“Ask Adam Anything” Videos Posted from the Heart Valve Society Conference!
By Adam Pick on February 20, 2020
Great news! As we continue to celebrate “Heart Month”, I am very happy to share that the Facebook LIVE videos from the “Ask Adam Anything” patient event have been posted below!
As you might recall… These Facebook LIVE sessions were filmed in direct response to patient questions submitted at HeartValveSurgery.com, our Facebook Page and by email. In total, I received over 150 patient questions about heart valve disease.
To answer your questions, I met with world-renowned surgeons, cardiologists and researchers at the Heart Valve Society Conference in Abu Dhabi. Our expert panel included Dr. Rakesh Suri (Cleveland Clinic Abu Dhabi), Dr. Martin Leon (Columbia University), Dr. Vinod Thourani (Piedmont Health), Dr. Hanneke Takkenberg (Erasmus University), Dr. Marc Gillinov (Cleveland Clinic), and Dr. James Thomas (Northwestern Medicine).
Here are the Facebook LIVE videos:
“What Is The Development Status for Catheter Mitral Valve Replacements?” asks Dana
To get started, I received an interesting question from Dana about transcatheter mitral valve therapies. Dana wrote to me, “Hi Adam – “What is the status of development for catheter-placed mitral valves (similar to transcatheter aortic valve replacement)?” To answer Dana’s question, I connected with Dr. Rakesh Suri. In addition to answering Dana’s question, Dr. Suri shared several interesting comments about the Heart Valve Society and Dr. Suri addressed how a unified “Heart Team” can evaluate the best treatment options available to patients – including mitral valve repair techniques. So you know, Dr. Suri is also the current President of the Heart Valve Society.
“Can TAVR Be Used for Aortic Insufficiency?” asks Frances
Frances emailed me a great question about transcatheter aortic valve replacement (TAVR). As you may know, TAVR devices are primarily known to treat aortic stenosis only. Frances wrote to me, “Hey Adam, I’d love to hear the latest on the use of TAVR to treat aortic insufficiency (a leaking aortic valve). I’m a terrible surgical candidate and I’m presently moderate-to-severe. So, my time is coming sooner than later. I know there are some prototypes in Europe. But, I wonder if anything is going on in the USA?” To answer Frances’ question, I was fortunate to sit down with Dr. Martin Leon, the Professor of Medicine at Columbia University Medical Center, who shared insights about new clinical trials that leverage TAVR devices for aortic insufficiency – including the JenaValve.
“What About AFib, Eloquis, Mechanical Valves & New Valve Replacement Devices?” asks Jim and Dennis
Jim and Dennis sent in similar questions specific to atrial fibrillation and Eloquis after heart valve surgery. In his email, Dennis asked, “If you end up getting atrial fibrillation after surgery, is it necessary to stay on Eloquis ‘permanently’ after your aortic valve was replaced?” Thanks to Dr. Vinod Thourani, the Chief of Cardiovascular Surgery for Piedmont Healthcare and the Marcus Heart Valve Center, for answering this question. In addition, Dr. Thourani and I discussed several other topics in this video including mechanical valves, the use of Warfarin, electrophysiology, the PROACT Xa clinical trial, and new types of polymer materials for heart valve replacement.
“Why Isn’t The Ross Procedure Advertised To Patients?” asks Jason
Considering that I had a Ross Procedure performed 14 years ago by Dr. Vaughn Starnes, I was intrigued by Jason’s question. In his email, Jason asked, “Hey Adam, Why isn’t the Ross Procedure advertised more widely for patients under 55?” To answer Jason’s question, I was very lucky to connect with Dr. Hanneke Takkenberg, the immediate past-President of the Heart Valve Society and a world-renowned researcher who specializes in clinical decision-making for cardiothoracic interventions at Erasmus University in Rotterdam, Netherlands. So you know, Dr. Takkenberg has performed research specific to the Ross Procedure with Sir Magdi Yacoub.
