Surgeons & Clinics Blogs

By Adam Pick

Doctor Q&A: “What Criteria Do Surgeons Use to Choose a Heart Valve Replacement?” asks Peter

By Adam Pick on December 17, 2018

I just received a great question from Peter about heart valve replacement devices. Peter asked me, “Hi Adam – I have moderate-to-severe aortic stenosis and I will need surgery soon. I’m curious to know… How do surgeons select a valve replacement for me?  It seems like there are so many choices our there – mechanical, tissue, sutureless valves, that new INSPIRIS valve and TAVR.  What are the key criteria the docs use to choose a valve replacement. Can you please ask a surgeon for me? Thanks, Peter”

 

(Sources: Abbott, Cryolife, Edwards Lifesciences)

 

This is a phenomenal and VERY appropriate question. For patients with diseased heart valves that are beyond repair, it is so critical that you and your surgeon are on the “same page” when it comes to valve selection given the different types of valve that are available today.

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“What Happens to Aortic Valve Debris During TAVR?” asks Shripad

By Adam Pick on November 8, 2018

I received a ton of GREAT questions for our recent Ask Adam Anything: Facebook LIVE Sessions at the Heart Valve Summit.   One of the questions that I didn’t have time to answer came in from Shripad who asked, “Hi Adam – In the transcatheter aortic valve replacement procedure (TAVR), what happens to the debris of the old diseased aortic valve which is crushed by the balloon catheter? If the debris cannot be removed, can tiny particles of the debris cause stroke or heart attack? Thanks!”

Before answering Shripad’s question, I thought it would be helpful to show how a TAVR is implanted.  As you can see in this video animation, a TAVR device is positioned inside a stenotic aortic valve and then expanded using a balloon.  During that expansion, the new aortic valve essentially “smushes” the old valve out of the way.  That is why Shripad’s question is so interesting.   What happens to the defective leaflets and/or calcium deposits that caused the aortic valve disease?

 

 

 
 

Dr. Craig Smith Says…

Now that we understand how a TAVR works and why aortic valve debris may occur, let’s answer this very important question.

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“Ask Adam Anything” Videos from Facebook LIVE Just Posted!

By Adam Pick on October 15, 2018

In case you missed it…  Our first “Ask Adam Anything” video series on Facebook LIVE was amazing!!!  So many great questions.  So many great answers! To educate and empower you, I just posted the videos with Drs. Bolling, McCarthy and Roselli below, in our Videos section, and in our YouTube channel.

 

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Inside The Operating Room: Dr. Allan Stewart Explains Heart Surgery

By Adam Pick on September 25, 2018

It’s not every day I get a chance to see a “Chief” of cardiac surgery operate.  So… When Dr. Allan Stewart invited me into his operating room to observe a mitral valve repair and Maze procedure for atrial fibrillation, I immediately booked a flight and hopped on a plane to Miami Cardiac & Vascular Institute.   As you can see below,  this educational experience was extraordinary!

 

 

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Heart Surgery Innovation: Robotic Mitral Valve Surgery Evolves with Percutaneous Cannulation

By Adam Pick on September 11, 2018

There are LOTS of great advances happening in the treatment of heart valve disease.  Many of those technological breakthroughs enable cardiologists and surgeons to perform life-saving procedures with smaller-and-smaller incisions.

As you might recall, one of the big breakthroughs in valve therapy was the FDA approval of the da Vinci Surgical System to perform robotic mitral valve repair procedures for patients with mitral valve regurgitation in 2002.  Since then, we have collectively learned a lot about robotic surgery from leading clinicians including Drs. Chitwood, Trento, Gillinov, Mihaljevic and Badhwar.

 

 
Recently, I’ve received several great questions about robotic mitral valve surgery.  For that reason, I felt it was time to get an update about robotic technology.  I wanted an expert opinion, so I reached out Dr. T. Sloane Guy at Weill Cornell Medicine in New York City.  Dr. Guy is a robotic specialist that has helped many patients from our patient community.  Here are the highlights from our recent exchange.

 

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