{"id":2207,"date":"2022-05-18T18:49:08","date_gmt":"2022-05-18T18:49:08","guid":{"rendered":"https:\/\/www.heart-valve-surgery.com\/learning\/?page_id=2207"},"modified":"2025-06-10T00:09:06","modified_gmt":"2025-06-10T00:09:06","slug":"calcification-stroke-risk-gerdisch","status":"publish","type":"page","link":"https:\/\/www.heart-valve-surgery.com\/learning\/calcification-stroke-risk-gerdisch\/","title":{"rendered":"Stroke Risk &#038; Heart Valve Calcification: What Should Patients Know?"},"content":{"rendered":"<p>For many patients, calcium build-up on heart valves is considered &#8220;Public Enemy No. 1&#8221; as calcified valves lead to stenosis, debilitating symptoms, heart failure and death.\u00a0 In addition, as we recently reported <a href=\"https:\/\/www.heart-valve-surgery.com\/heart-surgery-blog\/2022\/04\/27\/calcium-supplements\/\">here<\/a>, our community of patients and medical care providers are learning about potential risks of calcium supplements for older patients.<\/p>\n<p>As a result, my inbox has lit up with great questions about calcium and heart valve disease.\u00a0 In particular, patients are concerned about whether-or-not calcium deposits on a diseased heart valve can &#8220;break off&#8221; and cause a stroke.\u00a0 To learn about calcified valves and stroke risk, we interviewed <a href=\"https:\/\/www.heart-valve-surgery.com\/surgeons\/dr-Marc-Gerdisch-Indianapolis-Indiana.php\">Dr. Marc Gerdisch<\/a>, the Chief of Cardiac Surgery at Franciscan Health in Indianapolis, Indiana. Dr. Gerdisch is a heart valve expert who has performed more than 4,000 heart valve repair and replacement operations.\u00a0 In our community, Dr. Gerdisch has successfully treated over 120 patients including Dan Rhoden and Janelle Hurst.<\/p>\n<p>&nbsp;<\/p>\n<p style=\"text-align: center;\"><iframe loading=\"lazy\" title=\"YouTube video player\" src=\"https:\/\/www.youtube.com\/embed\/wvSsw1ps_ak\" width=\"560\" height=\"315\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe><\/p>\n<p>&nbsp;<\/p>\n<h2>Key Learnings About Heart Valve Calcification &amp; Stroke Risk<\/h2>\n<p>Important learnings shared by Dr. Gerdisch in our interview include:<\/p>\n<ul>\n<li>Calcified heart valves are stiff and narrowed which blocks blood flow through the valve, the heart and, ultimately, the body.<\/li>\n<li>Calcification is a function of metabolic changes in the leaflets and valve structure.\u00a0 The changes can occur due to atherosclerotic changes, inflammation, and abnormal cell development.\u00a0 As Dr. Gerdisch states, &#8220;When we\u2019re talking about calcium in the body, we\u2019re talking about something similar to bone. It\u2019s getting deposited, not in an organized fashion like a bone, but getting deposited in this inflamed space that induces the stiffening of the leaflets. Overtime, they can become rock hard.&#8221;<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p style=\"text-align: center;\"><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter size-full\" src=\"https:\/\/www.heart-valve-surgery.com\/profileImages\/306_129_173.jpg\" alt=\"Dr. Marc Gerdisch\" width=\"129\" height=\"173\" \/><a href=\"https:\/\/www.heart-valve-surgery.com\/surgeons\/dr-Marc-Gerdisch-Indianapolis-Indiana.php\">Dr. Marc Gerdisch<\/a><\/p>\n<p>&nbsp;<\/p>\n<ul>\n<li>Risk factors that may lead to atherosclerosis (calcification) include smoking, diabetes and hypertension (high blood pressure).\u00a0According to Dr. Gerdisch, genetic pre-disposition plays a critical role in the development of heart valve calcification. In addition, patients who undergo radiation to their chest may struggle with aortic and mitral stenosis. Rheumatic disease is another source of calcified heart valves.