{"id":401,"date":"2020-10-08T18:03:44","date_gmt":"2020-10-08T18:03:44","guid":{"rendered":"https:\/\/www.heart-valve-surgery.com\/learning\/?page_id=401"},"modified":"2023-09-27T20:08:38","modified_gmt":"2023-09-27T20:08:38","slug":"mitral-dr-vaughn-starnes","status":"publish","type":"page","link":"https:\/\/www.heart-valve-surgery.com\/learning\/mitral-dr-vaughn-starnes\/","title":{"rendered":"Surgeon Q&#038;A: Treating Mitral Valve Disease in 2020"},"content":{"rendered":"<p>During the past 20 years, there has been a rapid transformation specific to the treatment of mitral valve disease.\u00a0 There are new devices, new techniques and new considerations for the management of mitral regurgitation and mitral stenosis.<\/p>\n<p>To answer your questions about the treatment of mitral valve disease, I was very lucky to interview <a href=\"https:\/\/www.heart-valve-surgery.com\/surgeons\/dr-Vaughn-Starnes-Los+Angeles-California.php\">Dr. Vaughn Starnes<\/a>, the Surgeon-in-Chief of Keck Medicine of USC in Los Angeles, California.\u00a0 As may know, Dr. Vaughn Starnes is heart valve specialist who has successfully treated many patients in our community including Arnold Schwarzenegger, Anna Brusso, Nathan Higginbotham and many others (including me).<\/p>\n<p>&nbsp;<\/p>\n<p style=\"text-align: center;\"><iframe loading=\"lazy\" src=\"https:\/\/www.youtube.com\/embed\/6OTWLF-8olA\" width=\"560\" height=\"315\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe><\/p>\n<p>&nbsp;<\/p>\n<h2>Key Points From Dr. Starnes About Mitral Valve Surgery<\/h2>\n<p>There were a lot of great points shared by Dr. Starnes during this interview.\u00a0 So, I jotted them down below:<\/p>\n<ul>\n<li>Dr. Starnes has been treating mitral valve disease for nearly 30 years.\u00a0 Dr. Starnes treats children and adults with heart valve disease.<\/li>\n<li>According to Dr. Starnes, mitral valve surgery is somewhat like plastic surgery.\u00a0 There is a lot of creativity when performing mitral valve operations.<\/li>\n<li>While echocardiograms provide Dr. Starnes a great deal of information before surgery, he is always curious to see the actual condition of the mitral valve after he opens the chest.<\/li>\n<li>The mitral valve is a &#8220;functional valve&#8221; not a &#8220;static valve&#8221;.\u00a0 The mitral valve does not open and close by pressure differential.\u00a0 The valve is attached to the heart by <a href=\"https:\/\/www.heart-valve-surgery.com\/heart-surgery-blog\/2017\/05\/30\/mitral-chordae-chords\/\">strings (chords)<\/a> and papillary muscles.<\/li>\n<li>In America today&#8230; Most disease associated with the mitral valve is called <a href=\"https:\/\/www.heart-valve-surgery.com\/mitral-valve-regurgitation-symptoms-leaking.php\">mitral regurgitation<\/a>, a leaking valve.\u00a0 In the past, mitral stenosis (a narrow valve) was more common due to infection (rheumatic heart disease).<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-medium wp-image-436 aligncenter\" src=\"https:\/\/www.heart-valve-surgery.com\/Images\/mitral-regurgitation-2020.jpg\" alt=\"Mitral Regurgitation\" width=\"600\" height=\"320\" \/><\/p>\n<p>&nbsp;<\/p>\n<ul>\n<li>Symptoms of mitral regurgitation include leg swelling, shortness-of-breath, difficulty exercising and arrhythmias (abnormal heartbeats).<\/li>\n<li>As mitral regurgitation progresses, the patient is at risk for left ventricular dilation, decreasing left ventricular function leading to heart failure, and a dilation of the atrium which can lead to <a href=\"https:\/\/www.heart-valve-surgery.com\/atrial-fibrillation\/\">atrial fibrillation (AFib)<\/a>.\u00a0 AFib, an abnormal heart rhythm, can lead to stroke.<\/li>\n<li>A mitral valve repair, which may include fixing (or adding) mitral strings and\/or implanting a mitral support band (annuloplasty ring), provides advantages for patients including long-term durability and better preserved heart function compared to mitral valve replacement.<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-medium wp-image-440 aligncenter\" src=\"https:\/\/www.heart-valve-surgery.com\/Images\/mitral-valve-strings-chords.jpg\" alt=\"Mitral Valve Strings (Chords)\" width=\"600\" height=\"318\" \/><\/p>\n<p>&nbsp;<\/p>\n<ul>\n<li>Dr. Starnes performs mitral valve replacement procedures for patients who have mitral valves that are stenotic (narrow) or have a calcified annulus, bileaflet issues and\/or coronary artery disease that may cause ischemic mitral disease.<\/li>\n<li>For younger patients (less than 50 years of age) needing mitral valve replacement, Dr. Starnes may use a mechanical heart valve replacement as it is more durable than a tissue valve which can make the patient susceptible to repeated operations.