Adam's Heart Valve Surgery Blog – Page 33

Given the recent FDA approval of transcateher aortic valve replacement devices (TAVR), I continue to receive interesting questions from our patient community. For example, Denise recently wrote to me, “Hi Adam – My mom is 84 years old and diagnosed with severe aortic stenosis. We’re researching the possibility of using the catheter valve to help her. I’ve read that the valve can be inserted through the groin or through the heart. What determines the way in which this valve is implanted? Is one better than the other? Thanks, Denise.”

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I am thrilled to shine our “Surgeon Spotlight” on Dr. S. Chris Malaisrie. Over the years, Dr. Malaisrie’s support of our community has been fantastic. In addition to hosting live educational webinars, Dr. Malaisrie has also filmed several videos to empower our patients through the surgical process. If you are unfamiliar with this incredibly talented and nice surgeon — who has successfully treated many patients in our community including Janis Kielbasa, Fran Bernstein, and Jeff Petto — I encourage you to continue reading this post.

Dr. Malaisrie’s approach to heart surgery

As a heart surgeon at Chicago’s Northwestern Memorial Hospital, S. Chris Malaisrie, MD, is accustomed to performing surgery in the operating room every day. But he never forgets there is something new to learn with each operation.

“Heart surgery is a truly enjoyable experience,” says Malaisrie. “To put someone’s circulation on a machine—to maintain their circulation in an artificial circuit, and stop the heart to operate on its internal structures—is an incredible technical feat, and an enormous responsibility.”

Dr. S. Chris Malaisrie – Heart Surgeon

As associate director for Bluhm Cardiovascular Institute’s Center for Heart Valve Disease and co-director of its Thoracic Aortic Surgery Program, Malaisrie maintains an intense focus on heart valve research and elevating industry best practices. He believes that valve repair will become a more standard operation than heart valve replacement in the coming years, and that the use of transcatheter heart valves for higher-risk patients will also increase dramatically.

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After heart surgery, you’ll likely go home with a list of dos and don’ts from your physician. Preparing for surgery beforehand will also help the recovery process go more smoothly and comfortably.

Cindy Wilson, Heart Valve Patient, Begins Her Recovery

More than 85,000 aortic valve replacements are performed on average in the United States each year, according to the University of Maryland Medical Center. It’s a life changer, and prepping for the recovery process minimizes risks of short-term and long-term complications.

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I just received a great question from Barbara about aortic aneurysms, bicuspid aortic valves and the guidelines used by physicians to determine treatment. In her email, Barbara wrote to me, “Hi Adam – I have a bicuspid aortic valve with stenosis. I also have an aneurysm (4.1 cm) that we have been tracking for a number of years. I have heard that the guidelines for treatment just changed from 5cm to 4.5cm. Is that true? If so, why did the guidelines change? Is this change causing more patients, like me, to get treatment earlier? Thanks, Barbara”

Diagram Showing An Aortic Aneurysm

Barabara raises a great question considering so many patients in our community experience valvular disorders and aortic aneurysms simultaneously.

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Several weeks ago, I was fortunate to meet Nathan Higginbotham — a patient from Louisville, Kentucky who was diagnosed with aortic stenosis and an aortic aneurysm. During our phone call, I quickly sensed that Nathan had done his homework. He was asking all the right questions about his upcoming procedure.

Nathan and Me (Room 568 at USC Medical Center)

When I asked Nathan about his surgeon, he said something like, “I think you know the guy. His name is Dr. Vaughn Starnes.”

I immediately smiled from ear-to-ear.

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It is very common for patients to be confused when a doctor says to you, “I am sorry. The valve is in bad shape. I think it is time for surgery.”

In that moment… It is likely the doctor is pointing at an ultrasound you can not interpret. In that moment… You may be processing new words, like stenosis, that you have never heard before. In that moment… You may not know the difference between a valve repair or a valve replacement. You may not know the difference between an annuloplasty ring or a pig valve.

 
Dr. John Byrne

I was recently talking about this moment with Dr. John Byrne, the chief of the Division of Cardiac Surgery at Brigham & Women’s Hospital in Boston.