<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter \" src=\"https:\/\/www.heart-valve-surgery.com\/Images\/calcified-aortic-valve-tavr.jpg\" alt=\"Calcified Aortic Valve Leaflets\" width=\"700\" height=\"390\" \/><\/p>\n<p>&nbsp;<\/p>\n<ul>\n<li>Age-related calcification is a newer consideration for patients and their medical teams. Dr. Gerdisch states, &#8220;Folks develop age-related calcification, both in the aortic valve, the leaflets, and the annulus, which is where the valve leaflets attach, but also in the mitral valve. We\u2019re seeing more of that, especially in women. That\u2019s heavy calcification in the annulus, the ring around the valve. Very difficult to manage and treat because that calcification can grow through the wall of a heart.&#8221;<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-full wp-image-2212 aligncenter\" src=\"https:\/\/www.heart-valve-surgery.com\/learning\/..\/Images\/heart-valve-calcification-causes-gerdisch.jpg\" alt=\"Heart Valve Calcification Causes\" width=\"700\" height=\"392\" \/><\/p>\n<p>&nbsp;<\/p>\n<ul>\n<li>Specific to the risk of calcium &#8220;breaking off&#8221; a heart valve and causing a stroke (thromboembolism event), Dr. Gerdisch believes that is possible but very rare. &#8220;Another concern that people have, and it\u2019s legitimate, is can that calcification break off? Can it mobilize and embolize?&#8221; states Dr. Gerdisch, &#8220;The answer is yes, but it is rare. It has always been fascinating to me when I look at a valve in the operating room, aortic or mitral, but especially aortic we see this in, and we just touch that valve and the calcium will just break off. You can\u2019t believe that it doesn\u2019t come off all the time.&#8221;<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-full wp-image-2213 aligncenter\" src=\"https:\/\/www.heart-valve-surgery.com\/learning\/..\/Images\/stroke-risk-heart-valve-calcification-break-off.jpg\" alt=\"Stroke Risk &amp; Heart Valve Calcifcation\" width=\"700\" height=\"392\" \/><\/p>\n<p>&nbsp;<\/p>\n<ul>\n<li>Dr. Gerdisch is sensitive to any form of &#8220;mobile calcium&#8221; that is detected under echocardiography which is ultimately treated surgically or via transcatheter approaches. Dr. Gerdisch states, &#8220;If you had an echocardiogram and you see calcium that\u2019s flipping around, then that\u2019s a little bit more concerning. We will see at times filamentous or mobile calcium. The other important concern for us is that when we do something to the valve that we ensure that that calcium doesn\u2019t go anywhere that it\u2019s not supposed to go. It\u2019s very straightforward when, for example, we replace a valve or work on a calcified valve directly in surgery with an open heart because we can see it all. We take the calcium out. When we do transcatheter interventions, especially when we do transcatheter aortic valve replacements (TAVR), we don\u2019t have that luxury. We\u2019ve learned that if we see anything mobile, then we should \u2013 we can protect the cerebral vasculature.&#8221;<\/li>\n<li>De-calcification surgical techniques are used by Dr. Gerdisch when possible to help patients retain their own tissue which is advantageous for long-term outcomes. Dr. Gerdisch states, &#8220;We\u2019ll take a piece of calcium out and reconstruct the valve, do what we need to do to make the valve soft and working again because our goal still remains to leave the patient with their own tissue. Folks all know about this at some degree, but every time we can leave you with your own tissue, you\u2019re better off. &#8220;<\/li>\n<li>Patients with calcified heart valves need to have thoughtful conversations about treatment approaches (repair versus replacement) specific to durability and quality-of-life. Should a patient and their medical team determine a heart valve replacement is required, a discussion of which valve to select &#8211; mechanical or tissue valve &#8211; is critical.