By Adam Pick on April 22, 2011
I just received an interesting email from Judy about adhesions, the pericardium and heart valve re-operations.
Judy writes, “Hi Adam, I am a 66-year old female preparing for aortic valve replacement. I have calcification at the sinotubular junction. Reoperation would be tricky in my case as I have an anomalous circumflex artery. I wondered what can be done to minimize the chances of adhesions? Could not closing the pericardium contribute to adhesions? What are the pros and cons of leaving the pericardium open? Thanks, Judy”
To answer Judy’s questions, I contacted Dr. Craig Smith, the chairman of surgery at NewYork-Presbyterian Hospital / Columbia University Medical Center. If you did not know, Dr. Smith recently performed aortic valve replacement on Barbara Walters. Doctor Smith has also operated on Former President Bill Clinton and several members of our patient community including Gary Poltorak.
Dr. Craig Smith – Heart Surgeon of Former President Bill Clinton
and Barbara Walters (NewYork-Presbyterian Hospital)
In his response to Judy, Dr. Smith noted…
By Adam Pick on April 15, 2011
Alice just sent me a great question about the use of heart-shaped pillows after heart valve surgery. She writes, “Hi Adam, I’m 61-years old and preparing for a mitral valve repair due to mitral regurgitation disease. I can’t help but notice the huge pillows clutched by patients in several photos across your website. What are those used for? Thanks, Alice”
In case you have yet to see them, here are four pictures of heart valve surgery patients (David Swendson, Anita Devine, Carla Hansen and John Turan) which feature these unique, heart-shaped pillows.
Heart Valve Surgery Patients – David Swendson,
Anita Devine, Carla Hansen & John Turan
“Pradaxa For Atrial Fibrillation? Heart Valve Disease? Mechanical Heart Valve Replacements?” Asks Gene
By Adam Pick on April 10, 2011
I’ve received several questions about the use of Pradaxa as a potential Coumadin-substitute for patients with atrial fibrillation, valve disease and/or mechanical heart valve replacements. I am a “better safe than sorry” type guy, so I wanted to make sure our patient community was on the same page specific to this new anticoagulant.
For those of you unfamiliar with Pradaxa, it was approved by the FDA in October, 2010. Following the results of its RE-LY study, Pradaxa is now considered by some to be an alternative to Coumadin — an established anticoagulant (blood thinner) for preventing strokes in patients with atrial fibrillation. During the RE-LY trial, patients with atrial fibrillation taking Pradaxa had fewer strokes compared to those using Coumadin.
In light of this news, patients in our community – including Gene – sent me questions about Pradaxa. I contacted Dr. Niv Ad, a leading cardiac surgeon at White Oak Medical Center in Takoma Park, Maryland, to learn more about this drug and its potential utility for patients with mechanical heart valve replacements.
By Adam Pick on April 7, 2011
A common consideration among patients preparing for valvular treatment is whether or not they will get a heart valve repair or a heart valve replacement.
Recently, Dr. Lars Svensson and I discussed the clinical indicators for aortic valve repair due to aortic regurgitation. Relative to the mitral valve, here is an educational video in which Dr. Jeffrey Swanson answers Barbara’s question, “From a surgeon’s perspective, what differentiates the need for mitral valve repair versus mitral valve replacement due to mitral regurgitation?”
Also, for the hearing impaired, I have provided a video transcript below.
By Adam Pick on April 4, 2011
Carole recently sent me an interesting email about Ian, her sixteen-year old son who suffers from aortic valve disease.
She writes, “Hi Adam, My son needs to have his aortic valve replaced. His surgery is scheduled for August. We are struggling with the decision of which valve replacement to have implanted. Ian is leaning towards the On-X mechanical valve but is hesitant because of the Coumadin factor. Do you know any other patients in Ian’s age group? What do you think is the best valve replacement for Ian? Thanks so much for your wonderful and informative heart valve book. Carole”
This is a great and complex question. As we have discussed before, if a valve repair is not possible, a key consideration for the patient will be, “Which type of heart valve replacement is best for me?” The answer to that question is dependent upon several factors – including age, active lifestyle, risk factors, etc.
