By Adam Pick on August 3, 2009
Ray just emailed me a great question about heart valve disease.
He writes, “Adam – Try this one on for size… I’m 57 and newly diagnosed with severe stenosis in my aortic valve. The docs think I need surgery soon. I can’t believe it. I feel fine. No real symptoms. But, the echo shows my heart is already dilated somewhat. Even though the cardiologist told me what is wrong… I want to see what is wrong. Do you have any pictures of heart valve disease? Thanks, Ray”
Like Ray, I experienced a very similar thought upon diagnosis, “What does a diseased heart valve look like?” That said, please find several pictures below to help Ray (and perhaps you) better understand the visual anatomy of several different types of valve disease.
First, however, I thought you might like to see what a normal heart valve looks like for comparison. Here are two pictures of a normal aortic heart valve and tricuspid heart valve:
By Adam Pick on July 31, 2009
Over the past few months, several patients have written-in about pregnancy, child birth, heart valve disease and the complex issue of… surgery timing.
In fact, this morning I received an exciting email about Melinda, her new husband, her bicuspid aortic valve and her pregnancy. I thought you might enjoy reading about Melinda’s approach to having a baby before before heart valve replacement surgery. Here is what she writes:
By Adam Pick on July 30, 2009
One of my critical heart valve surgery recovery tips for patients is… to attend a cardiac rehabilitation program following heart surgery.
From my own personal experience and patient research, I have learned that cardiac rehab programs provide significant benefit to the physical and emotional well-being of patients during heart surgery recovery. Unfortunately, I have also learned that 49% of patients do not attend cardiac rehab.
On Tuesday, a report published in the Journal of the American College of Cardiology further supported the data and opinion referenced above. The highlights of this study which surveyed 72,187 patients discharged from hospitals after a heart attack, angioplasty of bypass surgery between 2000 – 2007, include the following:
- Even though cardiac rehabilitation has been shown to guard against future heart trouble once a cardiovascular event has landed someone in the hospital, only 56 percent of these patients are referred for the therapy.
- Despite national guidelines that say hospitalized patients with a qualifying cardiovascular disease event should be referred to outpatient cardiac rehabilitation before hospital discharge, the study demonstrates this doesn’t happen often enough.
By Adam Pick on July 28, 2009
Aaron just emailed me an interesting question about physical limitations following open heart surgery.
He writes, “Adam – I was just given the news that my aortic valve is at the end of its rope. I knew it would happen someday as I was diagnosed years ago with stenosis. However, I wish that someday wasn’t now. I’m a very active father and husband that enjoys playing football, soccer, tennis and golf with my boys. I want to know the truth about the recovery. Will I be physically limited after this is all over? If so, how? Thanks, Aaron”
Aaron’s email just brought back several, distinct memories following my own diagnosis. Mostly, I remember the fear, uncertainty and doubt that rattled through my brain in overwhelming, unanswered questions like, “Will I ever be the same again?”
By Adam Pick on July 28, 2009
Cheryl McDavitt wrote to me, “Please warn your readers of the dangers of this infection.”
She also wrote to me, “Unfortunately, my husband had another stroke and the MRI showed a mass beneath the aortic valve that was replaced. It turned out to be endocarditis and it developed into other complications. We took him off life support last night and he passed away this morning… I was totally ignorant of endocarditis. I did not know that this infection is common after valve replacement. It might be worth a discussion on your blog. I am giving the short version of a long complicated death because of a cardiologist ignoring endocarditis symptoms that should have alerted him to the infection.”
Carroll McDavitt (1928 – 2009)
By Adam Pick on July 25, 2009
As many of you know, I started this website to educate, inspire and empower patients with heart valve disorders including mitral regurgitation, aortic stenosis, etc.
Three years later… It turns out that I am the one who is inspired by the patient stories of Randy, Sylvia, Patricia, Anita, Robin, Charles, John, Leslie, Steve, Jonathan, Mavis and so many others. Each one of these patient stories (shared previously in this blog) radiate the extraordinary human will to face heart valve disease and rise above it.
On that note, Rodney from North Carolina just emailed me his story. At 78 years of age, Rodney is currently in the middle of his recovery. Here is what he writes:
This is to let you know I underwent aortic valve surgery and one bypass at the new heart hospital in Greenville, North Carolina on June 1, 2009. Dr. Randolph Chitwood, MD, who is recognized as one of the outstanding heart surgeons in country, performed the surgery.
Rodney Trueblood – Heart Valve Replacement Patient
By Adam Pick on July 25, 2009
As we have discussed, the competitive market for minimally invasive heart valve replacements and heart valve repair continues to heat up.
