Adam's Heart Valve Surgery Blog – Page 48

“What Happens To My Pericardium During Heart Valve Surgery?” Asks Bernie

By Adam Pick on October 31, 2010

I just received a very interesting question from Bernie about the pericardium and heart valve surgery.

Bernie writes, “Hi Adam – At 51 years old, I need to replace my disease aortic valve due to a stenotic bicuspid valve. I’m curious to know about the pericardium. I know the sac has to be opened. But, then what? Do they stitch-up the pericardium after the valve is fixed? Or, is it left open? Thanks, Bernie.”

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On Halloween, Brad Pitt & Ethan Say, “Yoooo Gabba Gabba!”

By Adam Pick on October 31, 2010

Robyn, Ethan and I want to wish everybody a very happy and very safe Halloween!

For his 2nd Halloween, Ethan is dressing up as “DJ Lance Rock” from the hit television show Yo Gabba Gabba.  The show has become a morning staple for Ethan as he gulps down his first glass of milk. Ethan loves running around, screaming “Yoooooooo” as waves his hands in the air like DJ Lance Rock.


Ethan With His Yo Gabba Gabba Friends


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Cardiac Clinic Tour: Dr. Scott Lim Extends MitraClip Competence At The University Of Virginia

By Adam Pick on October 24, 2010

As many of you know, I’m fascinated with technology.

That said, when I’m invited to see a clinical application of a new heart valve technology, I jump at the opportunity. So, last week, I found myself in a hybrid catheterization laboratory / operating suite at the University of Virginia in Charlottesville, Virginia. Dr. Scott Lim, Associate Professor of Pediatrics and Medicine, Division of Cardiology, was performing a MitraClip procedure.


Dr. Scott Lim & Adam Pick
Dr. Scott Lim, M.D. And Me (Adam)


“We’ve been investigating the MitraClip therapy in select patients as an alternative, less-invasive therapy for mitral regurgitation,” Dr. Lim shared with me. “By clipping the mitral leaflets into a double-orifice configuration we can reduce leakage across the valve – without inducing stenosis.”

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“What About Horse Valve Replacements?” Asks Joseph

By Adam Pick on October 21, 2010

I just received a very interesting question from Joseph about the different types of tissue heart valve replacements.

Joseph writes, “Have you ever heard of any surgeon using equine tissue valves for aortic valve replacement? In the 10 months of researching my aortic valve disease, I’ve not heard of EQUINE valves being implanted — not once. Can you provide some insight? Thanks, Joseph”


Animated Of ATS 3F Aortic Bioprosthesis Valve Video
ATS 3F Bioprosthetic Aortic Valve – Equine Tissue Valve


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Bob Uecker Requires Heart Valve Re-Operation Due To Infection

By Adam Pick on October 19, 2010

Considering our recent discussion about heart valve re-operations, often referred to as “Re-Dos”, I wanted to wish Bob Uecker a very successful surgery today. If you didn’t know, Bob Uecker — who was anointed  “Mr. Baseball” by Johnny Carson — will undergo his second heart valve surgery during the past six months.


Bob Eucker After Heart Surgery
Bob Uecker – Heart Valve Surgery Patient


According to reports, a pseudoaneurysm (a tear) happened where his heart valve replacement is located. According to his medical team, it’s believed a skin-related staph infection entered his bloodstream and got into his surgical repair site.

“I’m approaching this with the same optimism that I had the first time,” said Uecker. “I appreciate all of the kind thoughts and well wishes from Brewers fans and everyone who has reached out to me.”

Keep on tickin’ Bob!

Medtronic Gets FDA Approval For CoreValve Percutaneous Aortic Valve Replacement Trial

By Adam Pick on October 19, 2010

Interest in catheter-based technologies for heart valve repair and heart valve replacement continues to skyrocket.

As you have seen, we recently (i) reviewed new data for the SAPIEN aortic valve replacement and (ii) observed a MitraClip case for mitral valve repair. Recently, I learned that Medtronic, one of the leading heart valve manufacturers, received FDA approval for its investigational device exemption application. That means that Medtronic can conduct a patient trial to determine the safety and efficacy of its percutaneous CoreValve system for aortic valve replacement.


