Topic: Cardiac Surgery In The Adult – What Are The Common Ages Of Heart Valve Surgery Patients?

I must admit. When I tell people that I have had open heart surgery for valve replacement, I get an odd look.

Sometimes, the look translates into, “Oh My Gawd! You’re So Young! How Is That possible?”

Other times the look translates into, “What The Hell Happened To You?” (FYI, I’m 35 years old. I had my aortic and pulmonary valves replaced when I was 33.)

Regardless of the look (which can be quite funny), many people ask me, “Is adult cardiac surgery for heart valve repair and heart valve replacement the norm?”

Or, “Does heart valve surgery impact all age groups – from children to the elderly?”

It’s a great question. When I was diagnosed with severe aortic stenosis and regurgitation, I thought the cardiac surgery atlas would indicate that heart valve surgery was mostly for the older generations – 50 and above.

However, the more I researched the topic for my book, the more I learned that while adult cardiac surgery is status quo, heart valve defects (stenosis, regurgitation, prolapse, insufficiency, etc.) can and do impact many, many, many age groups.

Earlier this year, I surveyed 78 former heart valve surgery patients to better understand how cardiac surgery impacted their lives. As you can see in the chart above, operative cardiac surgery was needed for many different age groups. So there really is no cardiac surgery secret specific to age. However, as one would expect, the majority of patients in this survey, about 70%, were in the age range of 35-60 years of age.

You may be wondering about pediatric cardiac surgery patients…. “Where are they?” Well… They exist. Pediatric cardiac surgery is an entire surgical medical specialty unto itself. However, as pediatric cardiac surgery involves children, I chose not to interview or survey them for legal reasons.

Keep on tickin,

Adam

I just received an interesting email from Carol that directly relates to heart surgery recovery. Carol writes, “Hi Adam – My husband had mitral valve replacement three weeks ago. I’m curious… Did you experience depression after heart valve surgery? Is it common for patients to experience cardiac depression following heart valve repair or heart valve replacement?”

Let me start by answering Carol’s first question. Yes, I did experience both heart surgery and depression. I had my pulmonary and aortic valves replaced in 2005. As for cardiac depression, I did not have any immediate form of depression during my 5 days in the hospital or during the first three weeks following my heart valve replacement surgery recovery. However, as I entered into my fourth week of recovery, I did begin to experience many symptoms of cardiac depression.

Needless to say, this was not a very fun time in my life. Pre-surgery, I was a very upbeat person. For me, the glass was always “half-full”. I’m an optimist that believes anything is possible. Post-surgery, however, I was exactly the opposite. I was lethargic, anxious, confused, pessimistic and isolated. I was also having issues sleeping.

What a miserable experience for me and all of my caregivers, especially my fiance (Robyn). I was a mess. And, my family… I don’t know how they put up with me!!! Thank goodness those dark days are lonnnnnnnnnnng gone.

To better understand cardiac depression, I researched the topic of heart surgery and depression for my book. I created a survey that was completed by 78 former heart valve surgery patients. As you would imagine, several, survey questions directly related to cardiac depression.

The survey results are very, very, very interesting. In one of the questions about heart surgery and depression, I asked the former patients, “Did you experience any form of cardiac depression during your recovery?”

Before I give you the results, my previous research suggested that between 30% – 75% of heart surgery patients experience cardiac depression. My research also suggested that more men than women are impacted by depression after heart valve surgery.

With that said, here are the results from my survey. According to the 78 patients surveyed, 32% of patients experienced heart surgery and depression. That’s a pretty significant number.

Now, the questions become… How do you avoid cardiac depression? And, if you experience cardiac depression, how do you get your recovery back on track? To learn more about the answers to those questions, click here.

Keep on tickin!

Special survey of 75 former heart valve surgery patients reveals interesting details about heart valve surgery complications.
(by Adam Pick, author of The Patient’s Guide To Heart Valve Surgery)

Following cardiac surgery, heart valve surgery patients experience a very unique feeling. On one hand, the patient has just progressed through a very traumatic event. It doesn’t matter whether you had a heart valve repair or a heart valve replacement, cardiac surgery is typically nerve-wracking and fear-ridden for most patients and caregivers. To take that experience and put it into the past is, for many, a euphoric event. On the other hand, once the surgery is complete, the patient can unknowingly embark on an often mis-managed road to recovery. Personally, I experienced several issues – both physical and mental – following my aortic and pulmonary valve replacement surgery (known as the Ross Procedure).

As the patient transitions into the post-operative experience, he or she may find new challenges to consider. Such challenges may involve several different perceived or actual heart valve surgery complications. That said, the patient can experience heightened sensations that something is wrong post-operation. Whether it is a heart palpitation or chest-clicking, patients can be confronted by heart valve surgery complications. Ultimately, the patient may begin to generate several questions about their surgical experience and recovery. Questions include:

• What are the common heart valve surgery complications?
• Am I experiencing a heart valve complication that is not normal?
• Should I be worried?
  