Earlier this week, we learned more about Edwards’ SAPIEN technology. Then came this interesting story about Medtronic and its Melody transcatheter pulmonary heart valve replacement solution. Did you see this?
The Associated Press reported that federal health advisers unanimously backed an experimental heart valve replacement solution from Medtronic as a safe and effective treatment for patients with a rare heart defect.
The Melody Heart Valve Replacement
The Food and Drug Administration’s panel of heart experts voted 12 to 0 in favor of approving the Melody Pulmonary Valve, although stent fractures were identified during the study. According to The Wall Street Journal, the FDA said stents – which are a part of the Melody device – fractured in 18% of patients in the study. The concern about such fractures is that parts of the device could break off and result in blood clots. Ultimately, the FDA believes there is a “low probability” that such fragments would cause blood clots.
By Adam Pick on July 23, 2009
Elissa was recently diagnosed with severe mitral regurgitation due to mitral valve prolapse.
In an email to me, Elissa writes, “Hi Adam – I’m going through the challenging process of picking a mechanical or tissue valve in case my valve can not be repaired. I know I’ll have to use Coumadin for the rest of my life if I go with a mechanical valve. Are there side effects of Coumadin that I should be aware of? If so, what are the common Coumadin side effects? Thanks for everything! Elissa”
By Adam Pick on July 23, 2009
I just received a very interesting question about hair loss and heart surgery from Tim.
He writes, “Dear Adam – I had an aortic valve replacement and an aneurysm repair procedure done in February, 2009. Your book really helped me prepare for my surgery! Anyways, the operation and recovery went very well but now I seem to be losing my hair very rapidly. I am a 62-year old male that has been taking Propecia and using Rogaine for 20 years. Could it be the stress of the open heart surgery that is causing my hair loss? Has anyone else who has had this type of surgery had sudden hair loss like mine? Thanks, Tim”
By Adam Pick on July 20, 2009
I give A LOT of credit to patients and caregivers that really, really, really, really do their homework prior to heart valve replacement or heart valve repair surgery. I can immediately tell from the questions you ask me just how diligent you’re being at each phase of the surgical process.
Case in point… Duane Schlosser (55 years of age) from Austin, Texas just sent me two interesting questions about the Ross Procedure and minimally invasive pulmonary valve replacements that I thought you might benefit from. That said, here is what Duane writes:
Duane Schlosser – Heart Valve Replacement Patient
Thank you for your heart valve surgery book. It has helped me come to grips with my own situation. I am scheduled for aortic valve replacement in September via the Ross Procedure. I have a two-part question for you.
By Adam Pick on July 20, 2009
Bedora just sent me an interesting question about the use of Cordarone before heart surgery. If you are unfamiliar with Cordarone, this drug is used as an anti-arrhythmic. It works by stabilizing the heart rhythm in conditions in which the heart is beating too fast or in an irregular rhythm.
In her note, Bedora requests patient inputs specific to the use of Cordarone prior to surgery. Personally, I did not need to use Cordarone. Did you? If so, maybe you can leave Bedora a comment after reading her story?
By Adam Pick on July 10, 2009
Randy just sent me an email that made me think, “Wow! Scary! Oh My God! Phew! Good Move! Thank God! Great Job Dr. Werner! Way To Go Randy!” That said, I thought you might like to read it…
I am a 52-year old male. About 10 years ago, I was diagnosed with a bicuspid aortic valve. Every year since then, I have been getting regular echocardiograms to monitor the valve. Up until last year, when I fainted while running with my daughter, I remained active – biking, racquetball and tennis.
Randy With Cheryl, His Wife – Two Days After Surgery
Last year, my echocardiogram showed a larger-than-normal increase in aortic stenosis. Since then, I have given up most of the sports I played but still enjoyed riding my bike… That is until June 15, 2009.
By Adam Pick on July 9, 2009
A few months ago, I posted a note about a special project for women heart surgery patients called the “Close To My Heart Project”. As you might remember, a Florida-based artist, Angelica Hoyos, was looking to create artistic portraits of female heart surgery patients.
The goal of Angelica’s project is to help women view heart surgery as something magical, not a terrible curse. It is Angelica’s belief that the scar is a symbol of courage and inspiration. I completely agree!
Anyways, Angelica just emailed me an update with some pieces from the collection. I thought you might like to see how incredible women heart surgery patients can look post-operation. In my opinion, these portraits are… stunning.
The first portrait is of Aimee Jackson:
So you know, there will be a fund raising event this Saturday, July 11, from 7-10pm in Fort Lauderdale, Florida at the Pangae Lounge, 5707 Seminole Way. Here is the invitation if you are interested in attending. FYI, that is Debra North in the portrait on the invitation.
