Adam's Heart Valve Surgery Blog – Page 50

I just received an interesting question from Jenny about the size of a mechanical heart valve replacement.

Jenny writes to me, “Adam – Like many patients on your blog, I’m preparing for aortic valve replacement. I’m young, 29, with a bicuspid aortic valve that has severe stenosis. I’m thinking a mechanical valve is the best option for me. However, I can’t stop thinking about the little device clicking away in my heart. Quick question… Do you know the size of a mechanical heart valve? Thanks, Jenny”

There are a few ways to answer Jenny’s question. On one hand, I could assemble a table which contains the different sizes of mechanical valves — by diameter and by surface area. However, I often think the cliche, “A picture is worth a thousand words”, is more appropriate. That said, a mechanical valve is about this big…

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Every once in a while I see a product that makes me think, “Huh?”, “What?”, “No way!”, “Can’t be!” and “Really?” The last time I had that thought was when the marketeers at Chia America released… Chia Obama.

Today, I find myself thinking, “Huh?”, “What?”, “No way!”, “Can’t be!” and “Really?!” once again.

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Here’s a great question from Bruce about mitral valve repairs, tight annuloplasty ring and post-operative complications.

Bruce writes, “Hi Adam, I read your book about a year ago, before my surgery, and have faithfully read your newsletter. What have you ever heard about patients who had mitral valve repairs via open heart surgery and afterwards find the repair annuloplasty ring was a bit tight resulting in irregularities showing up in treadmill stress echocardiograms and shortness of breath? Thanks, Bruce”

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Jim just sent me this question about an echocardiogram after heart surgery. He writes, “Adam – How often should an echocardiogram be performed after surgery. I had my aortic valve replaced. Thanks, Jim”

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Some really interesting patient stories continue to fill up my inbox. Here’s a great one from Don about his new mission saving dogs after mitral valve replacement.

Don Hull, Heart Valve
Replacement Patient, With Hooch

Hey Adam,

I recently regained my Special Issuance Class III FAA medical certificate which allows me to fly my airplane as a private pilot again.  I had an Edwards Bovine tissue mitral valve placed in April 2009 and had to wait at least six months before beginning the rigorous physical testing to regain my FAA medical certificate.

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I just received a very unique question from Barb about carcinoid tumor injections and bovine heart valve replacements. Barb writes to me:

Bovine Aortic Valve Replacement

Hi Adam,

First, I’d like to express my appreciation to you for your very informative book and emails.  I am a 54-year-old woman who was aware of aortic valve stenosis since the age of 16, and finally had an aortic bovine valve replacement in January 2009.  I also had an aortic root aneurysm repair.  I’ve done very well in my recovery, and found your book extremely helpful.

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I always enjoy reading patient success stories. However, this update really made me think, “Fannnnn-tasssss-tic!”. Specifically, I like the way Chaz utilizes a “Before and After” approach to describe his heart valve replacement experience:

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Here’s an interesting question from Julie about heart valve stenosis and enlarged hearts.

Julie writes to me, “Adam – Like you, I was diagnosed with heart valve stenosis and an enlarged heart. I’m just curious. How big can a dilated heart get before failure? 20% bigger? 50% bigger? Any thoughts? Thanks, Julie”

I wanted an expert opinion for Julie’s question, so I contacted Dr. Kevin Accola, M.D., one of the leading heart valve surgeons from AdventHealth Cardiovascular Institute (formerly Florida Hospital). (As you might recall, Dr. Accola has operated on several patients, like Scott Nieman, that regularly visit this blog.)

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Over the past 4 years, many of you have written me with excellent and innovative suggestions for improving this website. As a result, we have created some great new services including the Heart Valve Surgeon Database and Heart Valve Journals.

