{"id":2378,"date":"2022-07-22T18:53:31","date_gmt":"2022-07-22T18:53:31","guid":{"rendered":"https:\/\/www.heart-valve-surgery.com\/learning\/?page_id=2378"},"modified":"2025-12-05T20:07:06","modified_gmt":"2025-12-05T20:07:06","slug":"shared-decision-making-dr-eric-roselli","status":"publish","type":"page","link":"https:\/\/www.heart-valve-surgery.com\/learning\/shared-decision-making-dr-eric-roselli\/","title":{"rendered":"Ari&#8217;s Patient Success Story: The Value of Shared Decision-Making for Patients &#038; Surgeons"},"content":{"rendered":"<p>Thirty years after meeting on a football field at the University of Michigan, the friendship of Ari Mintzer and Dr. Eric Roselli took an interesting turn.<\/p>\n<p>Ari, an attorney from Highland Park, Illinois, needed help.\u00a0 His first aortic valve replacement, implanted in 2007, was failing.\u00a0 He was short of breath. Ari needed another heart surgery.\u00a0 During his search for answers, Ari called <a href=\"https:\/\/www.heart-valve-surgery.com\/surgeons\/dr-Eric-Roselli-Cleveland-Ohio.php\">Dr. Eric Roselli<\/a>, his old friend, who was now the Chief of Adult Cardiac Surgery at the Cleveland Clinic and an aortic valve specialist.<\/p>\n<p>This is the story of Ari and Dr. Roselli, their friendship, and their shared-decision making processes as patient and surgeon.<\/p>\n<p>&nbsp;<\/p>\n<p style=\"text-align: center;\"><iframe loading=\"lazy\" title=\"YouTube video player\" src=\"https:\/\/www.youtube.com\/embed\/mbVTFGTOZjY?rel=0\" width=\"560\" height=\"315\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe><\/p>\n<p>&nbsp;<\/p>\n<h2>Key Learnings From Ari&#8217;s Patient Success Story<\/h2>\n<p>Here are important insights specific to Ari&#8217;s story, the lifetime management of heart valve disease and shared decision-making opportunities:<\/p>\n<ul>\n<li>Ari was born with a <a href=\"https:\/\/www.heart-valve-surgery.com\/bicuspid-aortic-valve-symptoms.php\">bicuspid aortic valve<\/a> that required a surgical aortic valve replacement (SAVR) and an <a href=\"https:\/\/www.heart-valve-surgery.com\/aortic-aneurysm.php\">aortic aneurysm<\/a> repair in 2007.\u00a0 Ari selected a <a href=\"https:\/\/www.heart-valve-surgery.com\/cow-valve-replacement.php\">cow (bovine) valve replacement<\/a> knowing that in the future he would need another operation.\u00a0 Most tissue valves &#8211; cow valves or <a href=\"https:\/\/www.heart-valve-surgery.com\/learning\/pig-valve-replacement\/\">pig valves<\/a> &#8211; last between 10 to 15 years.<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-full aligncenter\" src=\"https:\/\/www.heart-valve-surgery.com\/Images\/bicuspid-aortic-valve-comparison.jpg\" alt=\"Bicsupid Aortic Valve\" width=\"600\" height=\"269\" \/><\/p>\n<p>&nbsp;<\/p>\n<ul>\n<li>Following his initial SAVR, Ari had no health issues for the next 13 years until the cow valve began to fail. Ari became symptomatic and began to feel short of breath upon exertion.<\/li>\n<li>According to Dr. Roselli, the diagnosis of a bicuspid aortic valve and an aortic aneurysm is very common among his patients.\u00a0 &#8220;We know that close to 2% of the population is born with an abnormal aortic valve. It gets broadly categorized as bicuspid aortic valve but there\u2019s a real spectrum of how that congenital abnormality presents in different people,&#8221; states Dr. Roselli. &#8220;We have patients that range from infancy to their 80s. A lot of patients had aneurysms associated with the valve dysfunction.&#8221;<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-full wp-image-2391 aligncenter\" src=\"https:\/\/www.heart-valve-surgery.com\/learning\/..