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If you are a pet owner, you are well aware of the joy that pets bring to your daily life. Pet owners may also receive another added benefit: longevity, according to a recent study by the American Heart Association (AHA).

In the May 9 issue of the American Heart Association’s online medical journal, Circulation, the AHA details study findings that pets also offer their owners heart health benefits. Considering that cardiovascular disease (CVD) is the leading cause of death in the United States, as noted by the AHA, this is a potentially lifesaving discovery for some.

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A common question that patients have before cardiac surgery is, “How much pain will I experience?”

As we have previously discussed, each patient will have a unique experience during recovery. Some patients experience a lot of pain. Some patients experience some pain. And, some patients report no pain. For this reason, most patients will become familiar with a pain scale (see below) during their hospital stay.

Jim Swanson – Aortic Valve Replacement Patient

Recently, I received a patient update from Jim Swanson about his experience specific to pain.  I thought you might enjoy Jim’s update, so I posted it below.

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I recently attended a very unique event called the 2013 Valve Reconstruction Workshop at the Mitral Foundation Center. I thought you might like to see how this extraordinary workshop and this state-of-the-art conference center is transforming heart valve treatment… So, I filmed this video.

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The good news about heart valve surgery is… It will save your life. The other piece of good news about heart valve surgery is that most patients only need surgery once in their lifetime. For a small group of patients, however, the need for a second surgery may occur. While the thought of going through two cardiac procedures can be quite daunting, the good news is… The second procedure may also save your life.

The more I learn about the complexity of valve re-operations, the more inspired I am to educate our community about this very important topic. For that reason, I just met with Dr. Anelechi Anyanwu, a complex valvular specialist, at Mount Sinai Hospital in New York. As you will learn in this video, the differences and risks between a first and second surgery — for the patient — are significant.

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Keeping yourself entertained without leaving the limited vicinity of your hospital or home can be a challenge during the recovery from cardiac surgery. Searching for a solution can be a source of mental stimulation in and of itself. Although it might be tempting to spend your days immersed in soap operas or taking long cat naps, you’ll find that you feel more fulfilled and proud at the end of the day when you spend your time productively. So, if you want your recovery time to go by faster, preoccupy yourself with these five fun projects you can do while recovering from heart surgery.

1. Learn a Language

Even with all of your extra free time, you shouldn’t rely on yourself alone to learn an entirely new language. Frustration and overexertion are only bound to make you quit before you even master the basics. Use a resource like the Rosetta Stone to develop a holistic education through visual and aural software, speech recognition technology and the social network Rosetta World.

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I receive a lot of questions about the Ross Procedure from patients with aortic valve disease. For that reason, I traveled to New York to film an educational video with Dr. Paul Stelzer, a leading Ross procedure surgeon, and Peter Woglom, one of his patient success stories.

So you know, Dr. Stelzer has performed over 500 Ross Procedures during his 32-year career. Many patients from our community, including Jeff Shebovsky, Mark Kroto and Chris Dixon, have had successful Ross operations thanks to this valve guru — who often sings in a barbershop quartet.

I would like to extend a special thanks to Dr. Stelzer for his dedication and pursuit of healthy heart valves. I would also like to thank Dr. Stelzer for his ongoing support of the patients and caregivers in our community.

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Good news!

Our recent webinar, “The Importance of Mitral Valve Repair Surgery”, went really well. Over 140 patients and caregivers registered to learn critical insights about mitral valve disease and treatment from Dr. Anelechi Anyanwu and Dr. Robin Varghese, cardiac surgeons at Mount Sinai Hospital. In particular, the webinar focused on the advantages of mitral valve repair surgery for patients.

If you were unable to attend the webinar, no worries. I have created two ways in which you can access the information shared during this hour-long event. You can either:

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I just received a great question from Kate about mitral valve prolapse, severe regurgitation and the MitraClip.

In her email, Kate writes to me, “Hi Adam – I am a 33-year old, single mother of two, recently diagnosed with mitral valve prolapse and moderate to severe mitral regurgitation (MR).  I am exploring my options and was wondering if you could tell me which hospitals perform the MitraClip surgery? Also, how would I get evaluated to see if I am a potential candidate for this procedure?”