For more information, please contact Angelica Hoyos directly at (954) 665 3850.
Keep on tickin!
By Adam Pick on July 7, 2009
Thanks for your recent nominations regarding the selection of our next “Heart Valve Surgeon Of The Month”.
After reviewing your emails and comments, I am happy to announce that Dr. David Adams from Mount Sinai Hospital in New York City will be featured as the current “Heart Valve Surgeon Of The Month” at our Heart Valve Surgeon Finder.
Dr. David Adams – Heart Surgeon Of The Month
By Adam Pick on July 6, 2009
Jimmy just sent me a great question about the use of medications to treat heart valve disease.
He writes, “Adam – On Friday, I was diagnosed with severe regurgitation due to mitral valve prolapse. I’ve been short of breath for sometime but had no idea it was due to a heart valve problem. My cardiologist thinks I need a valve replacement within the next six months. I’m shocked and in ‘Why Me?’ mode right now. Given my disbelief, I’m curious to know if there are any medications that can treat heart valve disease? As you may have guessed, I’m not very excited about open heart surgery. Any thoughts? Thanks, Jimmy”
By Adam Pick on July 4, 2009
Since it is the Fourth of July weekend here in the United States, I thought it would be interesting to write a blog that connects the number “4” to heart valves. That said, here goes nothin’…
In the past, we’ve discussed the unique anatomy of heart valve leaflets – the tissue flaps that open and close in the valve to ensure that blood flows in one direction through the heart. While the aortic, tricuspid and pulmonary valves typically have three leaflets (also known as heart valve flaps), the mitral valve only has two leaflets. Here is a diagram of the human heart valves illustrating this point.
By Adam Pick on July 3, 2009
I just received a very appropriate email from Barbara about her mother who is suffering from severe aortic heart valve stenosis.
Barbara writes, “Dear Adam – My mother, who is a relatively active lady at 82 years old, was recently diagnosed as needing aortic valve replacement surgery. I’m obviously concerned and somewhat frightened given the invasive nature of this operation and her age. I just have to ask… Is 82 too old for heart valve surgery? Thanks, Barbara”
Considering the aging of our population, this is a great question for all of us to learn from. To start… Did you know that 13% of people age 75 or older in the United States have at least moderate heart valve disease? That said, as the baby boomers continue to age, I imagine this question is going to be asked by many, many, many, many sons and daughters in the future.
As for my research about octogenerians (people over eighty) and heart surgery, consider the following:
By Adam Pick on June 23, 2009
I just received a great question from Pete about high heart rates after open heart surgery.
Pete writes, “Hi Adam, I had an aortic valve replacement procedure on April 8, 2009, about two months ago. My main concern is that my heart rate is running quite high at 80 to 90 beats per minute. Before surgery, my heart rate was around 60. I contacted my cardiologist about this three times. Each time, they tell me this is one of the side effects from surgery and it should diminish over time. Quite frankly, I am concerned my heart is going to wear out. Any thoughts? Thanks, Pete”
Without a doubt, Pete raises a very valid concern of patients about a high heart rate after heart surgery.
By Adam Pick on June 23, 2009
I’ll never forget when I learned my options for a heart valve replacement.
Dr. Trento, the first surgeon I interviewed, briefly discussed the pros and cons of pig valves, cow valves, human donor valves (homografts) and mechanical valves with me. While I immediately understood the use of mechanical valves and homografts for aortic valve replacement, it took me some time to truly understand how pigs and cows provided a suitable alternative for a human heart valve.
That said, I was somewhat surprised to learn that patients might have another biological option to consider in the future. According to a recent report in the Canadian Medical Journal (CMJA), researchers in Quebec will soon begin testing heart valves from harp seals to determine if they are suitable for use in humans.
By Adam Pick on June 22, 2009
I just received a very interesting email from Mandy about heart valve surgery, vertigo, headaches and vision complications after heart surgery. As you can read below, Mandy is asking for all of our help.
Mandy writes to me, “Hi Adam, I had valve replacement on September 16, 2009. I am 34 years old. I am doing really well but I am having some vision disturbances and periods of vertigo. At first it was just vision disturbances and I wrote it off as ocular headaches. Then, I started having difficulty walking straight with these vision disturbances. I looked on-line and found transient ischemic attacks (TIAs) as a possible cause. I do not take Coumadin anymore because I have a bovine valve. My question is… Did you or any of your readers have similar experiences and if so what has been done? Thanks! Mandy”
While I do seem to have more headaches after my aortic valve replacement, I did not experience vertigo or vision loss during my recovery. However, I have met several patients that experience similar issues during their recovery.