Severely Stenotic Aortic Heart Valve Aortic Stenosis – Narrowed Trileaflet Valve


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“Will The Surgeon ‘Ice’ My Heart During Surgery?” Asks Alma

By Adam Pick on October 17, 2010

I just received an interesting question from Alma about a critical step during heart valve repair and heart valve replacement surgeries. Alma writes, “Adam – I’m going in for surgery next week. Thanks to your book, my anxiety has greatly decreased. I’m curious… I know my heart is going to be cooled and stopped during surgery. But, will my surgeon actually put ice on my bare heart? Alma”

Coincidentally, I just took the picture below while observing a heart valve surgery last week. As you can see, the answer to Alma’s question is typically… Yes.


Ice Chips On Heart During Cardiac Surgery
Ice Chips On Heart During Cooling Process


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Technology Update: Cardiologists & Surgeons Evaluate The SAPIEN Heart Valve Replacement Trial (Part II)

By Adam Pick on October 15, 2010

When the latest results of the PARTNER trial became available, many in the medical, investment and patient communities quickly analyzed the data specific to the new SAPIEN heart valve replacement. As you may be aware, the SAPIEN (i) requires no trauma to the sternum during aortic valve replacement, (ii) is currently used for high-risk patients suffering from aortic stenosis, and (iii) has yet to receive FDA approval in the United States.



While many physicians and investors took instant favor to the findings published in The New England Journal of Medicine, I was curious to know what cardiologists and heart surgeons thought of the study — after the data was digested.

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Before & After: Monique Gets A Much-Needed Mitral Valve Repair

By Adam Pick on October 9, 2010

Monique just sent me two, very interesting pictures of her mitral valve – before and after surgery. I thought you might like to see these pictures as they illustrate the challenges of heart valve disease and the opportunities of heart valve treatment. The procedure was performed by Dr. David Adams at Mount Sinai Hospital in New York City.


Patient Using Incentive Spirometer In Intensive Care Unit
Monique At Mount Sinai Hospital


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George Receives Motherly Miracle In The Form Of Dr. Gaudiani

By Adam Pick on October 9, 2010

A few months ago, I received a very difficult phone call from George Avakian who resides in Northern California.

George’s mother was suffering from severe heart valve disease. He was fearful that he might lose his mother. After speaking with George, he immediately took the steps needed to get the best care for his mother. If you are interested to learn about her surgical result, here is a follow-up email from George about his mom’s heart valve replacement surgery.


Patient Of Dr. Vince Gaudiani


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Patient Concern: Cardiac Rehab Referrals Continue To Disappoint

By Adam Pick on September 22, 2010

From my own experience and patient research, I know that the physical, social and mental benefits of attending a good cardiac rehabilitation program are overwhelming. Unfortunately, physician referrals of these patient programs are… underwhelming.


Adam Pick At Cardiac Rehabilitation Center Me Peddling Away On The Bike At Cardiac Rehab


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After Surgical Stroke & Three Heart Valve Replacements, Kirk’s Triathlon Passion Continues!

By Adam Pick on September 21, 2010

I just received an extraordinary email about Kirk Rose from his daughter, Angela. If anybody needs inspiration before or after heart valve surgery, I encourage you to read this:


Patient Triathlete After Heart Surgery & StrokeKirk Rose – Triple Heart Valve Surgery Patient



I just came across your website and noted that you mention Team Scar Trek of Oregon. So you know, my father was the organizer of this group and is currently on the comeback from his THIRD heart valve replacement.

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“How Much Do Heart Valve Replacements Cost?” Asks Mike

By Adam Pick on September 20, 2010

I just received a great email from Mike about heart valve replacements. Mike writes, “Adam – I’ve got a severely leaky valve and need mitral surgery. I’m 55 and never knew about my prolapsed valve. Just curious… If the surgeon can’t repair my leaflets, how much do the replacement devices cost? Thanks, Mike”

Like Mike, I had this same question when I was diagnosed with severe aortic stenosis. I wanted to know just how much this little medical device cost.


