Adam's Heart Valve Surgery Blog – Page 52

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.

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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 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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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”

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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. To learn more about minimally-invasive techniques for mitral valve repair, please watch this video with Dr. Marc Gerdisch, a leading mitral valve repair surgeon who has successfully treated over 100 patients in our community.

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

• Scarless Heart Valve Surgery For Women by Dr. Ciuffo
• “What About Port Access For Heart Valve Replacement?” Asks Taylor
• Jim’s Successful Aortic Valve Replacement Via Mini-Thoracotomy

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

Keep on tickin!
Adam

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!
Adam

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 Gray – Heart Valve Replacement Patient

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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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Within minutes of posting “CoreValve Technology Get E.U. Approval”, I received two excellent questions from Jim and Mark. Their questions were, “Can the CoreValve system treat aortic regurgitation?” and “Can the CoreValve technology replace my bicuspid aortic valve?”

To provide Jim, Mark and everybody else a thoughtful response, I contacted Dr. Eric Roselli, MD, a heart surgeon from The Cleveland Clinic, and Dr. Allan Stewart, a heart surgeon from Miami. Here are their responses:

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As difficult as the memories of today can be, I always end up smiling in Scotty’s memory – his bubbly laugh, constant high fives and ability to see the good in everything around him.

There will be a tomorrow that exists without me. And I know that. When that day arrives, I want this world to have seen greater beauty because I existed. I want my life to have meant something. I want this world to be brighter. I want this world to be happier. I want people to have smiled more and to have laughed more because I’ve spent time here. I want others to have seen and felt the uniqueness of my spirit. And if I accomplish that, when my soul does move on and my gift stays here and makes just one ripple, I will look down and I will smile. I will smile wide.

To learn more about my friend, please visit the Scott Weingard memorial.

Thinking of you Scottie!
Adam

As technology for heart valve treatment rapidly advances, we continue to learn more about the roll-out of percutaneous devices for both heart valve repair and heart valve replacement. On Tuesday, Medtronic announced that regulators in the European Union have approved the latest version of its CoreValve heart system.

The CoreValve delivery system is designed to help surgeons replace a diseased aortic valve without removing the original valve and without open heart surgery. Instead, they put a new valve into a catheter and guide the catheter to the heart from an artery in the leg.

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I just received a unique question from Dave about situs inversus and heart valve replacement.

Dave writes, “Hi Adam, I was recently diagnosed with severe aortic regurgitation and a dilated aorta. It’s now time for a valve replacement. I was born with situs inversus with dextrocardia – a rare condition in which my abdominal organs are reversed so my heart is located in the right side of my chest. I’m wondering if any of your readers have situs inversus? I would like to hear their experiences with valve replacement surgery. Thanks for your book! Dave”

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Great news! We have another patient success story!

After aortic valve replacement surgery due to aortic stenosis last May, Barbara Walters returned to The View yesterday. In case you missed it, the show opened with a fun parody about Barbara’s recovery and a meaningful discussion about heart disease.
 

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I just received an interesting question about overnight stays in the intensive care unit (ICU) for the friends and family members of heart valve surgery patients. In his email, Ted asks, “Adam – My wife is going in for aortic valve replacement operation next week. I want to support her morning, noon and night. Do you know if I will be able to stay in the ICU overnight with her? Thanks, Ted”

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I just received a question from Dawn about her recent diagnosis of mitral regurgitation.

Dawn writes, “Adam – Two days ago, I was diagnosed with “moderate to severe” mitral regurgitation. My cardiologist told me that surgery is likely in the next 24 months. Needless to say, I’m confused by all of this and looking to learn more. I never even knew I had a prolapsed valve. I’m curious to know what mitral regurgitation sounds like but I don’t own a stethoscope. By chance, do you have any MP3s you can send me? Thanks, Dawn.”

While I don’t have any audio files to send Dawn, the video above contains the actual sounds of a heart beating with mitral regurgitation. Do you hear the muffled sound of the heart beat? For comparison, I included the sound of a normal heart beat below.

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Cindy just sent me this great email. Given her unique story, I thought you might really enjoy it.

Hi Adam,

I have written you before about the recovery from heart valve surgery. We exchanged emails about when you really felt healed. Last year, I had mitral and tricuspid valve repair by Dr. David Adams in New York — even though I live in California.

We just returned from our summer vacation in Jackson, Wyoming. While I’ve been there many times, this experience was SO different!!!

Cindy & Rich Tarver

I was able to hike and SEE lakes that I never could see before! Prior to surgery, the altitude was too much for my severely damaged valve.  (So you know, I’ve had problems with mitral valve prolapse since childhood, gradually getting to the point of 100% mitral regurgitation with calcified leaflets.)

This year, I was hiking at 7,000 feet with NO shortness of breath!

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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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