Today, I am excited to share with you the new design for this blog. The new “look-and-feel” was developed to address many of your ideas including:

• Bigger, easier-to-read text. You will notice the letters of the body text are much BIGGER in 14 point size. Also, the text now has a gray overtone to ease the contrast on your eyes.
• Access information faster. You will notice two buttons in the upper right hand corner marked “Find Surgeons” and “Meet Patients”. When clicking these buttons, you will be taken directly to The Heart Valve Surgeon Database and Heart Valve Journals.
• Enhanced comments section. You will also notice the comments section is completely different. Now, in addition to a much larger font, each comment is separated by “quote bubbles” with individual name identifiers. I want to make sure that all of your insightful comments and questions are highlighted for others to learn from.
• Clutter removal. Finally, we removed other content (links, text) that cluttered the previous design. We even removed certain functions (email sharing, printing, etc.) to clean the screen and better organize content.

Going forward, we may make a few more changes. But, for now, I’m curious to know what you think about this new design. Do you like it? Do you hate it? Do you like parts of it? Do you dislike parts of it?

Keep on tickin!
Adam

These are the hardest posts to write. As the sadness is overwhelming my fingertips, I’ll be brief.

Earlier today, our community lost Lori from Austin, Texas following mitral valve surgery. Needless to say, my thoughts and prayers are with Lori’s husband, her three girls, her family and her friends.

Lori (1971-2010)

I am deeply moved by Lori’s passing. I’ve now been staring at my computer for an hour not knowing what to write. Although we only exchanged email one time before her surgery, I could sense Lori’s fun-loving nature and dedication to her family in the words of her Heart Valve Journal. Again, I am overwhelmed.

If you would like to share something (a thought, a story, a memory) about Lori, please click here or visit her Guestbook.

Update: There will be a visitation on Monday, August 23 from 6-8pm at Weed-Corley-Fish Funeral Home located at 3125 North Lamar Blvd. in Austin. On Tuesday, memorial services will be held at the Episcopal Church of the Good Shepherd, 3201 Windsor Rd. in Austin at 2pm. A reception will follow in Parish Hall.

The family has asked that – in lieu of flowers – donations may be made to the Lori Tullos Barta Memorial Fund, Downs Syndrome Association of Central Texas, 3710 Cedar Street, Austin, Texas 78705-1450.

In memory of Lori,
Adam

For those of you who have been keeping track of Baby Victor’s heart surgery journey, I have great news to share!

Victor is now back at home back in El Salvador with his mother and father. In fact, I was lucky enough to receive a picture which shows Victor’s homecoming.

Thanks again to all of you who supported Victor through the purchase of my book. Whether you knew it or not, you have helped save the life of a very courageous boy.

Keep on tickin!
Ada

Well, here’s something to make your old English teacher gasp in horror…

A road contractor hired to paint the word “school” on a freshly paved stretch of road near Southern Guilford High School in North Carolina rendered the traffic area in question a “shcool” zone.

Have a grat, phun weaknd!
Adam

When two, leading heart valve surgeons come together at an established cardiac care program, the expectations for success are high.

That said, it shouldn’t surprise you that Dr. David Adams and Dr. Paul Stelzer have transformed this hypothetical situation into reality at The Mount Sinai Hospital in New York City.

Dr. Paul Stelzer, Me (Adam) & Dr. David Adams

Since Dr. Adams took over the program in 2002 and Dr. Stelzer joined the staff in 2007, Mount Sinai’s heart program has soared 21 rankings in U.S. News and World Report’s annual survey of cardiac centers.

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Patricia just sent me an interesting question about heart valve surgery recovery.

She writes, “Adam – I had mitral valve repair via the Da Vinci robot on December 15th, 2009. For the 1st time in my life, I have a fully functioning heart with NO murmur!  I have been recuperating for the last 6 months and I am getting progressively better, a little at a time. My question to you is this:  How long did it take for you to fully feel like “YOU” again?  It has been 6 months, and I still don’t feel 100% yet. Thanks, Patricia.”

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Great news everybody!!!