As you may know, the MitraClip is a catheter-based technology that “clips” the two mitral leaflets together to reduce regurgitation. It should be noted that the FDA has not approved the MitraClip in the USA — although, it recently received an FDA panel approval vote of 5-3, which is a good sign.

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It’s not often that 1,000 heart surgeons and cardiologists gather in one spot to discuss and debate best practices for mitral valve therapy. In fact, it never happened until Dr. David Adams, Chairman of Cardiothoracic Surgery at The Mount Sinai Medical Center, brainstormed the idea. Then, with the full support the American Association for Thoracic Surgery (AATS), that idea transformed into the… Mitral Conclave.

Now, just a few years later, the Mitral Conclave is the largest symposium for physicians to teach — and learn from each other — about mitral valve repair and mitral valve replacement procedures. To help you understand how important this event is for you, the patient, cardiologists and surgeons, I jumped on a plane to New York to capture the highlights of the Mitral Conclave in this “Behind the Scenes” video.

Of all the great things I witnessed at the Mitral Conclave, it was a unique sense of community that struck me.

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I just received a great question from Rena about mitral valve repair and coronary artery bypass grafting (also known as CABG). Rena writes to me, “Hi Adam – I’m in for a ‘double doozie’. I have a bad mitral valve (severe regurgitation) and a blocked artery. My cardiologist suggests surgery soon. In looking at the different options, I’m curious to know if the robot can do both mitral valve repair and bypass in one procedure? If so, is it safe or risky?”

To provide Rena an expert response, I contacted Dr. Thomas Molloy, who is the Director of Cardiovascular Surgery at Adventist Medical Center’s Northwest Regional Heart Center in Portland, Oregon. In his response, Dr. Molloy wrote:

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There is nothing better than hearing from the patients and caregivers within our community.

A few minutes ago… Mark Uebelacker sent me this smiling picture of Natalie Uebelacker, his wife, who had aortic valve repair surgery earlier today at Northeast Georgia Medical Center. So you know, Natalie had a leaking bicuspid aortic valve. Like many BAV patients, Natalie also needed her ascending aorta replaced with a Dacron Graft due to an aortic aneurysm.

Natalie Uebelacker – Bicuspid Aortic Valve Patient

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We just had a great webinar about mitral valve repair surgery. (FYI, I’ll be posting the transcript and video shortly.)

Interestingly… Just before the webinar, Robyn, my wife, walked by make-shift desk in the living room.  She laughed and said to me, “Really? Do you really need all of those iPads and other stuff for the webinar? I need to get a picture of this!”

So, just how many iPads does it take to run a webinar? Take a look at the picture below for your answer.

My Desk 5 Minutes Before The Webinar

As you can see… During the webinar, I was doing my best to monitor 6 different Apple products at one time – 4 iPads, 1 Macbook and 1 iPhone.

For all of you Apple shareholders out there, I hope this made your day!

Keep on tickin!
Adam

I’ve received several questions about “The Importance of Mitral Valve Repair Surgery for Patients” webinar that is scheduled for today. That said, I’m posting the 5 most common questions for your review.

1. Can I still register for the webinar?

Yes. Due to a great patient response, we just increased the registrations for another 100 people. You can register for the webinar by clicking here.
 

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It is, by far, one of the most common questions I receive from patients who are NOT candidates for heart valve repair procedures. That question is, “How long do tissue valves last?”

As you may have seen in prior posts, several doctors in our community have commented that tissue valves can last between 10 to 15 years. That being said, Edwards Lifesciences just released some very interesting findings from a 25-year study of its PERIMOUNT valve replacement in the aortic position. So you know, the PERIMOUNT is a bovine pericardial heart valve. That means, the valve leaflets are made from the pericardium (heart sacs) of cows.

In this long-term study, 373 patients — who were under the age of 60 at the time of aortic valve implant — were followed to determine the longevity of the PERIMOUNT valve. The study, which ran from 1984 to 2008, determined that the actual durability of the PERIMOUNT valve replacement, in this patient segment, was not 10 years…

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