I wanted to provide Carole an expert opinion. So, I contacted Dr. Lucas Collazo.
By Adam Pick on March 27, 2011
Yesterday, I spoke with Denise, a 44 year-old patient suffering from severe mitral regurgitation disorder. She asked me, “Adam – The first surgeon I met with has yet to request a cardiac catheterization. Is that normal? I thought all patients got heart caths before surgery?”
First… Great question Denise!
Second… For those of you unfamiliar with this diagnostic test, I have posted a video below which describe a cardiac catheterization, commonly referred to as heart maths.\
Special Technology Update: “When Will Open Heart Valve Surgery Be A Bygone Era?” With Dr. Eric Roselli
By Adam Pick on March 21, 2011
With all the exciting possibilities of transcatheter heart valve therapy, my inbox is overflowing with questions about the CoreValve, the Sapien and the MitraClip. For example, Dorothy sent me a question that reads, “Given all the advancements in certain treatments… Can you estimate a time when open heart valve replacement surgery will be part of a bygone era?”
I wanted to get Dorothy the best possible answer to this question. So, I met with Dr. Eric Roselli, staff surgeon from The Cleveland Clinic, to obtain his clinical opinions. Dr. Roselli is actively using transcatheter heart valves replacement therapies in his practice. In fact, Dr. Roselli is so knowledgeable with the percutaneous technologies shaping heart valve treatment, he was named the TechCon Co-Chairman at the annual Society of Thoracic Surgeons meeting.
By Adam Pick on March 18, 2011
For those of you following the story of 5-year old Sarah Weir… I have great news to share!!!
Sarah’s mitral valve repair surgery was completed by Dr. Pedro Del Nido at Children’s Hospital Boston on Wednesday. After some minor post-operative issues (blood pressure, swelling), Dr. Pedro Del Nido is very happy with the results!
Sarah Weir – Two Days After Mitral Valve Repair Surgery
As for Sarah… Pam, her mother, writes, “Sarah is mad as hell – but doing GREAT!!! She wants to go home! I ask New York??? She says NO – HOME – THE FOUR SEASONS.”
By Adam Pick on March 18, 2011
One of the most visited sections at Heart Valve Journals, our social network, is the patient’s guestbook. It’s pretty amazing to see all the support, care, advice and love exchanged among patients, caregivers, friends and family members. For example, Judy Fridono has 775+ comments in her Guestbook following her recent heart valve surgery at USC.
To enhance the Guestbook, we just a launched a great new feature.
By Adam Pick on March 18, 2011
I don’t know about you… But, I’ve always been a huuuuuge Bill Cosby fan. That said, I’m hopeful this video — taken from a 1992 airing of “You Bet Your Life” — should start your weekend with a giggle.
Have a great weekend,
“Should Asymptomatic Patients With Moderate-to-Severe Mitral Regurgitation Have Surgery?” With Dr. David Adams
By Adam Pick on March 15, 2011
Recently, I received a great question from John Myers about asymptomatic patients with mitral regurgitation. John wrote to me, “Hi Adam, I’m 76 and in good shape. In 1999, I was diagnosed with moderate-to-severe regurgitation even though I have NO physical symptoms. I’ve read that some surgeons believe having mitral valve repair sooner than later is preferable. Should I be worried? Should I get a second opinion? Thanks, John”
Luckily, during the 47th annual Society of Thoracic Surgeons meeting, I had the chance to ask John’s question directly to Dr. David H. Adams, chairman of cardiothoracic surgery at The Mount Sinai Medical Center in New York. Considering Dr. Adams’ clinical focus on mitral valve treatment, I thought you might like to see his response.
“Can Heart Valve Replacement & Atrial Fibrillation Treatment Occur During The Same Surgery?” Asks Wendy
By Adam Pick on March 11, 2011
Wendy just sent me an interesting question about heart valve replacement surgery and atrial fibrillation. She writes, “Adam – At 68, I’m confused and nervous. I’ve been dealing with atrial fibrillation for some time. But, I was just diagnosed with a severely leaking mitral valve. Can a surgeon fix both problems during one operation? Or, will I need two separate procedures? Thanks, Wendy”
By Adam Pick on March 10, 2011
When we started HeartValveJournals.com, our social network, I didn’t know what to expect. But now, 15 months later, I am constantly touched, moved and inspired by the patients and the caregivers who openly share their hearts in this special community.
