Adam's Heart Valve Surgery Blog – Page 40

I just received a great email from James about the Ross Procedure and a diseased bicuspid aortic valve.

James writes, “Hi Adam – I’m 47 and recently told I need to replace my bicuspid aortic valve due to stenosis. Through your website, I’ve learned about the Ross Procedure as an option for me. It sounds interesting but I’m curious to know if the Ross Procedure can be used for my bicuspid aortic valve? Thanks, James”

Ross Procedure Diagram & Bicuspid Aortic Valve Picture

Typically, for technical questions about heart valve repair and heart valve replacement operations, I contact our cardiac surgeon team for their opinions on patient questions. Luckily, for this question, I can provide James a direct response.

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The possibility of aortic valve replacement without an incision to the sternum or ribs of the patient has become a reality for select patient categories. Together, our community has followed the evolution of catheter-based technologies including the SAPIEN heart valve replacement by Edwards Lifesciences which received FDA approval for “inoperable” patients last year. Needless to say, patient interest specific to this and other transcatheter devices, including the CoreValve and the MitraClip, is significant.

SAPIEN Heart Valve Replacement (Edwards Lifesciences)

For that reason, I wanted to make sure you were aware of a recent announcement in which an FDA panel recommended the SAPIEN heart valve replacement for wider use among “high-risk” aortic stenosis patients. So you know, a “high risk” patient is healthy enough to have surgery but faces serious health risks because of age (often greater than 80 years old) or illnesses (like diabetes).

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In 2008, when I first spoke with Doctor David Adams, the Chairman of Cardiothoracic Surgery at The Mount Sinai Medical Center, he immediately understood the key objective of this website – to educate and empower patients from diagnosis through recovery. Over the years, Dr. Adams’ support of this project has been extraordinary and, most importantly, Dr. Adams has performed successful surgery on many patients in our community. As you can see at his profile page, Dr. Adams has 25 patients testimonials in our Surgeon Finder.

Today, I’m happy to announce that Dr. Adams and The Mount Sinai Medical Center launched a ‘Heart Valve Clinic Microsite’ at HeartValveSurgery.com.

Now, patients and caregivers in our community can quickly learn about Mount Sinai’s unique approach to valvular treatment, its surgical outcomes, its team of cardiac surgeons, patient success stories, and more. To visit the microsite, simply click here.

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I wanted to shine our “Heart Valve Journals Spotlight” on Trent Viavattene, a mitral regurgitation patient from Plano, Texas.

So you know, Trent is preparing for mitral valve surgery to be performed next Monday by Dr. William Ryan. I could ramble on about Trent, his wife (Amanda) and his two boys (Riley and Jake). Instead, I’d encourage you to visit Trent’s journal and, perhaps, leave him an encouraging note at his guestbook.

Trent, Riley & Jake

Personally, I was inspired to learn that Trent recently met up with Thomas Hunt, another patient from Texas, who just had mitral valve surgery with Dr. Gillinov at the Cleveland Clinic.

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Thanks to everybody for your ongoing inquiries about Ethan, our 3-year old son.

Since the last update, Ethan has developed a passion for the performing arts. Actually, it’s less of a passion and more of a rampant addiction. It started with him imitating, role-playing and singing the songs from Yo Gabba Gabba. Then, it progressed to the Mickey Mouse Clubhouse.

Ethan as Mickey Mouse

After the Mickey Mouse Clubhouse ran its course, Jake and the Neverland Pirates became his favorite “show” to perform. After Jake, it was Handy Manny, then the Muppets and… the list goes on.

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I just received an interesting email from Steve about the time in which the heart is iced and stopped during heart valve replacement and heart valve repair surgery.

In his email, Steve writes, “Hi Adam – I am having mitral valve repair surgery next month. One glaring question… I’ve read that when the heart is stopped it is “iced” and therefore can last 2-4 hours without tissue damage.  However, a whole bunch of these surgeries take between 4-7 hours, sometimes more. How do we reconcile the discrepancy? Thank you, Steve”

Ice Chips On Heart During Cooling Process

Steve raises a great question. For that reason, I contacted Dr. Marc Gillinov to get a great answer. If you were unaware, Dr. Gillinov is a staff surgeon at the Cleveland Clinic, co-author of Heart 411 and a super nice guy.

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Hi everybody,

I wanted to take a quick moment to share that Dr. Randolph Chitwood, Director of the East Carolina Heart Institute, has been named our current ‘Featured Heart Valve Surgeon’.  In addition to being a pioneer and innovator in the field of cardiac surgery, Dr. Chitwood has been an incredible supporter of the patients and caregivers within our community — including Richard, Nick, Rodney and Amy.