<\/li>\n<li>For patients wanting a tissue valve replacement, Dr. Starnes typically uses a <a href=\"https:\/\/www.heart-valve-surgery.com\/learning\/pig-valve-replacement\/\">pig (porcine) valve<\/a> in the mitral position.\u00a0 His rational for using a pig valve instead of a cow valve in the mitral position is that Dr. Starnes believes a cow valves may get stiffer quicker and develop a gradient faster in the mitral position.\u00a0 Interestingly, Dr. Starnes typically uses a cow valve in the aortic position.<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-medium wp-image-442 aligncenter\" src=\"https:\/\/www.heart-valve-surgery.com\/Images\/pig-valve-replacement-2020.jpg\" alt=\"Pig Valve Replacement\" width=\"600\" height=\"322\" \/><\/p>\n<p>&nbsp;<\/p>\n<ul>\n<li>New surface coating technologies have been developed to prevent the calcification and the durability of mitral valve replacements.<\/li>\n<li>The next generation of mitral valve therapy includes the use of transcatheter technologies for mitral valve repair (e.g. <a href=\"https:\/\/www.heart-valve-surgery.com\/mitraclip\/\">MitraClip<\/a>) and mitral valve replacement.\u00a0 Dr. Starnes believes these technologies have greatly expanded the ability to provide care to high-risk patients.<\/li>\n<li>While transcatheter devices require no incision to the patient&#8217;s chest or ribs, the main advantage for these newer technologies is that patients do not need to be on the heart-lung machine, according to Dr. Starnes.\u00a0 \u00a0The ability to avoid the use of a heart-lung machine for higher-risk (and elderly) patients, who may have vascular disease, is a huge advantage as it can reduce the potential risk of stroke.<\/li>\n<\/ul>\n<p>In closing, Dr. Starnes provided excellent advice to patients with mitral valve disease given the different therapeutic options available today.<\/p>\n<blockquote><p>Understand there is a menu of things that are out there. There\u2019s no one particular one that is best. It\u2019s what\u2019s best for your particular circumstance. If you\u2019re a good surgical risk and you\u2019ve got a mitral valve prolapse or regurgitation, your best option is a surgical repair. If you\u2019re elderly and have got a high-risk for surgery, your best chance is with a MitraClip or even a transcatheter mitral replacement. It\u2019s important that you go to a heart valve center where you have cardiologists and surgeons both looking at your case to give you great advice about what\u2019s best for you.<\/p><\/blockquote>\n<p>&nbsp;<\/p>\n<h2>Thanks Dr. Starnes &amp; USC!!!!<\/h2>\n<p>On behalf of our patient, their families and friends, I want to thank <a href=\"https:\/\/www.heart-valve-surgery.com\/surgeons\/dr-Vaughn-Starnes-Los+Angeles-California.php\">Dr. Starnes<\/a> for sharing his clinical expertise and research specific to the treatment of mitral valve surgery.\u00a0 I also want to thank Dr. Starnes and the entire team at <a href=\"https:\/\/www.heart-valve-surgery.com\/hospital\/usc-heart-valve-clinic-starnes\">Keck Medicine of USC<\/a> for providing excellent care to so many patients with heart valve disease!<\/p>\n<p>Related Articles:<\/p>\n<ul>\n<li><a href=\"https:\/\/www.heart-valve-surgery.com\/mitral-leaflets.php\">Mitral Valve Leaflets: 7 Important Facts<\/a><\/li>\n<li><a href=\"https:\/\/www.heart-valve-surgery.com\/heart-surgery-blog\/2019\/05\/18\/dr-vaughn-starnes-aats-president\/\">Dr. Starnes Named 100th AATS President!<\/a><\/li>\n<\/ul>\n<p>Keep on tickin!<br \/>\nAdam<\/p>\n<p>P.S. For the hearing impaired members of our community, I have provided a written transcript of this interview 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":[13],"class_list":["post-401","page","type-page","status-publish","hentry","category-mitral-valve-repair"],"acf":[],"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/www.heart-valve-surgery.com\/learning\/wp-json\/wp\/v2\/pages\/401","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=401"}],"version-history":[{"count":28,"href":"https:\/\/www.heart-valve-surgery.com\/learning\/wp-json\/wp\/v2\/pages\/401\/revisions"}],"predecessor-version":[{"id":3879,"href":"https:\/\/www.heart-valve-surgery.com\/learning\/wp-json\/wp\/v2\/pages\/401\/revisions\/3879"}],"wp:attachment":[{"href":"https:\/\/www.heart-valve-surgery.com\/learning\/wp-json\/wp\/v2\/media?parent=401"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.heart-valve-surgery.com\/learning\/wp-json\/wp\/v2\/categories?post=401"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}