\u00a0 While mechanical valves do not &#8220;re-calcify&#8221;, the patient is required to be on blood thinners for the balance of their lives. While tissue valves do not require blood thinners, the cow or pig tissue tends to start deteriorating upon implant. Dr. Gerdisch states, &#8220;Once you put that tissue valve in, it starts to deteriorate. Part of that deterioration is very similar to what\u2019s happening to a native valve, inflammation, calcification.&#8221;<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-full wp-image-2214 aligncenter\" src=\"https:\/\/www.heart-valve-surgery.com\/learning\/..\/Images\/Extracellular_Matrix_Gerdisch-Heart-Valve.jpg\" alt=\"Extracellular Matrix Heart Valve Tissue Engineering\" width=\"700\" height=\"469\" \/><\/p>\n<p>&nbsp;<\/p>\n<ul>\n<li>Looking into the future&#8230; Dr. Gerdisch is currently researching-and-developing new forms of tissue for heart valve replacement devices. Dr. Gerdisch states, &#8220;The last thing I would add is tissue engineering, which we\u2019ve been working on for 15 years. The past decade, we\u2019ve made some real progress. We have a valve that is made of extracellular matrix, which that\u2019s in the midst of an FDA study. Our goal there is to provide matrix for the patient to build their own tissue and hopefully have a native valve again. Probably it won\u2019t be perfect, but it might get closer to something that will last a long time and behave like their own tissue.&#8221;<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<h2>Many Thanks Dr. Gerdisch &amp; Franciscan Health!<\/h2>\n<p>On behalf of our entire patient community, many thanks to <a href=\"https:\/\/www.heart-valve-surgery.com\/surgeons\/dr-Marc-Gerdisch-Indianapolis-Indiana.php\">Dr. Gerdisch<\/a> for sharing his clinical experience and research with our community!\u00a0 Also, many thanks to the Franciscan Health team for taking such great care of heart valve patients.<\/p>\n<p>Related links:<\/p>\n<ul>\n<li><a href=\"https:\/\/www.heart-valve-surgery.com\/learning\/coronary-artery-disease\/\">Coronary Artery Disease &amp; Heart Valve Surgery: Top 9 Facts<\/a><\/li>\n<li><a href=\"https:\/\/www.heart-valve-surgery.com\/learning\/atrial-fibrillation-cox-maze-iv\/\">Atrial Fibrillation: A Concern for Heart Valve Patients<\/a><\/li>\n<li><a href=\"https:\/\/www.heart-valve-surgery.com\/learning\/need-for-mitral-surgery-gerdisch\/\">Surgeon Q&amp;A: Will I Need Mitral Valve Surgery?<\/a><\/li>\n<li><a href=\"https:\/\/www.heart-valve-surgery.com\/learning\/tavr-stroke-risk-prevention-dr-isaac-george\/\">Stroke Risk &amp; TAVR: What Should Patients Know?<\/a><\/li>\n<\/ul>\n<p>Keep on tickin!<br \/>\nAdam<\/p>\n<p>P.S. For the hearing impaired members of our patient community, I have provided a written transcript of this video below.<\/p>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":2,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"cms.php","meta":{"_acf_changed":false,"footnotes":""},"categories":[15],"class_list":["post-2207","page","type-page","status-publish","hentry","category-recovery"],"acf":[],"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/www.heart-valve-surgery.com\/learning\/wp-json\/wp\/v2\/pages\/2207","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.heart-valve-surgery.com\/learning\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.heart-valve-surgery.com\/learning\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.heart-valve-surgery.com\/learning\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.heart-valve-surgery.com\/learning\/wp-json\/wp\/v2\/comments?post=2207"}],"version-history":[{"count":19,"href":"https:\/\/www.heart-valve-surgery.com\/learning\/wp-json\/wp\/v2\/pages\/2207\/revisions"}],"predecessor-version":[{"id":5894,"href":"https:\/\/www.heart-valve-surgery.com\/learning\/wp-json\/wp\/v2\/pages\/2207\/revisions\/5894"}],"wp:attachment":[{"href":"https:\/\/www.heart-valve-surgery.com\/learning\/wp-json\/wp\/v2\/media?parent=2207"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.heart-valve-surgery.com\/learning\/wp-json\/wp\/v2\/categories?post=2207"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}