To help you learn more about Dr. Chitwood and his unique approach to cardiac care, here are two interesting links:

• Heart Valve Clinic Tour: Keeping up with Dr. Chitwood
• First-In-Man Implant of ValveXchange performed by Dr. Chitwood and Dr. Svensson

Lastly, if you would like to see Dr. Chitwood’s surgeon profile, video and patient testimonials, please click here.

Keep on tickin’ Dr. Chitwood!
Adam

I recently received a question from Randy about his teenage daughter who requires surgery due to a leaking aortic valve.

In his email, Randy writes, “Hi Adam – My daughter, Haley, has severe aortic valve regurgitation.  She is 14-years old and was diagnosed at age 9.  She is asymptomatic but conditions have progressed to a point where surgery is warranted. My wife and I are struggling with choosing the right procedure.  Our medical team has recommended valve repair first and valve replacement second.  Based on all information gathered to this point, we are leaning towards mechanical valve replacement for Haley. What do you think? Thanks, Randy”

I wanted to provide Randy an expert opinion, so I contacted Dr. Fayyaz Hashmi from Mercy Health System in Toledo, Ohio. I recently met Dr. Hashmi at the Heart Valve Summit. Beyond being a very experienced surgeon, with over 10,000 procedures completed, Dr. Hashmi is a very kind, soft-spoken man with an altruistic and global approach to cardiac care.

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There are no words for what you are about to see… For what is about to occur…

To learn more about ‘Flatline to Finish’ and how you can support this extraordinary effort, please click here. Go Dave!

Go Iron Heart Racing Team!

Adam

As many of you know, Dr. Kevin Accola and his team at AdventHealth (formerly Florida Hospital Cardiovascular Institute) have been incredibly supportive of our patient and caregiver community. In addition to providing  great surgical results — to patients like Denise Ring, Duane Hunt, Scott Nieman and many others — Dr. Accola and AdventHealth have provided excellent content to further educate and empower us through heart valve surgery.

Today, I am very excited to announce that the Orlando-based cardiac center launched the AdventHealth Heart Valve Clinic Microsite within the cardiac clinics section of our website.

At their microsite, you can go on a virtual tour of AdventHealth, learn more about their cardiac specialties, see patient success stories, and watch a video about Dr. Accola’s approach to heart valve surgery. To visit the AdventHealth Heart Valve Microsite, please click here.

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Tony, my father-in-law, and I are technology enthusiasts. In particular, we have a mutual fondness for Apple products. That said, when Tony sent me this video, I found myself saying ‘Wow’ several times. Already, over 2 million people have watched the video. I hope you enjoy it!

Keep on tickin!
Adam

I just received a great question from Carolyn about ‘heart healing’ after valve repair or valve replacement surgery. In her email, Carolyn writes, “Adam – I’ve read a lot on your website about the time needed for the sternum to heal. But, what about the heart? After it’s stopped, opened, fixed and restarted, how long does it take for the cardiac muscle to heal? Thanks! Carolyn”

I wanted to provide Carolyn an expert opinion, so I contacted Dr. Luis Castro, the Medical Director of Sequoia Hospital Heart & Vascular Institute, in Redwood City, California.

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Since launching this website, I’ve noticed a trend favoring tissue valves over mechanical valves. While patients are attracted to the durability of a mechanical valve replacement, it seems as if many patients — of all age categories — want a Coumadin-free life. Plus, the possibility of valve-in-valve procedures appears to be another key factor in their selection process.

However, a study published in the Annals of Thoracic Surgery, reported that the On-X mechanical heart valve replacement performed favorably to tissue valves. More specifically, the On-X valve offered the 172 patients in the study a mortality benefit 7.5 years after surgery.

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I just came across an interesting study published in the Journal of Internal Medicine about men and heart murmurs.

According to Dr. Johan Bodegard, a physician at the Oslo University Hospital in Norway, more than 20% of middle-age men have a heart murmur. This low-grade systolic murmur, over time, creates a five times risk of future aortic valve replacement. The study evaluated over 2,000 men, aged 40 to 49, during a 35-year time frame.

A key finding of the study suggested that men with moderate valve disease were 89X more likely to have AVR and a 1.5X risk of death due to heart disease. To learn more about heart murmurs, click here.

This is, yet again, another good reason to actively monitor your valvular defect with regular echocardiogram check-ups.

Keep on tickin!
Adam

Earlier today, I spent some time at Heart Valve Journals, our online community. While there, I read an interesting question posted by Stephanie Cole, who had mitral valve replacement surgery on March 16, 2012.