“Why Did My Ejection Fraction Fall After Heart Valve Surgery?” asks Sherry
Sherry sent me several interesting questions about the ejection fraction. In her email, Sherry asks, “Hi Adam – My questions are related to falling ejection rate fractions after surgery: What causes a major reduction in ejection fraction rates for some patients who have undergone mitral valve repair surgery? Can anything been done to return the rate to normal? If not, does it return to normal on its own? If so, how long does it typically take to return to normal? How prevalent is this condition? Thankfully, I was able to ask these excellent questions to Dr. Marc Gillinov, the Chairman of the Department of Cardiothoracic Surgery at Cleveland Clinic, who has successfully treated many patients from our community including Pam Hascall, Tee Adler and Emily Rothrock.
“Why Do Heart Valve Replacements Fail Early?” asks Charlie
In this video, Dr. James Thomas, Professor of Medicine (Cardiology) and the Director of the Center for Heart Valve Disease at Northwestern Medicine, answers an interesting question from Charlie about tissue heart valve replacement failure. Charlie asked me, “Hi Adam – I had heart valve surgery with a cow valve about 4 years ago. My mean gradient is 34 and peak velocity is 3.9. I may be headed for another valve replacement soon. How common is it that a valve would last only 4-5 years? If I get the valve replaced, is it likely to only last that long a second time?” In addition to Charlie’s question, Dr. Thomas also answered Sylvia’s question in this video. Sylvia asked me, “Adam, I have a mechanical aortic valve by open heart surgery about 1.5 years ago due to congenital bicuspid aortic valve. What are the most likely failures of this valve and what are the symptoms of failure (e.g. leaking)?”
“Is A Specialist Needed For A Mitral Valve Re-Repair?” asks Steve
As we have learned from many experts, mitral valve repair (also known as mitral valve reconstruction) can be part science and part art. For that reason, I thoughts Steve’s question about mitral valve re-repairs was very interesting. Steve asked me, “Hello Adam, Do doctors specialize in mitral valve re-repairs? I had a mitral valve repair performed 23 years ago. I will need surgery soon.” For this question, I was very lucky to get it answered by Dr. Rakesh Suri, the Chair of Thoracic & Cardiovascular Surgery and the CEO of Cleveland Clinic Abu Dhabi. So you know, Dr. Suri is a mitral valve specialist who has published articles specific to the topic of mitral valve re-repair.
“Can TAVR Be Inserted Under My Collarbone?” asks Nancy
In her email to me, Nancy writes, “I have severe aortic stenosis. It was suggested that I have a TAVR inserted through an artery under my collarbone. What exactly does that entail? What are the risks and benefits? I am 68 and have a large body size so the other options were ruled out.” To answer Nancy’s question, I was fortunate to sit down with Dr. Martin Leon, the Professor of Medicine at Columbia University Medical Center, who has led many TAVR clinical trials.
“Is It Possible to Perform A Minimally-Invasive Procedure to Treat Defective Aortic & Mitral Valves During The Same Operation?” asks Marc
Marc emailed a great questions about minimally-invasive heart valve surgery. Marc asked, “Hello Adam, I have both mitral disease (moderate to severe) and aortic disease (mild to moderate). When the time comes for intervention is minimally-invasive surgery a possibility to correct both valves at the same time? I am 68 years old.” To answer this Marc’s question, I sat down with Dr. Vinod Thourani, the Chief of Cardiovascular Surgery for Piedmont Healthcare and the Marcus Heart Valve Center, and the next president of the Heart Valve Society. In this video, Dr. Thourani also addresses the rise of concomitant (multiple) procedures to treat heart valve disease and the importance of a “Heart Team” to determine the best therapeutic approach for patients.
“What Is The Expected Lifespan of A Multiple Mechanical Valve Replacement Patient?” asks Dwayne
In this video, Dr. Hanneke Takkenberg, the immediate past-President of the Heart Valve Society and a world-renowned researcher who specializes in clinical decision-making for cardiothoracic interventions, addresses Dwayne’s question about life expectancy for patients with double mechanical heart valve replacements. In his email, Dwayne wrote to me, “Hi Adam – What is the lifespan of people who have more than one mechanical valve and live the rest of their lives on anticoagulants?”
