Linda's Posts

Surgery is still scheduled for late November. Any heart surgery has potential problems especially for someone who has smoked for fifty years. The Clip was Linda's choice and she was the one who wanted to press on. She had a bad Afib event in April and recent very difficult colon surgery that delayed the heart surgery evaluation for months. Linda did have a second opinion, the first TEE discovered the MVR at HFHS, she was then referred to U of M and underwent another round of tests, a CT Scan revealed the colon problem with an abscess, they required the abscess be cleared before the heart condition could be revisited. Another round of tests, where the latest TEE confirmed the MVR, and that was rated severe regurgitation. She has a few more pre-surgery tests in a few weeks. U of M is 90 minutes away and we have made many trips since 2023. We are all hoping for the best. Doug

Linda had her Mitral valve repaired on November 25, they also performed the Maze procedure Mini MVr (36mm Simuplus annuloplasty ring, PTFE chord x 1), MAZE, LAAL via R anterior thoracotomy and R axillary cannulation She was discharged December 6th to home. After much rest she is doing very well, we are closely monitoring her vitals. We will have a Zoom follow up call December 26th.

Hi Linda, have you had a second opinion on the clip being the best option? Sometimes, surgeons only sell what they do/know, and sometimes interventional docs cannot do open surgeries. U Michigan has a designated reference mitral valve surgeon - Dr Bolling. Looks like you are already at that center, though. Are you not cleared for an open surgery? Your Doc has a bio stating interest in Mitral Clip.

I was referred to Dr Ailawadi by a cardiologist from another hospital system. Dr Ailawadi can perform conventional heart surgery or minimally invasive procedures. He is highly reguarded in the field. He felt due to decreased lung capacity the Mitraclip is a better option. Open heart surgery may be my only other option. It might be a little late in the process for a second opinion, but I will start looking. I have all the testing results in my possession.

Linda - I see. Well, Dr Bolling has a long reputation at Michigan on open Mitral Valve Repair. I see that Dr A does both. I just don't get why you need to be accepted into a trial for the procedure if you are a standard Mitral Clip patient. Typically, age 70 and younger is an argument for open surgery. Over 70 and comorbidities, then case by case. There are potential Mitral Clip durability issues. Don't be rushed to make the choice. Get a consult from a pulmonologist, too if this helps clarify the situation. And definitely another cardiac surgeon. Many of us take weeks to months (me 6 months) to make these choices. If you have a planning window which allows this, take your time. Feel good about decision. Good luck !

Linda - just pulled this for you. Key questions is are you a high risk patient, or a low to moderate. If low-moderate, you have more choice in the open surgery. This should be discussed. Taken from Michigan web site. TMVr uses a catheter (thin tube) inserted into a vein in your groin and guided to your heart. The doctor inserts a clip through the catheter and uses the clip to fasten the leaflets together. Because the clip only closes off part of the valve, blood still flows around the repaired area when the valve opens. When the valve closes, the clip helps the leaflets stay closed and prevents backflow of blood. Two clips are available for mitral valve repair: MitraClip(link is external) (https://mitraclip.com/?gclid=CjwKCAjwxo6IBhBKEiwAXSYBsxdHGpqwvGemzaJUMtJH3JNd3mXtMOdOJw-PblLbVxvNXZfkFYkdqBoCz2IQAvD_BwE&gclsrc=aw.ds)®, which is approved by the Food and Drug Administration (FDA)PASCAL®, which is available through a clinical trialWho is Eligible for Transcatheter Mitral Valve Repair? TMVr(link is external) (https://www.umcvc.org/sites/all/libraries/tinymce/jscripts/tiny_mce/plugins/paste/pasteword.htm#_msocom_1) (link is external) (https://www.umcvc.org/sites/all/libraries/tinymce/jscripts/tiny_mce/plugins/paste/pasteword.htm#_msocom_1)is FDA-approved for high-risk patients who are not candidates for surgery. And clinical trials are underway to determine how effective the procedure is in moderate- and low-risk patients.(link is external) (https://www.umcvc.org/sites/all/libraries/tinymce/jscripts/tiny_mce/plugins/paste/pasteword.htm#_msocom_3) Doctors determine surgical risk by a patient's age and pre-existing medical problems that could lead to complications during or after surgery: High-risk patients are usually older and have multiple chronic conditions. They are more likely to experience serious complications from major surgery.Moderate- and low-risk patients are typically younger and have fewer underlying health problems. They are better able to undergo open procedures with fewer complications.

Thank you! I am aware of these options and Dr Ailawadi is very good at explaining options. We have viewed the actual procedures, kind of by accident. I am 75 years old. Take a look at my valve story. I am not in a high enough risk category yet, to automatically qualify for the Clip, yet Dr Ailawadi seems to think my request for the clip over surgery is the best option due to decreased lung capacity. I too have problems with not being able to just get an FDA device if that's what I need. Can I get a second opinion with mt test information and not go through another round of tests? Here it can take a few months just to get an appointment and the better the known cardiologist is the longer it takes. It would probably not be appreciated for me to contact Dr Bolling who is in the same system????

Hi Linda - just to close the loop, here is the other mitral reference center in Michigan. You could do a virtual visit there, I assume to discuss. Sounds like you are all in on the Clip Option, so I wish you luck on getting it, and a speedy recovery. Corewell Health Butterworth Hospital Reference Surgeons: Charles Willekes, MD, and Edward Murphy, MD 221 Michigan St. NE, Suite 300 Grand Rapids, MI 49503 Telephone: 616-459-7258 Website: https://www.spectrumhealth.org/services/heart-lung-and-vascular-care/heart-and-lung-surgery

Thanks, My husband does all the computer and medical research stuff. He did contact the referring cardiologist about second opinions, U of M and Dr Ailawadi. He will follow up on the Spectrum Health Cardiac system. We are north of Detroit, in general patients with complex problems often end up at U of M. We have the Beaumont - Corewell and the Henry Ford Hospital System close by.

Hi Linda, I have a congenital heart defect and 11 mo ago had open heart at UM with Dr Bolling. My cardiologist recommended Dr Ailawadi, who is cardiac chair, but also was very confident with Dr Bolling, who doesn't as much specialize in minimally invasive. In any case, repair is typically preferred than the clip if your body can tolerate. I think either surgeon would be able to assess what is best for you. Bolling also operated on my father 7 yrs ago. In any case, I highly recommend UM as the surgical center. The overall care was absolutely excellent. Even the Corewell and ascension doctors all recommended UM for mitral valve repair (as well as Mitral Clip).