Adam's Heart Valve Surgery Blog

Get the latest news, patient advice and insights about heart valve surgery from Adam Pick, patient, author and website founder

“Pictures Of Heart Valve Disease?” Asks Ray

Ray just emailed me a great question about heart valve disease.

He writes, “Adam – Try this one on for size… I’m 57 and newly diagnosed with severe stenosis in my aortic valve. The docs think I need surgery soon. I can’t believe it. I feel fine. No real symptoms. But, the echo shows my heart is already dilated somewhat. Even though the cardiologist told me what is wrong… I want to see what is wrong. Do you have any pictures of heart valve disease? Thanks, Ray”

Like Ray, I experienced a very similar thought upon diagnosis, “What does a diseased heart valve look like?” That said, please find several pictures below to help Ray (and perhaps you) better understand the visual anatomy of several different types of valve disease.

First, however, I thought you might like to see what a normal heart valve looks like for comparison. Here are two pictures of a normal aortic heart valve and tricuspid heart valve:

Normal Aortic Valve Picture
Normal Tricuspid Valve Picture

As for the different types of valvular disorders, here is a picture of aortic valve stenosis. The valve cusps are rigid, distorted and deformed.

Here is a picture of a bicuspid aortic valve that is severely calcified. (So you know, this was my diagnosis prior to double heart valve surgery.)

Pictures of mitral valve prolapse rarely show the problem caused by this diagnosis, so I included a diagram of this valvular disorder:

Finally, if you were wondering, “Does calcification of the leaflets impact the mitral valve?” The answer to that is yes. Here is picture of a mitral valve with severe calcification:

I hope these pictures help you better visualize some of the various forms of heart valve disease. If you have any additional pictures to share, please let me know!

Keep on tickin!

How A Heart Surgery Stitch Can Impact A Patient’s Life

I just received an amazing patient success story from Ron Wells.

Even after three heart surgeries (with suture issues, seizures and some memory loss), Ron maintains an incredibly positive attitude. That said, I thought you might want to hear about Ron’s experience. Here is what he writes:

Hi Adam,

I ran across your web site today and found it interesting.  I too am a survivor.  I had my first aortic valve transplant in 1975.  At the time, I elected for the mechanical valve replacement instead of the tissue valve.

I was able to hear every heartbeat after that surgery.

In 1982, the valve came lose and I was forced to have another operation. The heart valve replacement was throwing off bits of whatever. Some of those bits went to my brain which resulted in seizures.  So you know, my memory during that period is gone.

When I finally arrived for surgery, the surgeon found only one stitch holding it in place. Lucky guy, right?

I received a new valve and now… Now, I am actually doing great.  I work every day. I offshore fish in my own boat and basically do whatever I want, within reason.


Ron On The Back Of His Boat

If I had a message for future patients I would tell them, “It’s all about your attitude!!!” If you believe you can, you will.  You must have a positive attitude, don’t expect people to feel sorry for you. It’s hard for them to relate.

Good luck to all of you!!!

Ron Wells

P.S. To leave a comment, please click here.

Getting The Real Details About About The Ross Procedure

Scheline just sent me an interesting email about the Ross Procedure for aortic valve replacement.

She writes, “Adam – I had open heart surgery in 1981 to repair my aortic valve and now am facing another surgery to repair an aortic aneurysm and valve replacement.  I am 45, very active and love wine.  I do not want the mechanical valve as I would have to be on blood thinners for the rest of my life and I’ve heard there is a clicking noise with the valve.  I am going to talk with my surgeon about the Ross Procedure. What meds are you on? What is the risk of reoperation? Will you have to face another surgery down the road or are you good to go and not on blood thinners? Did they use a cadaver valve? How long were you in surgery and on the heart-lung machine? Your book brought back a lot of memories from when I had the first surgery but also made me realize how far things of progressed in the last 28 years. Good luck to you and thanks again for your heart valve book. Scheline”

Continue reading this post »

Melinda Gets Pregnant With A Bicuspid Valve & Aneurysm

Over the past few months, several patients have written-in about pregnancy, child birth, heart valve disease and the complex issue of… surgery timing.

In fact, this morning I received an exciting email about Melinda, her new husband, her bicuspid aortic valve and her pregnancy. I thought you might enjoy reading about Melinda’s approach to having a baby before before heart valve replacement surgery.  Here is what she writes:

Adam,

I was diagnosed with a bicuspid aortic valve about 21 years ago. I’m now 39 years old and I’m 6 weeks pregnant!!!

I have been having semi-annual check ups with my cardiologist for about 4 or 5 years now. The cardiologist has been monitoring me closely so that the timing of my replacement surgery is as best as it can be.

After the cardiologist read my most recent echocardiogram he was concerned so he sent me for a TEE. The results of both tests concluded that my time was coming near (as in the next 18 to 24 months).  During our conversation, the possibility of having a baby came up. I just got married in May and my husband and I wanted to get started on a family, given that we are both 39.

