Lately, there have been a lot of patient comments and questions posted about pregnancy and heart valve disease. To extend this discussion, I wanted to share with you a fantastic email I just received from Sara Bloomfield. Sara writes to me:

Sara & Matt Bloomfield (Chicago, Illinois)

I have a bicuspid aortic valve, dilated aortic root, and coarctation of the descending aorta. Like many other women with valve conditions that are hoping to have children, pregnancy has been an ongoing topic with my cardiologist throughout my life. The conversation was left open after each visit as it would depend on the state of my heart at the time I was ready to have a baby.  After getting married last year, my husband and I were ready to address this.  Based on the function of my valve and root, I am considered to be in the “grey zone” for pregnancy.

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Jenny just sent me a very interesting question about surgical approaches for heart valve repair. She writes, “Dear Adam – I was just diagnosed with severe mitral regurgitation. I have regular degenerative mitral valve prolapse. An annulus ring has been recommended as well. I’m thinking of having a mini-sternotomy and wondering what the risks are compared to a full sternotomy? Are there any other approaches that might be advantageous for me? Thanks, Jenny”

Mini-Sternotomy For Heart Valve Surgery

To provide Jenny with an expert opinion, I contacted Dr. Harold Roberts, a leading heart valve surgeon, from Fort Lauderdale, Florida.

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Within our patient and caregiver community, there is great excitement about transcatheter aortic valve replacement technology. These non-invasive approaches for aortic stenosis treatment are often described with adjectives including revolutionary and transformational.

Edwards SAPIEN Heart Valve Replacement

I wanted to relay new information about the FDA approval process for one of these percutaneous devices, the SAPIEN aortic valve replacement by Edwards Lifesciences. This valve, which does not require an incision to the sternum or ribs for implant, received two favorable votes from an advisory panel of cardiologists which reviewed its most recent clinical trial:

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When evaluating surgical options for a heart valve replacement procedure, a common patient concern is selecting the “right” mechanical or tissue valve. Specific to this topic, Jenny recently wrote to me, “Hi Adam – I’m 38 years old and need aortic valve replacement surgery. The durability of a mechanical valve is attractive but it seems like so many people, of all ages, are getting tissue valves. Is that a trend that I should be paying attention to?”

I was very fortunate to ask Dr. Richard Shemin, the Professor and Chairman of Cardiothoracic Surgery at UCLA Medical Center, this exact question. Here are the highlights from our discussion.

Thanks to Jenny for her question and a special thanks to Dr. Shemin for taking the time to discuss this important question with our community.

• To learn more about Dr. Shemin and his patients, please click here.

For those patients who are hearing impaired, I have provided a written, video transcript of my discussion with Dr. Shemin below.

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Considering that over 45 million residents of the United States do not have health insurance, my inbox is filled with questions about the costs of heart valve surgery. Many of those emails inquire about the use of foreign, cardiac centers for valvular treatment.

Medical Tourists For Mitral Valve Repair – Robin Steel & Ros Hernmarck

As you may already know, several patients within this community have traveled abroad with positive results. For example, Robin Steel and Ros Hernmarck both traveled to India for mitral valve repair surgery. Recently, however, I’ve learned that facilities in Europe are offering medical tourism packages which compete on quality, cost and access to “next-generation” technologies.

To learn more about heart valve surgery programs in Germany, I contacted Dr. Juergen Ennker, chief of cardiothoracic surgery at MediClin Heart Center, which is close to Frankfurt. Here are the highlights of my interview with Dr. Ennker.

Dr. Juergen Ennker, Chief of Cardiothoracic Surgery, MediClin Heart Center

Adam: Dr. Ennker thanks so much for chatting with me today.

Dr. Juergen Ennker: I have to thank you Adam. You are increasing the quality of care for heart valve patients around the world.

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