Costs of Heart Valve Replacements - Mechanical, Tissue, Bioprosthetic, Homografts


As you might imagine, obtaining pricing data on heart valve replacement devices is a bit difficult. You can’t just run down to your local Wal-Mart and order an ATS Open Pivot Valve. And, you definitely can’t purchase a Medtronic Freestyle pig valve from

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Study: How Gender Impacts Enlarged Hearts After Valve Replacement

By Adam Pick on September 20, 2010

In the past, we’ve talked about the risks of valvular disorders and enlarged hearts. Recently, a study was released which further examined whether or not dilated hearts return to normal size after heart valve surgery. Interestingly, the study considered this post-operative objective from a male and female perspective.


Normal And Enlarged Heart Comparison


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Remote Second Opinion Changes Anne’s Surgical Approach

By Adam Pick on September 17, 2010

One of the ongoing themes in this blog focuses on patient advocacy — before, during and after surgery. Specific to this point, I just received an interesting letter from Anne about second opinions, patient research, chest incisions and surgeon selection. In her note, Anne writes to me:


Anne Shannone - Heart Valve Replacement - Aortic Valve With Bovine Prosthetic
Anne Shannon – Heart Valve Surgery Patient (Evergreen, Colorado)


Dear Adam,

When I had my yearly echo in May, I learned it was time to start thinking about aortic valve replacement due to stenosis. My cardiologist strongly recommended two local surgeons at the new heart center in Denver. After doing some research, I asked about minimally invasive surgery.

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“What Percent of Heart Valve Surgeries Are Re-Operations?” Asks Marc

By Adam Pick on September 14, 2010

I just received a very interesting email from Marc about heart valve surgery re-operations. He writes, “Adam, I’m an active 47 year-old just diagnosed with severe mitral regurgitation. I can’t help but think that I’ll need a 2nd surgery if I get a repair or a tissue valve. Do you know what percent of valve surgeries are re-operations? Are they primarily from surgical error or degenerative reasons? Thanks, Marc”


Black Percent Sign WIth Question Marks


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Video: Mini-Thoracotomy For Minimally Invasive Mitral Valve Repair?

By Adam Pick on September 13, 2010

As I remember… Once diagnosed with severe heart valve disease, many patients begin researching surgical options immediately.

During that process, we quickly realize that different approaches for open heart surgery exist. One approach, the mini-thoracotomy, deploys a surgical technique unlike a median sternotomy, robotic surgery or transcatheter procedure.

In the past, we have discussed mini-thoracotomy for aortic valve replacement and mitral valve repair. That said, I thought you might like to see a video which shows a mini-thoracotomy being performed. While this video is a bit graphic, I found it very educational.



To learn more about mini-thoracotomy (also referred to as port access), you might want to consider the following:

I hope the video and information provided above helps us all learn more about mini-thoracotomy for heart valve surgery.

Keep on tickin!

Blog Milestone: We’re Over 1,000 Posts!

By Adam Pick on September 13, 2010

Hi everybody,

I just realized that this website reached a fun milestone in its ongoing development. Earlier today, I posted the 1,000th blog about heart valve surgery.

Thanks to you – the patients, the caregivers, the cardiologists and the surgeons – for your ongoing contributions (questions, answers, guest blogs, comments, etc.) to this online resource.



Great job everybody!

Patient Recovery Update: Kerrigan Stops Beta Blockers, Gains Energy and Improves Blood Pressure

By Adam Pick on September 12, 2010

Kerrigan just sent me a very interesting update about his heart valve surgery recovery. As his email touched on many patient issues — fatigue, blood pressure, beta blockers and patient advocacy — I thought you might enjoy his perspective and positive results.


Kerrigan - Aortic Valve Replacement PatientKerrigan Gray – Heart Valve Replacement Patient


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“How Will My Heart Valve Replacement Be Measured?” Asks Kate

By Adam Pick on September 11, 2010

I just received a great question from Kate about heart valve replacement surgery.

Kate writes, “Hi Adam, I’m going in for surgery next week and I have a quick, follow-up question about the size of a heart valve replacement. It might sound silly, but… During the operation, how will the surgeon measure my valve? Do they have some kind of sterile tape measure? Thanks, Kate”

While we might think that a “surgical tape measure” would determine the diameter of the mechanical or bioprosthetic replacement valve, the reality is a bit different.



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