Adam's Heart Valve Surgery Blog – Page 59

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.

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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”

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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”

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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

Adam,

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.

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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?

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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…

Hi Adam,

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.

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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.

Thanks Angelica!!!

Keep on tickin!
Adam

All,

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

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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”

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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.

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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:

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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.

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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.

Now, however, I am fully aware of the benefits that pig valves (aka porcine valves) and cow valves (aka bovine valves) offer patients requiring heart valve replacement surgery.

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.

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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 With Her Two Children

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.

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Quick trivia for you…

According to The Cleveland Clinic, “How long does it take for blood to circulate through your vascular system?”

A. 2 second
B. 20 seconds
C. 2 minutes
D. 20 minutes
E. 2 hours

To find the answer, scroll down below the beating heart.

The answer is… 20 seconds.

That’s pretty amazing considering the complex network of blood vessels – arteries, veins and capillaries – that carry blood through the body. According to The Cleveland Clinic, that system is over 60,000 miles long. That’s long enough to circle Earth twice!

Keep on tickin!
Adam

When it comes to making investments, I’m no Warren Buffet.

However, every once in-a-while, I come across a company that is uniquely positioned within a growing industry. Such is the case of… Edwards Lifesciences (NYSE: EW). As you may know, Edwards Lifesciences, founded in 1958, is the leading heart valve replacement manufacturer on the planet.

I originally became familiar with Edwards Lifesciences as I prepared for my own heart valve replacement surgery. However, I really became interested in Edwards’ product and financial strengths during the research for my book.

In 2007, I was lucky to tour Edwards headquarters, to walk through its heart valve museum and to visit its manufacturing center in Irvine, California. During that visit, I learned more about the history of the company, its unique product portfolio and its ongoing dedication to patients requiring heart valve surgery.

The Heart Valve Museum At Edwards Lifesciences

Edwards commitment to the heart valve market is proving valuable to its shareholders. I just learned that the company’s shares touched $68.23 last week. That is a 52-week high for the Edwards. (You might recall that I have highlighted the company’s financial performance on a few occasions. Since my first blog, the stock has increased $14 per share, a 26% increase.)

Again, I’m no Warren Buffet… This is simply a very good company that is making a difference in the lives of people with heart valve disease.

Keep on tickin!
Adam

I just received an interesting question about memory loss after heart valve surgery from Paige Mitchell of Virginia.

Paige writes, “Hi Adam, I had my aortic valve replaced in March, 2009. A few weeks later, I became agitated that I couldn’t remember peoples’ names, what I had just been doing, etc. I mentioned this to my cardiologist and he said this may happen as a side-effect due to anesthesia and the heart-lung machine lowering oxygen levels to the heart and brain during surgery. The cardiologist also said my memory loss would diminish over time. I’m 11 weeks post-op and still experiencing problems remembering.  However, it is less than it was. Did you experience any of this? Thank you for writing your book and this blog! Paige”

While I never experienced any complications specific to memory loss, many patients report experiences of cognitive decline following heart surgery. In fact, this condition is often referred to as “pumphead” for the reasons that Paige provides above.

Interestingly enough, there is ongoing debate as to whether-or-not use of the heart-lung machine is really the source of memory loss after surgery.

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Great news!!!

Ed Koch, the former mayor of New York City, is reported to be in stable condition following his aortic valve replacement surgery earlier today.

A spokesman says the 84-year-old mayor is doing “as well as expected” after a challenging open heart procedure at New York Presbyterian Hospital.

Ed Koch’s surgeon was Dr. Craig Smith, one of the leading heart surgeons on the East Coast. Doctor Craig Smith also performed a bypass procedure on former President Bill Clinton in 2004.

Dr. Craig Smith, M.D.

Ed Koch served as mayor of New York City from 1978 to 1989. Koch told Mayor Michael Bloomberg earlier this week that he was doing fine and was looking forward to getting out of the hospital.

Keep on tickin!
Adam

I just received a great question from Steve about heart flutters and palpitations following heart valve surgery. In fact, Steve’s question brought back a very distinct memory from my own heart surgery recovery.

Steve writes, “Hi Adam – I had my aortic valve replaced, with a pig valve, 7 weeks ago today.  During the past couple of weeks my heart is very fluttery and I feel like I have motion sickness.  It lasts for most of the day and is gone after a good nights rest.  Did you ever experience something like this? And, is this something I should worry about? I hate calling my doctor for something that is normal. Thanks, Steve”

I have a couple thoughts for Steve…

First, something similar to this happened to me six months after my double, heart valve surgery. I was at work when… All of a sudden, my heart felt like it was flip-flopping and beating upside-down in my chest.

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You might remember Shannon’s last email about diseased heart valves, pregnancy and child birth. Well…. Here is her post-operative update:

Hey Adam!

I wrote to you several months ago about heart valves and pregnancy. I just wanted to send you a quick update!

I had my surgery on May 14th at Emory University Hospital in Atlanta, Georgia. Doctor Ed Chen was my surgeon. I cannot say enough about how wonderful he and the Emory staff were to work with.

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