In her journal, Stephanie asked, “When does that little, tiny ‘Voice Of Doubt’ go away? Is my valve still intact? Is my heart still shrinking? I love the freedom to do ‘anything’ but what if the doc’s were wrong? I wish I could have monthly echo’s for reassurance.”

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Valerie sent me an interesting question about leaky valves after heart valve repair surgery.

Her email reads, “Hi Adam – I had my mitral valve and tricuspid valve repaired in October 2011. I recently had an echocardiogram done. The echo showed that both valves are leaking (mildly).  I went to my cardiologist and the surgeon to discuss this. They both told me there was “nothing to worry about”.  I am worried!  I cannot seem to get a straight answer. Is this common to have leakage after a repair with an annuloplasty ring?  I would appreciate any information you have on this situation of a mild leak after a repair. Thank you, Valerie”

Leaking Mitral Valve Diagram

As I’ve received this question twice in the last week, I wanted to provide Valerie (and you) an expert response, so I contacted Dr. Patrick McCarthy, the Chief of Cardiothoracic Surgery at Northwestern Memorial Hospital in Chicago, Illinois. During his thirty-year career, Dr. McCarthy has performed over 10,000 cardiac procedures of which more than 4,000 included valvular treatment.

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Over the years, I’ve received hundreds of success stories from patients and caregivers within our community.

With the relaunch of our website, I wanted to create a special place to feature your inspirational stories and your smiling faces. For that reason, I just built a new ‘Patient Success Stories’ section of the website. Today, you will see 16 patient success stories featured. However, this number will quickly increase as I go back through all the wonderful stories previously posted in the blog and our Heart Valve Journals community.

 
If you have a story you would like to share, please send me your story along with a picture or two. My email is adam@heartvalvesurgery.com!

• Click here to visit the new ‘Patient Success Stories’ section of the website.

Thanks again to everybody who has shared their experiences within our community!

Keep on tickin!
Adam

Hi everybody,

I wanted to take a quick moment to introduce you to Karen Campo, the new featured patient at our Heart Valve Journals Community. Unlike many patients who monitor their heart valve disease for years, Karen is on the “Fast Track” to heart valve surgery as she was recently diagnosed with severe mitral regurgitation.

Karen with her son Matty

Karen’s attitude warrants attention. She’s very positive and upbeat. As she writes in her journal, “This has all happened really fast, but I am trying to learn as much as I can, have a positive outlook and look to family and friends for support.”

• Visit Karen’s journal. 
• Leave Karen a message at her Guestbook.
• See pictures of Karen’s friends and family.

Keep on tickin’ Karen!

My thoughts and prayers are with you!
Adam

I am very, very, very sad to report that Cindy Pastrano, a fellow patient from San Antonio, Texas, recently passed away.

Since joining our community, I had become familiar with Cindy as she shared her experiences with us at her journal. Given her energetic attitude, funny remarks (including her distaste for the dentist), and post-operative status, I was shocked to learn of her passing.

 
At her journal, Cindy’s sister-in-law, Lori, provided this note:

We have some very sad news to share. As you might have known, Cindy was expected to be discharged yesterday. However, she suffered some complications. At approximately 11:30 pm Thursday night, it appears she suffered a severe heart attack and was in critical condition in ICU. She under went 2 surgeries and her condition never improved. At 12:15 am today, while surrounded by her family, Cindy left us to be with her Lord. Love never dies and her love will live on in our hearts. We will miss her very much.

If you would like to leave a message in Cindy’s memory, please click here.

Needless to say, my thoughts and prayers are with Cindy, her husband Peter, Cory, Sean and Eileen (her children), her family and friends.
Adam

As we continue to track the new technologies impacting heart valve treatment, I thought you might like to know about an interesting treatment method for mitral regurgitation. The Mitralign device enables physicians to repair a mitral valve using a catheter-based procedure instead of an incision to the sternum or ribs.

Unlike the Mitraclip, another transcatheter technology which clips the mitral valve leaflets together to reduce regurgitation, the Mitralign system repairs a dilated mitral valve by reducing the size of the annulus which moves the leaflets closer together. The result is a decrease in mitral insufficiency.

• To see a video of the Mitralign technology, please click here. As I watched this video, I began to see how this technology is similar, in concept, to the surgical use of an annuloplasty ring. To learn more about annuloplasty rings, click here.

Mitralign is currently conducting clinical studies. Ultimately, its recent $35 million financing, will be used to secure a European CE Mark that will enable Mitralign to market the device overseas. As you may be aware, this approach is common for companies with new technologies that eventually apply for FDA approval here in the United States.

As we continue to learn more about this and other exciting technologies, I’ll continue to feature them here in this blog.

Keep on tickin!
Adam