As a follow-up to our recent discussion about re-operation rates, I just received an interesting question from Steve about tissue valve replacements and the potential reasons for premature failure.
Steve writes to me, “Hi Adam – It has been 16 months since my aortic valve replacement. I am being told I need another bovine valve replaced. This is not due to infection. How often does this happen? Why does this happen? Thanks for all you do! Steve”
Tissue Heart Valve Replacement
To get an expert response to Steve’s question, I contacted Dr. Junaid Khan and Dr. Allan Stewart — two leading heart valve surgeons.
Robyn, Ethan and I want to wish all of our friends in the United States a very “Happy Thanksgiving!”. And, even if you’re not from the U.S., we want you to know how grateful we are for you and your contribution to this caring community of patients, caregivers, cardiologists and surgeons.
Recently, I spent two days at Inova’s Heart & Vascular Institute in Falls Church, Virginia — which is about 10 miles from downtown Washington, D.C. in Northern Virginia. It was my first visit to the new $150 million facility that (i) holds a #1 ranking from HealthGrades for Virginia hospitals and (ii) a 5-Star excellence rating for heart valve replacement surgeries.
Dr. Paul Massimiano, Me, Dr. Niv Ad
I have to admit… The four-story cardiac center was immaculate… and BIG. To give you some idea about the facility size, consider that it maintains 13 catheter labs, 6 cardiac operating rooms, over 200 patient rooms and an impressive cardiac rehab center.
However, what struck me most about the Inova Heart & Vascular Institute had little to with architectural design or hospital feng shui. Instead, I was most impressed by a unique approach to cardiac care nurtured by Dr. Niv Ad, the chief of cardiac surgery, and Dr. Paul Massimiano, the president of CVTSA, the private surgeon group at Inova.
Let me explain…
CONSIDER THAT INOVA IS A MAJOR CARDIAC SURGERY CENTER
During my brief 48-hour stay in Falls Church, I observed a (i) stand-alone mitral valve repair, (ii) a stand-alone MAZE procedure, (iii) a minimally invasive mitral valve repair and MAZE procedure, and, of all things, (iv) an actual heart transplant.
Needless to say, seeing a transplanted heart (shown below) beat for the first time is something I will never forget. I’ll also never forget seeing the patient’s old heart and dissected pump that was keeping him alive.
I just received an interesting question from Frank about heart rhythms after heart valve surgery. Frank writes, “I had a tricuspid valve repair, a Patent Foramen Ovalve (PFO) repaired and a Maze procedure performed in July. Now, it appears I will need to have a pacemaker put in next week. I was told that my Atrioventricular (AV) node may have been damaged and I am now in “heart block”. I was wondering if this is common? Thanks Adam!”
Diagram of Pacemaker Implant
Frank raises a great question. As we have seen in prior blogs, several patients receive pacemakers after heart valve surgery. However, Frank’s question addresses two, other surgical considerations which you may not be familiar with — The Maze procedure and heart block.
I’m very happy to announce that Dr. Allan Stewart has been named our Heart Valve Surgeon of the Month at HeartValveSurgeons.com for November!
As many of you know, Dr. Stewart — who is the Director of Aortic Surgery at NewYork-Presbyterian Hospital and Columbia University Medical Center — has been an incredible supporter of our growing community. In addition to answering many of your questions, Dr. Stewart has teamed up with several, former patients to promote awareness to heart disease and recovery.
Below is a touching and inspirational video which discusses the unique relationship between Gregory O’Keeffe, a heart valve surgery patient, and Dr. Stewart.