• Should I go to the doctor for my heart valve surgery complicaton?
• Is there something very wrong with me?
  

Again, as a former, heart valve surgery patient, I can relate to most of the questions raised above. Recovering from heart valve surgery is, for most patients, very difficult and very time-consuming.

To better understand patient complications following heart valve surgery, I conducted an extensive online and offline survey of almost one hundred former patients. One of the questions asked during that survey was, “Did you experience any form of heart valve surgery complication following your heart valve repair or heart valve replacement?”

As you can see on the chart below, over 66% of patients responded that they had some form of heart valve surgery complication following surgery. It is critical to note that this response considers the patient’s perspective only. It does not provide a clinical understanding of what a physician may deem a true or untrue complication. Still, it is very interesting to see that most patients feel that “something is wrong” at some point during their recovery.

Yet another heart study on the linkage between obesity and heart disease has come up with a possible reason for the increase in risk of heart disease and excessive body weight. The research was conducted at The University of Arizona Sarver Heart Center.

The largest of its kind study was carried out by cardiologist Dr. M. Reza Movahed and research specialist Dr. Adolfo A. Martinez and colleagues. The researchers analysed a total of 17,261 ultrasounds before arriving at their findings. They studied moving images of the heart to evaluate the structure and function of the organ.

Their analysis revealed that excessive body weight is linked to a thickening of the heart muscle in the heart’s main pumping chamber – the left ventricle. This condition is medically termed left ventricular hypertrophy (LVH) and can potentially cause heart failure and rhythm problems.

The researchers found that narrowing of the aortic valve was the strongest predictor of LVH. The aortic valve is the main valve that carries blood away from the heart to the rest of the body. Gender and Body Mass Index were next in line in terms of being strong predictors.

“We observed that the thickening in the muscle wall becomes especially noticeable in obese patients who have a Body Mass Index (BMI) of 30 or greater,” said Dr. Movahed. “Previous studies have shown that left ventricular hypertrophy is associated with a higher risk of mortality.”

The researchers haven’t been able to pinpoint the cause of LVH in obese patients but hypothesize that it might be on account of increased work load on the heart or the presence of other cardiac risk factors in the patients.

Presenting their findings at the 18th Annual Scientific Sessions of the American Society of Echocardiography (ASE) in Seattle, the researchers expressed hope that their findings may help physicians studying obesity and cardiac function.

“These results are another stake in the ground that supports healthy lifestyles for the benefit of heart protection,” said Dr. Movahed. “Maintaining a proportionate BMI may prevent LVH and lead to better heart function.”

Source: www.Heartzine.com

Hey everybody!

One of the most frequent questions I am asked when talking to future heart valve surgery patients and their caregivers is, “What is the death rate of heart valve surgery?”.

It’s a morbid question. But, as I have written about before (See “Disspelling The Fear Of Heart Valve Surgery?”), the statistics are overwhelmingly positive. And, the statistics continue to get better.

That said, I just reviewed a unique study that makes some interesting observations about the death rates of heart bypass and heart valve procedures. I thought you might want to review some of the latest statistics specific to the success and failure of bypass surgery.

So you know, I cover each of the topics below in the new revision of my book, The Patient’s Guide To Heart Valve Surgery.

From Pennlive.com:

The in-hospital death rate for coronary bypass surgery patients declined in 2005, while the rates of readmission increased slightly during the same period, according to a new report on cardiac operations in Pennsylvania.

The 2005 mortality rate among bypass patients was 1.9 percent, down from nearly 2 percent the previous year and from 2.4 percent in 2000, the Pennsylvania Health Care Cost Containment Council said in the report released today.

At the same time, 5.5 percent of bypass patients were readmitted within seven days of being discharged — up from 5.2 percent — and 13.6 percent were readmitted within 30 days of being discharged, up from 13.2 percent. Heart failure, infections and abnormal heart rhythms were the top three reasons for readmissions (see “Heart Valve Surgery Complications”).

The council, a quasi-governmental agency that monitors hospital finances and performance, has published annual reports on bypass surgeries and how much hospitals charge for them since 1992.

This year, it added information on heart-valve procedures, which are more invasive and complicated than bypasses, and included payment data on both procedures for the first time.

The information on valve surgery was added because bypass surgeons were telling the council that the number of operations they performed were “dropping dramatically,” while the number of heart-valve surgeries was increasing, Volavka said.

Bypass patients using private insurers remained hospitalized for nearly six days after surgery on average, with payments for the full hospital stay averaging $30,247, while Medicare patients stayed for nearly eight days and paid $29,175. (See “The Costs Of Heart Valve Surgery”) Patients who had both procedures at once had the longest post-surgery hospital stays and highest average payments.

Of the 17,331 patients who had one or both surgeries, 755 patients, or more than 4 percent, contracted infections during their hospital stays.

Carolyn F. Scanlan, president and CEO of the Hospital and Healthsystem Association of Pennsylvania, noted that the report does not take into account factors such as a patient’s vulnerability to contracting an infection in the hospital, such as diabetics.

Here is a look at midstate hospitals: