Adam’s Heart Valve Surgery Blog

I was just reading the New York Times when I came across a very interesting study about the use of “off-pump” techniques for heart surgery.

The study, just published in the New England Journal of Medicine, suggests that use of heart-lung machines may actually provide enhanced surgical outcomes (inclusive of pumphead) when compared to beating heart procedures.

The highlights of the study, which evaluated 2,203 patients that were randomly assigned to have bypass surgery on-pump or off-pump, were:

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As patients and caregivers… We need to research our heart valve disease. We need to research our surgical options. We need to research surgeons. And, we need to research hospitals.

Why do we do this? Ultimately, I believe this research empowers us to make smart and confident choices that minimize our surgical risk.

On that note, I just read a fascinating report that suggests there is (i) a significant gap in quality among America’s hospitals, and (ii) a corresponding large difference in the rate of patient deaths.

Healthgrades said patients have a 52% percent lower risk of dying in a top-rated hospital than in United States hospitals in general. The study is based on an evaluation of hospital mortality related to 17 procedures and diagnoses at 5,000 non-federal U.S. hospitals. The study’s conclusions came after researchers examined 40 million Medicare hospitalization records from the years 2006, 2007 and 2008.

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In the past, we have had several discussions about cardiac depression as a common, patient pitfall after heart valve surgery. Now, it appears there is some new evidence which suggests that treating depression may help treat patients after a cardiac event.

Sarah sent me this very interesting article which was recently featured in The Wall Street Journal.

Patients who develop depression after heart attacks fare worse in the long term than those who don’t. But will treating their depression prevent further heart problems and safe lives? That question plagues medical experts and is a source of fresh contention among cardiologists and behavioral scientists looking for effective strategies to help patients suffering from both conditions.

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The University of Michigan Cardiovascular Center just released a rather troubling study about patients who are  diagnosed with mitral regurgitation and do not receive surgical treatment. I guess this is one more reason why second opinions are so valuable. Here are the details:

Overblown fears about (i) surgical risk and (ii) lack of awareness about the risk of not operating are among the reasons only half of eligible patients were referred for mitral valve repair, according to a study by doctors at the University of Michigan Cardiovascular Center.

Mitral Valve Repair (Annuloplasty)

A leaking mitral valve, known as mitral regurgitation or mitral insufficiency, can lead to fatigue, abnormal heart rhythms with irregular heart beats, and congestive heart failure. The longer the leak continues, the more likely there will be permanent heart damage.

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