\/Images\/ari-mintzer-family-heart-valve-patient.jpg\" alt=\"Ari Mintzer with Family\" width=\"700\" height=\"387\" \/><\/p>\n<p>&nbsp;<\/p>\n<ul>\n<li>Using a shared decision-making approach, Ari and Dr. Roselli developed a unique 50-year strategy for Ari&#8217;s lifetime management of heart valve disease.<\/li>\n<li>While a <a href=\"https:\/\/www.heart-valve-surgery.com\/mechanical-prosthetic-heart-valve.php\">mechanical valve replacement<\/a> may have provided Ari a lifetime solution, given the potential long-term durability of mechanical valves, Ari is very active and did not want to be on blood thinners (e.g. warfarin) for the rest of his life.<\/li>\n<li>To avoid another incision to his chest, Ari considered a <a href=\"https:\/\/www.heart-valve-surgery.com\/tavr-procedure.php\/\">transcatheter aortic valve replacement (TAVR)<\/a>.\u00a0 However, the durability of TAVR, using a Valve-in-Valve approach, was questionable given the lack of research, data and outcomes for younger patients.<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-full wp-image-2392 aligncenter\" src=\"https:\/\/www.heart-valve-surgery.com\/learning\/..\/Images\/Aortic-Valve-Re-Replacement-Options.jpg\" alt=\"Aortic Valve Re-Replacement Options\" width=\"700\" height=\"392\" \/><\/p>\n<p>&nbsp;<\/p>\n<ul>\n<li>Ari and Dr. Roselli also considered the <a href=\"https:\/\/www.heart-valve-surgery.com\/learning\/ross-procedure\/\">Ross Procedure<\/a>. Ari states, &#8220;I was dead set on going with the Ross Procedure for a period of time. It just was one of those things where, at the end of the day, there was a potential risk of creating another valve problem on the pulmonary side.&#8221; Reflecting on the possibility of a\u00a0 Ross Procedure for Ari, Dr. Roselli states, &#8220;I\u2019m a little stricter about who I do Ross Procedures on. In Ari\u2019s particular situation, he&#8217;s already had his aortic root and his ascending aorta replaced.\u00a0 It didn\u2019t make sense to do a Ross Procedure as the redo in a guy who had a history of aortopathy whose valve was degenerated.&#8221;<\/li>\n<li>After many conversations, Ari and Dr. Roselli collectively felt a second SAVR was the best option for Ari&#8217;s next procedure. Ari states, &#8220;I had surgical aortic valve re-replacement with another cow tissue valve. We went with a bigger valve this time so that we could do a Valve-in-Valve down the road.&#8221;<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-full wp-image-2393 aligncenter\" src=\"https:\/\/www.heart-valve-surgery.com\/learning\/..\/Images\/Ari-Mintzer-After-Heart-Valve-Surgery.jpg\" alt=\"Ari Mintzer After Aortic Valve Replacement\" width=\"700\" height=\"392\" \/><\/p>\n<p>&nbsp;<\/p>\n<ul>\n<li>According to Dr. Roselli, &#8220;shared decision-making&#8221; is an important topic right now.\u00a0 Dr. Roselli states, &#8220;It\u2019s kind of a buzzword topic these days. I\u2019m glad because in the current world of healthcare where you have really a really broad spectrum of decisions to make, which is nice, but also can be very confusing. In the end of the 1800s, it was considered ethically wrong for a patient to not listen to their doctor. We don\u2019t live in that kind of world now. It\u2019s great that we don\u2019t because there\u2019s knowledge everywhere for everybody.\u00a0 I love it when a patient comes in with one of those yellow legal pads full of questions.\u00a0 Even physicians have these guidelines. It\u2019s a guideline. For any individual patient, your decision should be personal. They should be tailored to all of your medical specifics and your personal desires as well as the expertise of that physician you\u2019re working with. To me, that\u2019s what shared decision-making means. I think everybody does better when we embrace this concept.