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

“How Many Ross Procedures Each Year?” Asks Evelyn

I just received a question about the Ross Procedure for aortic valve replacement from Evelyn.

She writes, “Adam – The stenosis in my aortic valve is getting worse and I’m starting to feel the symptoms. My valve has been upgraded to severe stenosis from moderate status and it looks like surgery is in my future. I’m investigating my options and considering the Ross Procedure. By chance, do you know how many Ross Procedures are performed each year? Thanks, Evelyn”

Evelyn raises a great question. In fact, when I first learned of the Ross Procedure, as an alternative to traditional approaches, I thought to myself, “Sound goods. But, what is the surgical success rate of the Ross Procedure? And… How many of those procedures have been done?”

In talking with Dr. Vaughn Starnes (my surgeon), Dr. Donald Ross (the inventor of the procedure) and doing my own research, I learned that the Ross Procedure is definitely NOT performed as frequently as bioprosthetic and mechanical valve replacements. In fact, several surgeons do not favor the procedure as it requires a double valve replacement – the pulmonary valve is replaced with a homograft.

However, the more I learned about the Ross Procedure, its patient advantages, the surgical statistics of the Ross Procedure and Dr. Starnes’ familiarity with the procedure (he had performed over 200 Ross Procedures at the time), this option made sense for me. Three years later… I’m doing great.

Now, specific to Evelyn’s question…

I did some digging on the topic and learned very little as to “How Many Ross Procedures occur annually?” Then, I came across a recent reference from Cryolife, a heart valve manufacturer, which suggests that 1,500 Ross Procedures are performed annually on a global basis.

That number seems very appropriate if you do a quick estimate… Consider that the American Heart Association suggests that 18,000 aortic valve replacements were performed in the United States during 2007. Then, estimate what percent of those surgeries are Ross Procedures. My gut tells me it’s a very low percentage. Maybe it’s 5%. So, if you do the math, about 1,000 Ross Procedures are performed each year in the United States. Then, to account for the rest of the world, I would estimate another 500. Again, this is just a rough, quick estimate.

Well, I hope that helps Evelyn and you learn more about the number of Ross Procedures performed each year.

Keep on tickin!

From Brazil to Cleveland, Patrick Fights For Minimally Invasive Surgery

One of the critcal learnings from my heart valve surgery experience was:

The patient (or their caregiver) must, at times, be tenacious. We must, at times, ask questions that may or may not be silly. We must, at times, stand up for ourselves and our hearts. Ultimately… we must, at all times, be our own, best advocate.

I am reminded of this belief as my inbox is often filled with patient and caregiver emails that radiate frustration and confusion. Many of these emails begin, “Adam, I really need to vent right now. I’m having problems with __________.” However you chose to fill-in that blank, I can relate.

Patrick Hightower – Heart Valve Surgery Patient

Recently, I received a patient story that illustrates just how far certain patients and caregivers will go to get the best care. Here, for your review, is the educational and inspirational story of Patrick Hightower:

Adam, I had this picture taken 24 days after my heart valve surgery on August 9, 2009.  As you can see, my main incision is about 2 1/2 inches long. I also have a 1/2 inch scar just below it – which was for the drain line.

Although it may appear that I had minor heart surgery, I did in-fact have degenerative mitral valve with severe regurgitation, persistent atrial fibrillation, and tricuspid regurgitation. An annuloplasty band was installed in each valve, each valve was repaired and a MAZE procedure was done to stop the fibrillation. The actual surgery was six hours plus two hours pre-op and another two-hours post-op. I have no idea how long I was on the heart-lung machine.

I owe a huge debt of gratitude to my surgeon, Dr. Marc Gillinov and The Cleveland Clinic for my successful surgery. I realize that each person’s situation is different but, for me, the minimally invasive surgical procedure used by Dr. Gillinov was ideal.

