“What About Risk, Mortality & Age?” asks Mark
Written By: Adam Pick, Patient Advocate, Author & Website Founder
Medical Expert: Marc Gerdisch, MD, Chief of Cardiac Surgery, Franciscan Health
Published: May 18, 2023
At the recent Mitral Conclave conference, I received a great question from Mark about heart valve surgery risk, mortality and age. In his email, Mark asked me, “Hi Adam, I am 87 years old. I’ve had an aortic valve replacement in July. I then needed a MitraClip in October. Now, I have been diagnosed with severe mitral valve regurgitation again. I am investigating less-invasive surgical treatments. I feel like I’m a walking time bomb. Do you have any data on mortality for age groups?”
To answer Mark’s question, I was very fortunate to interview Dr. Marc Gerdisch, the Chief of Cardiac Surgery at Franciscan Health in Indianapolis, Indiana, who has successfully treated over 125 patients in our community. Here’s the highlights from our discussion.
Thanks Mark & Dr. Gerdisch!
Many thanks to Mark for his question and a special thanks to Dr. Gerdisch for sharing his insights, research and clinical experiences specific to age, risk and mortality with our patient community!
- Surgeon Insights: Minimally-Invasive Mitral Valve Repair
- Why Is The Mitral Conclave So Important for Patients?
Keep on tickin!
P.S. For the deaf and hard of hearing, I have provided a written transcript of this video below.
Adam Pick: Hi, everybody, it’s Adam with heartvalvesurgery.com, and we are at the Mitral Conclave in New York. I am thrilled to be joined by Dr. Marc Gerdisch who’s the Chief of Cardiac Surgery at Franciscan Health in Indianapolis, Indiana. Dr. Gerdisch, thanks for being with me today.
Dr. Gerdisch: Hey, such a pleasure, Adam. We’re at a great meeting, too, by the way.
Adam Pick: Great meeting. We are seeing a lot of research come out. You’re sharing some new research. We also get questions from patients at this meeting. We got one that came in, Dr. Gerdisch, from Mark, and he asks, “I’m 87 years old. I’ve had an aortic valve replacement in July. I then needed a MitraClip in October. Now I have been diagnosed with severe mitral valve regurgitation again. I am investigating less-invasive surgical treatments. I feel like I’m a walking time bomb. Do you have any data on mortality for age groups?”
Dr. Gerdisch: Sure, so first, Mark, let’s start with you’re not a walking time bomb. I don’t want you to live in fear every day. You do have a badly leaking mitral valve. It’s going to have to be addressed, but the likelihood of something really dramatic happening suddenly is pretty small if you’re feeling okay-ish right now. Now you’re probably short of breath. You’re probably limited aerobic capacity. I don’t know about your other conditions; those’ll play a role in our conversation. Being 87 is only one factor; it’s one potential risk factor. I’ve operated on plenty of people in their 80s and early 90s and – actually up to 96. You – that is not a reason that you can’t have treatment.
The other things that’ll play a role is what kind of shape your heart’s in overall right now, how the rest of it’s working; if you have any what we call comorbid conditions, so diabetes, obesity, hypertension, sleep apnea, other metabolic disorders, problems with your kidneys All of those things will play a role in defining the risk. All of that can be put together into a rational algorithm for you to determine based on how you live your life and what you’re willing to put at risk in order to address the problem.
Typically in your scenario, if we had someone who’d already had their aortic valve operated, we might go through a minimally invasive approach to address the mitral valve. It has a clip on it now, so having operated several of those patients who had clips already, sometimes we get the clip off and repair the valve. Sometimes we just replace the valve, but we would have to do whatever would give you a definitive, absolute I’m finished and fixed result. If not minimally invasive, then going back through same incision, that is fine, too. This all depends on your specific anatomy, how we access your vascular system in order to put you on the heart/lung machine, and then what kind of – if you have any disease in your blood vessels outside of the heart. Those are all things we would have to completely assess but certainly being 87 is not a reason to not have heart surgery. Being 87 and having a lot of other things going on could potentially change that. It’s a matter of putting it into risk stratification so you can understand what your opportunity is.
Adam Pick: Mark, I hope that helped you. I know Dr. Gerdisch helped me learn about risk, specific patient anatomy, age, and the possibility of a minimally invasive procedure after two prior cardiac operations. It’s just – once again, so amazed by all the wonderful things you and your team at Franciscan Health are doing.
Dr. Gerdisch: Oh, thanks.
Adam Pick: Thanks for being with us today and have a great rest of the meeting.