&#8221;<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p style=\"text-align: center;\"><a href=\"https:\/\/www.heart-valve-surgery.com\/surgeons\/dr-Eric-Roselli-Cleveland-Ohio.php\"><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter size-full\" src=\"https:\/\/www.heart-valve-surgery.com\/profileImages\/71_129_161.jpg\" alt=\"Dr. Eric Roselli\" width=\"129\" height=\"161\" \/><\/a><a href=\"https:\/\/www.heart-valve-surgery.com\/surgeons\/dr-Eric-Roselli-Cleveland-Ohio.php\">Dr. Eric Roselli<\/a><\/p>\n<p>&nbsp;<\/p>\n<ul>\n<li>Ari&#8217;s advice to patients is to gather as much knowledge as possible about your disease, your medical team and your treatment options. &#8220;It starts with knowledge. I know it\u2019s clich\u00e9. Knowledge is power. But it really is, especially in this world,&#8221; states Ari.<\/li>\n<li>Dr. Roselli&#8217;s advice to patients complements Ari&#8217;s point about knowledge.\u00a0 &#8220;Knowledge is power. The reason is because fear comes from the unknown. I have seen this over and over again where I meet with a patient. I can tell sometimes they don\u2019t know how to ask the right questions. But, I can tell they don\u2019t understand the situation. I think it\u2019s our responsibility to make sure that when we leave the office, the patient understands enough that they feel comfortable with the decisions they\u2019ve made. Sometimes it means drawing a picture or finding some way to communicate with them and make sure that their questions are answered.&#8221;<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<h2>Many Thanks to Ari, Dr. Roselli and Cleveland Clinic<\/h2>\n<p>On behalf of our patient community, many thanks to Ari and Dr. Roselli for sharing their fantastic story with us.\u00a0 We also want to thank the entire Cleveland Clinic team for taking such great care of patients with heart valve disease.<\/p>\n<p>Related Links:<\/p>\n<ul>\n<li><a href=\"https:\/\/www.heart-valve-surgery.com\/surgeons\/dr-Eric-Roselli-Cleveland-Ohio.php\">See Dr. Eric Roselli&#8217;s Interactive Surgeon Profile<\/a><\/li>\n<li><a href=\"https:\/\/www.heart-valve-surgery.com\/bicuspid-aneurysm-modified-david-procedure.php\">Heart Surgery Innovations: Bicuspid Aortic Valve &amp; Aortic Aneurysms with Dr. Eric Roselli<\/a><\/li>\n<li><a href=\"https:\/\/www.heart-valve-surgery.com\/hospital\/cleveland-clinic-microsite\">Explore the Cleveland Clinic Heart Valve Microsite<\/a><\/li>\n<\/ul>\n<p>Keep on tickin!<br \/>\nAdam<\/p>\n<p>P.S. I didn&#8217;t mention it above&#8230; But, I attended the University of Michigan at the same time as Ari and Dr. Roselli.\u00a0 In fact, the three of us were in the same fraternity, Sigma Alpha Mu, and Dr. Roselli was my &#8220;Big Brother&#8221; in that fraternity.\u00a0 I can not be more happy and more thankful knowing that Ari&#8217;s heart is doing great thanks to Dr. Roselli.<\/p>\n<p>P.P.S. I have provided a written transcript of this video interview below for the the deaf and hard of hearing members of our community.<\/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":[14],"class_list":["post-2378","page","type-page","status-publish","hentry","category-patient-stories"],"acf":[],"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/www.heart-valve-surgery.com\/learning\/wp-json\/wp\/v2\/pages\/2378","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=2378"}],"version-history":[{"count":20,"href":"https:\/\/www.heart-valve-surgery.com\/learning\/wp-json\/wp\/v2\/pages\/2378\/revisions"}],"predecessor-version":[{"id":6356,"href":"https:\/\/www.heart-valve-surgery.com\/learning\/wp-json\/wp\/v2\/pages\/2378\/revisions\/6356"}],"wp:attachment":[{"href":"https:\/\/www.heart-valve-surgery.com\/learning\/wp-json\/wp\/v2\/media?parent=2378"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.heart-valve-surgery.com\/learning\/wp-json\/wp\/v2\/categories?post=2378"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}