Just now, I was surfing through the website when I came across the journal of Sarah Weir from New York, New York.
Sarah Weir – Heart Valve Repair Patient
As you can read in her story, Sarah was recently diagnosed with severe mitral valve regurgitation. Her surgery is scheduled for March 16th — next Wednesday. Doctor Pedro Del Nido at Children’s Hospital Boston will be performing the mitral valve repair. As you may recall, Dr. Del Nido was Baby Gabe’s surgeon.
By Adam Pick on March 10, 2011
By Adam Pick on March 8, 2011
Thanks to your excellent questions, I had several meaningful discussions at the recent 47th annual meeting of The Society of Thoracic Surgeons in San Diego, California.
For example, Peggy wrote to me, “Adam – I’m diagnosed with severe aortic stenosis. I’m curious… How do I know if my heart valve surgeon is good?” I posed that exact question to Dr. Jurgen Ennker, the chief of cardiothoracic surgery at MediClin Heart Center in Lahr, Germany which is just outside of Frankfurt.
So you know, Dr. Jurgen Ennker is a leading heart valve surgeon in Germany. Over the past 15 years, Dr. Ennker and his team have replaced over 3,000 diseased valves with the Medtronic Freestyle device (a porcine heart valve replacement).
By Adam Pick on March 6, 2011
Since posting my video interview with Doctor Marc Gerdisch about Extracellular Matrix, I have received several patient emails about this unique technology. Paul writes to me, “Adam – What do you think about the procedure where an Extracellular Matrix cloth is attached to the damaged valve which stimulates tissue growth and fixes the problem without a heart valve replacement? Thanks, Paul”
By Adam Pick on March 5, 2011
In case you missed it, some interesting data was just released about the Mosaic porcine heart valve replacement. According to a report in The Journal of Thoracic and Cardiovascular Surgery, the Mosaic bioprosthetic valve — which has been implanted in patients for the past 12 years — continues to demonstrate positive performance.
Mosaic Bioprosthetic Heart Valve Replacement (Porcine Tissue)
By Adam Pick on March 3, 2011
At the recent Society of Thoracic Surgeons convention, I was fortunate to meet several leading heart valve surgeons. One of those surgeons was Dr. Tomislav Mihaljevic from The Cleveland Clinic. Considering that Dr. Mihaljevic’s specialty is minimally invasive heart valve surgery, I was intrigued to hear his clinical response to the question, “What are the advantages of robotic mitral valve repair?”
To help those patients and caregivers that are hearing impaired, I have provided a video transcript of Dr. Mihaljevic’s interview below.
By Adam Pick on March 1, 2011
Ken just sent me a financial question about the cost of an echocardiogram. He writes, “Adam – A few years back, I was diagnosed with moderate mitral valve regurgitation. Since then, I lost my job and my health insurance. Lately, I’ve experienced shortness of breath and fatigue. Do you know how much a heart valve echocardiogram costs? I’m nervous and curious to see if my mitral valve prolapse has gotten worse? Thanks, Ken”
To help Ken, I just asked Robyn, my wife, for our medical statements from December — which is when I had my last echocardiogram.
By Adam Pick on February 26, 2011
I recently received an interesting question from Paul about aortic stenosis and nutrition. Paul writes, “Hi Adam – I’m in my 40’s and just diagnosed with a severely leaking valve. I was told I need a mechanical valve or I will drop dead in 2 to 3 years. I do not want to take Coumadin. Is it possible for patients to enter a natural program — via a qualified nutritionalist — which may actually stimulate tissue growth around the valve, thus fixing the cause rather than treating the symptoms?”
Aortic Valve Stenosis – Narrowing Heart Valve
While I have my own thoughts on this topic, I wanted to get an expert opinion for Paul. That said, I contacted Dr. Marc Gerdisch, MD, chief of cardiothoracic surgery at St. Francis Heart Center in Indiana. As many of you know, Dr. Gerdisch is a specialist for valvular treatment and cardiac tissue repair.