Fortunately, my cardiologist was agreeable to me getting pregnant. He said that if we’re going to try to get pregnant then it should be soon. So, fortunately on the first try, we got lucky!

My doctor says that I should do fine throughout the pregnancy, but soon after the baby is born, I have to have my aortic valve replaced along with a portion of my aorta, as it is slightly enlarged (4.2 cm). I recently visited with a cardiothoracic surgeon who will most likely perform my surgery.


Melinda’s Baby: 6-Week Ultrasound

The surgeon agreed that at my current state, I should do fine through my pregnancy. Today, my husband and I went for our first prenatal appointment. The OBGYN was more concerned about my high-risk pregnancy than either of the two cardiac specialists.

I’m already a high risk case because of my age. The bicuspid valve just escalates my risk. I’m a trooper though. I’m confident I’ll do just fine with the team of doctors I have working with me. Other than my defective heart valve, I am a picture of good health. I don’t smoke, I’m not overweight, I’m very active (I was running 4 miles about 4 times a week, but the doctor said no more to that… only walking from here on out).

I tell you all of this because I thought you might find my story rather interesting. I’ve been following your blog for over a year now. I’ve never posted anything… I just really enjoy reading what is going on with everyone else in the world of heart valve surgery.

I really appreciate the work you do and I hope that you will continue. Your site has really helped me sort out some of the decisions that I have to make about my surgery.  It has also made me feel at ease knowing that there are so many success stories out there.

I’ll be happy to share my experience with you throughout my pregnancy and surgery.  I don’t think there are too many of us heart valve patients getting pregnant with heart valve replacement surgery in the near future.  Let’s assume that my story will have a happy ending and this might help others.

Your friend,

Melinda
Tampa, Florida

Recovery Alert: Cardiac Rehab Programs Are “Under-Utilized”

One of my critical heart valve surgery recovery tips for patients is… to attend a cardiac rehabilitation program following heart surgery.

From my own personal experience and patient research, I have learned that cardiac rehab programs provide significant benefit to the physical and emotional well-being of patients during heart surgery recovery. Unfortunately, I have also learned that 49% of patients do not attend cardiac rehab.

On Tuesday, a report published in the Journal of the American College of Cardiology further supported the data and opinion referenced above. The highlights of this study which surveyed 72,187 patients discharged from hospitals after a heart attack, angioplasty of bypass surgery between 2000 – 2007, include the following:

  • Even though cardiac rehabilitation has been shown to guard against future heart trouble once a cardiovascular event has landed someone in the hospital, only 56 percent of these patients are referred for the therapy.
  • Despite national guidelines that say hospitalized patients with a qualifying cardiovascular disease event should be referred to outpatient cardiac rehabilitation before hospital discharge, the study demonstrates this doesn’t happen often enough.

“Cardiac rehabilitation improves clinical outcomes, but is widely underutilized,” said researcher Dr. Gregg C. Fonarow, a professor of cardiology at the University of California, Los Angeles. “A large number of patients hospitalized with coronary artery disease may be having recurrent cardiovascular events and deaths that could be prevented by greater participation in cardiac rehabilitation programs,” Fonarow added.

The study also suggests that among the 156 hospitals surveyed, there was no consistency in referring patients to cardiac rehab. “These cardiac rehabilitation referral rates varied widely by hospital, ranging from as low as 0 percent of eligible patients referred, to as high as 100 percent of patients referred,” Fonarow said.

Dr. Byron Lee, an associate professor of cardiology at the University of California, San Francisco, says that cardiac rehabilitation can be just as effective in preventing another heart attack as the drugs these patients take. “It is shameful how physicians under-utilize cardiac rehabilitation in the United States,” Lee said. “We emphasize expensive drugs and interventions, when a simple rehabilitation program can do just as much, if not more, to reduce the risk of death and recurrent heart attack,” he said.

I have to admit… I was thrilled to read this report. I can not tell you how many patients I speak with that experience difficult recoveries and do not attend cardiac rehab. I am hopeful that this study will serve as a fantastic reminder / wake-up call to the medical community (especially cardiologists and surgeons) that cardiac rehab should be highly recommended, if not deemed necessary, following cardiac surgery. Plus, cardiac rehab is fun! 🙂


Adam At Cardiac Rehab Riding An Exercise Bike

I have several, wonderful memories from my 8-week cardiac rehab program at Torrance Memorial Hospital. The patient-to-patient and nurse-to-patient exchange was full of support, encouragement, relatedness, trust and… patient success stories. Considering the challenges I faced during my early recovery from aortic valve replacement (pain, cardiac depression, etc.), I consider the day I entered cardiac rehab as the day my recovery truly began.

So you know, in line with the study referenced above, neither my surgeon nor cardiologist initially referred me to cardiac rehab.

Keep on tickin!

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