“Can Lipoprotein(a) and Calcium Supplements Cause Aortic Stenosis?” asks Carol & Adele
Thanks to Carol and Adele… I received two great questions about lipoprotein(a) and calcium supplements as potential causes of aortic stenosis. To learn the answers, I connected with Dr. Marc Gillinov, the Chair of the Department of Cardiothoracic Surgery at the Cleveland Clinic. Dr. Gillinov, who has over 70 patient testimonials from our community, has been a great supporter of HeartValveSurgery.com over the years. Here is what Dr. Gillinov shared about lipoprotein(a) and calcium supplements specific to calcified heart valves.
“Can TMVR Treat A Failing Tissue Valve?” asks Rita
With all the new advances in transcatheter valve-in-valve therapies, patients want to learn more. For example Rita Kanouse sent me an email that asks, “Hi Adam, I have a prosthetic mitral cow valve from 2008. I just found out I have mitral valve stenosis. One leaflet is closed and the other leaflets are showing wear and damage. My doctors are evaluating valve-in-valve replacement versus a full open heart surgery. Can I have more than one “valve-in-valve” procedure – potentially in another 12 years – when this replacement wears out?” To answer Rita’s question, I sat down with Dr. Rakesh Suri, the Chair of Thoracic & Cardiovascular Surgery and the CEO of Cleveland Clinic Abu Dhabi, who raises several interesting points specific to valve-in-valve procedures, patient risk and re-operations.
“What’s Next For Transcatheter Aortic Valve Replacement (TAVR)?” asks Adam
It was great to finally meet Dr. Martin Leon at the Heart Valve Society Conference. Given all that Dr. Leon has accomplished at Columbia University Medical Center, the Cardiovascular Research Foundation, the Transcatheter Cardiovascular Therapeutics Conference, and the TAVR clinical trials, I was really excited to sit down and ask him, “What’s next for transcatheter aortic valve replacement (TAVR)?”
“Should Dental Work Be Performed Before Surgery?” asks Marylin
Marylin Menger wrote to me, “Hi Adam, Regarding tooth extraction… If my tooth is asymptomatic but clearly has an infection because of a failed root canal is it best to wait to have the tooth extracted before I have heart valve surgery?” For this question, I met with Dr. Marc Gillinov, the Chairman of the Department of Cardiothoracic Surgery at Cleveland Clinic. I also asked Dr. Gillinov whether-or-not patients should continue to take antibiotics prior to dental appointments.
“Can TAVR Treat An End-of-Life Tissue Heart Valve Replacement?” asks Ed
Ed asked me, “What are the options for a patient that received a biological aortic heart valve replacement and is in otherwise good health — other than reaching the natural end life for this type of valve. Is a TAVR or some other method an option for replacing an end of life biological valve?” Watch the video below to learn the answer from Dr. Martin Leon, Professor of Medicine and Interventional Cardiologist at Columbia University Medical Center. So you know, Dr. Leon is transcatheter aortic valve replacement (TAVR) guru who was the co-national principal investigator on the clinical trial which led to the FDA approval of Low-Risk TAVR in the United States.
Thank You! Thank You! Thank You!
Thanks to the wonderful patients at HeartValveSurgery.com for your support of this interactive “Ask Adam Anything” event! You continue to inspire me with your ongoing requests for educational information! As I mentioned earlier, I received over 150 questions from our community. As I only had a limited time with the panelists, I unfortunately could not answer everybody’s questions. That said, I am holding onto your questions in the hopes that there may be another real-time learning session at HeartValveSurgery.com in the near future. So, please stay tuned!
To Drs. Gillinov, Leon, Suri, Takkenberg, Thomas, Thourani, thanks so much for sharing your valuable time, your research and your clinical experiences with our patient community during this special event at the Heart Valve Society Conference in Abu Dhabi. On behalf of the patients, thank you for your pursuit of healthy heart valves!
Lastly, I need to extend a special thanks to Aurelie Alger and Stan Alger of PRRI for inviting me to speak at the Heart Valve Society Conference and host the “Ask Adam Anything” event. I really appreciate your support and help with the event!
Keep on tickin!