Several weeks ago, I learned that our $5,000 donation to the Gift of Life was going to help pay for the heart surgery of Victor Saravia, a 14-month old baby boy from El Salvador.

 
Today, I’m very happy to report that Victor is doing incredibly well after his complex heart surgery. Rob Raylman, a director from Gift of Life, wrote the following to me…
 
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As Dr. Allan Stewart wrote to me, “We did it!”

“It” was the New York City triathlon.

Dr. Allan Stewart (Surgeon) with Greg O’Keeffe (His Patient)

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Similar to its mitral regurgitation tool, The Cleveland Clinic just announced a new, online program to help patients and caregivers determine their need for cardiac surgery relative to aortic stenosis.

Here is a snippet from their website about the interactive, aortic stenosis tool:

“Is surgery recommended for your aortic stenosis? This interactive tool, based on the American College of Cardiology and American Heart Association Guidelines for management of aortic valve disease will help determine if it is. The tool asks you several simple questions, considers your answers, and tells you whether you may be a candidate for surgery.”

In addition, Dr. E. Murat Tuzcu, cardiologist, and Dr. Lars Svensson, cardiac surgeon, provide some additional information about aortic valve stenosis – narrowing of the heart valve – in an educational video.

I hope you enjoy this new tool for aortic stenosis diagnosis.

Keep on tickin!
Adam

Recently, I was extremely lucky to observe Dr. Saibal Kar and his team perform its 103rd MitraClip procedure on a patient with severe mitral regurgitation at Cedars-Sinai Hospital in Los Angeles, California.

Dr. Saibal Kar And Me In The Cath Lab At Cedars-Sinai

While I expected to watch the procedure from a gallery – much like an episode of Grey’s Anatomy – I quickly found myself inside the cardiac catheter lab wearing scrubs and a lead suit used to protect me against x-ray exposure from fluoroscopy.

For the next three hours, I had front-row access to Dr. Saibal Kar’s team as they cared for the patient and deployed the new MitraClip device. Yes… This was much, much, much better than an episode of Grey’s Anatomy.

Although the MitraClip has yet to receive FDA approval in the United States, Dr. Kar has been using the device to treat mitral valve regurgitation without causing any physical trauma to the patient’s sternum or ribs. As previously discussed, the results of the MitraClip clinical trials have been encouraging.

A few minutes before the procedure began, I was very surprised to see a familiar face enter the cardiac catheterization lab. Doctor Alfredo Trento, the Chief of Cardiothoracic Surgery at Cedars-Sinai Hospital, quietly assumed a position to left of Dr. Kar.

Dr. Kar (Cardiologist) and Dr. Trento (Cardiac Surgeon)
Work Side-By-Side During A MitraClip Procedure

“This has got to be somewhat unique,” I thought to myself, “Given the distinct nature of their specialties and some of the skepticism surrounding the MitraClip from the surgeon community, I can not imagine this is common.” (I would later learn that, so far, only a handful of cardiac surgeons have taken a serious clinical interest in this non-invasive procedure used to treat mitral valve regurgitation.)

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I just received a great question from Diane about heart valve replacements.

Diane writes, “Adam – Yesterday, I was diagnosed with severe mitral valve regurgitation. My cardiologist said I should start planning on having my heart valve replaced soon. I’m confused by all of this. One thing I can’t figure out is where will the new valve goes? Do you have any pictures that could help me visualize this? Diane”

To see how a heart valve replacement device is positioned in the mitral location, please review the picture above. As you can see, a mitral valve replacement – which is typically a tissue valve or a mechanical valve – is inserted where the defective valve previously resided in the heart.

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[Update: Please note that Dr. Allan Stewart no longer practices at Columbia University Medical Center.]

This is a special guest blog by Greg O’Keeffe. I thought you might really appreciate hearing about Greg’s recovery, Dr. Stewart’s unique connection with his patients, and their combined athletic and charitable efforts. Here is what Greg wrote me:

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