Dr. A. Marc Gillinov – Patrick’s Surgeon

In my situation, I had to literally fight for my right to have a top surgeon, minimally invasive surgery and a little scar.  My first doctor in Brazil thought I needed to see a psychiatrist because I was so adamant about the minimally invasive approach. Another doctor said I didn’t need to do anything. The third cardiologist, who is now my primary Brazilian cardiologist, said, “Go to the States!” He felt my problem could not be surgically treated safely in Brazil. Finally, my cardiologist in Houston said, “We really don’t do the minimally invasive procedure.”

Frustration Heart Valve Surgery

After all of those dead-ends, I wrote Dr. Gillinov at The Cleveland Clinic. Soon after, I sent Dr. Gillinov my test results and waited, hoped and prayed for him to accept me. I did this with no cardiologist recommendation, just perseverance.

As for the details of my surgery:

  • I was in the hospital for a total of five days which includes my surgical day. As you know, surgical complications can occur. Mine was a problem with residual air in the surgical cavity. As I live in Brazil, this presented a problem with my flight home. After discharge, I was released to the adjoining hotel. After my 7-day checkup, I was allowed to fly home.
  • Eight days after surgery, I was only taking four Motrin and two Vicodin a day. Plus, I am taking one heart rhythm pill for six weeks and a baby aspirin. No Coumadin for me.
  • Like most, I get tired quickly and need to rest often. I am sore and have an occasional muscle spasm. The hospital really did a number on my sleeping rhythm, so that is still disrupted.

In light of my story, please tell others to research their problems, consider their options and get second, third and forth opinions if at all possible.

Finally, your heart valve surgery book provides a great service for all of us patients – both before and after surgery.

Thank you!

Patrick M. Hightower

The MitraClip Gets Gobbled Up By Abbott

Since my heart valve surgery, I have been fascinated by the strategic, corporate acquisitions of leading device manufacturers in this industry.

In fact, I began writing about the ongoing consolidation of heart valve manufacturers years ago. As of late, the “urge-to-merge” has really focused on the minimally invasive technologies for both heart valve repair and heart valve replacement.

That said, it was somewhat expected that a company like Evalve, with its MitraClip technology for mitral regurgitation, would be acquired. However, for some reason, I didn’t think that Abbot Laboratories would be the gobbler. I thought Edwards or Medtronic or St. Jude might be the buyer. (Then again, I think Abbot was one of Evalve’s investors.)



Continue reading this post »

Remembering Scotty

Waking up today is never easy.

When I see the September 11 on my clock, I know I need to stop and think.

I also need to… remember.

Specifically, I remember Scott Weingard, my friend and fraternity brother. Among all the goodness in Scotty, he had an infectious laugh (more like a giggle) and positive outlook on everything. Scottie radiated possibility – both on and off the basketball court.

Today, like many days, I am thinking about Scotty. My prayers are with him, his family, our friends. To learn more about Scotty, please visit the Scott Weingard Memorial Website.

Keep on tickin!

Fantastic Video: Dr. Gaudiani Discusses Surgical Outcomes (Part I)

Dr. Vince Gaudiani has provided us with several insightful videos in the past. As you might recall, we recently featured Dr. Gaudiani’s two-part video series about heart valve surgery. Given Dr. Gaudiani’s 25-year career as a cardiac surgeon, this video was applauded by our patient and caregiver community.

Yesterday, I learned from Dr. Vince Gaudiani that he has created a new video titled, “How To Think About Surgical Outcomes?” Considering our ongoing discussion about (i) how to manage patient expectations and (ii) how to prepare for surgery, I found this video very, very, very interesting.



Above, you will find the first part of the video. In the next few days, I will post the second part. Simply press the play button and make sure the volume on your computer is on.

Thanks to Dr. Gaudiani for taking the time to share his unique experiences, thoughts and data. It should be no surprise that if you visit our Heart Surgeon Database, Dr. Gaudiani has received several glowing reviews from our patient community. (Just type “Gaudiani” in the last name search field.)

Keep on tickin!

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