Ken just sent me a financial question about the cost of an echocardiogram. He writes, “Adam – A few years back, I was diagnosed with moderate mitral regurgitation. Since then, I lost my job and my health insurance. Lately, I’ve experienced shortness of breath and fatigue. Do you know how much a heart valve echocardiogram costs? I’m nervous and curious to see if my mitral valve prolapse has gotten worse? Thanks, Ken”

To help Ken, I just asked Robyn, my wife, for our medical statements from December — which is when I had my last echocardiogram.

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I just received a very interesting email from Marc about heart valve surgery re-operations. He writes, “Adam, I’m an active 47 year-old just diagnosed with severe mitral regurgitation. I can’t help but think that I’ll need a 2nd surgery if I get a repair or a tissue valve. Do you know what percent of valve surgeries are re-operations? Are they primarily from surgical error or degenerative reasons? Thanks, Marc”

You can probably understand why I wanted to feature Marc’s email… He asks a great question. Unfortunately, I did not have a great answer. So, I contacted Dr. Kevin Accola, M.D. and Dr. Paul Stelzer, M.D. — two leading heart valve surgeons to learn more about heart valve re-operations.

Dr. Kevin Accola, M.D.

In response to Marc’s question, Dr. Accola, who practices at Florida Hospital Cardiovascular Institute, wrote:

Most institutions with significant volume do between 10% and 15% redo’s on average… Mine is about 12% in regards to patients who have had previous bypass surgery and now need a valve procedure, or a redo valve which has degenerative changes and now needs to be replaced. Sometimes these valves can calcify or the initial degenerative process continues and over time progresses to the point that the valve needs replacement.

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I just received a unique question from Dave about situs inversus and heart valve replacement.

Dave writes, “Hi Adam, I was recently diagnosed with severe aortic regurgitation and a dilated aorta. It’s now time for a valve replacement. I was born with situs inversus with dextrocardia – a rare condition in which my abdominal organs are reversed so my heart is located in the right side of my chest. I’m wondering if any of your readers have situs inversus? I would like to hear their experiences with valve replacement surgery. Thanks for your book! Dave”

This is the first time I heard about situs inversus with dextrocardia. That said, I really wanted to help Dave and learn more about this condition. I wasted no time in contacting two, surgical experts for their opinions.

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My wife, Robyn, loves the television show Grey’s Anatomy.

That said, on Thursday nights, after Ethan goes to bed, we enjoy watching the trials-and-tribulations of the fictitious Seattle Grace Hospital.

I will admit, the writers of Grey’s Anatomy do a great job developing likable characters (Meredith, McDreamy, The Chief) that are caught in a perpetual whirlwind of personal, professional and medical drama.

However, I want to gently remind us all that Grey’s Anatomy is, to some extent, written and produced to garner ratings and large advertising budgets.

“Why the heck is Adam posting about Grey’s Anatomy?” you might be wondering.

Well, in a recent episode, one of the stories within the hour-long show was about a female patient, late-40s, who needed… Yes, you guessed it… Heart valve replacement surgery.

While Robyn and I were initially excited to watch this patient story develop, we quickly became disappointed. Instead of depicting an accurate account of heart valve surgery, the writers used the heart valve replacement procedure to conjure drama in the form of comedy and horror.

First, there was the comedy… The writers portrayed the patient as silly as she debated the pros-and-cons of using a mechanical valve replacement, a pig valve replacement and a cow valve replacement.

St. Jude Medical’s Regent Mechanical Valve Replacement

Then, came the horror… The patient almost died in the operating room due to a personal issue / love triangle amongst three staff surgeons.

I could go on-and-on-and-on about how unrealistic this episode of Grey’s Anatomy was. But, I won’t. (If you like, you can watch the entire episode online and judge for yourself.)

However, I can’t stop thinking about the patients who watched the show and might be thinking, “Yikes! I’m not having surgery after seeing all that craziness!” I mean… Can you imagine if you were scheduled for surgery and happened to be a Grey’s Anatomy fan?

It’s for this reason, that I want to gently remind us of the known fact that Grey’s Anatomy is just a television show. And, when it comes to heart valve surgery… rather unrealistic.

The reality is that heart valve surgery is a medical miracle. Yes, there is some risk. But, for most, the reality is that patients live longer, healthier lives following the procedure.

Keep on tickin!

When I receive a patient or caregiver question that is unique and interesting, trust me… you are the first to read about it.

For example: This morning, I woke up, gave Robyn (my wife) a kiss as she left for work, made a cup of coffee and then turned on my computer. Among all the spam emails that I quickly deleted, there was a question from Bhupinder about kissing heart valve patients.

Bhupinder’s question was, “Hi Adam, Is there any risk to kiss or to smooch a heart valve patient? Please advise. Thanks! Bhupinder”

First, I had to chuckle a bit… Why?

Well. There are certain words in the English language that I thoroughly enjoy. And yes, you guessed it, “smooch” is one of those words. I don’t know why. There is something so honest, so innocent, so traditional and so cuddly about the word, smooch. That said, when I actually saw “smooch” in an email about heart surgery, I let out a “He.. He… He…”

Now, as for an answer to the question, I believe the answer is no. From what I understand, there is no risk to smooch or kiss a heart valve patient. Heart valve disease is not contagious or transmitted through human contact. While there are certain, medical terms associated with heart valve disease that suggest potential risks (e.g. bacterial endocarditis infection), they are only medical terms. They are not infectious in the sense that we might think of the common cold.

I hope that helps you understand more about kissing, smooching and heart valve patients.

Keep on tickin!