaneurysm (a tear) happened where his heart valve replacement is located. According to his medical team, it’s believed a skin-related staph infection entered his bloodstream and got into his surgical repair site.

“I’m approaching this with the same optimism that I had the first time,” said Uecker. “I appreciate all of the kind thoughts and well wishes from Brewers fans and everyone who has reached out to me.”

Keep on tickin’ Bob!