About Dr. Michael Bowdish,
Heart Valve Surgeon

"My life was in danger, and I didn’t even know it. I was walking around with an aneurysm that had swollen to over five centimeters. My defective aortic valve had increased the blood pressure against my aortic arch, contributing to its dangerous enlargement. On Thursday, June 6, as I was doing a crossword puzzle on my I-Pad, I felt a sudden, stabbing pain in the middle of my chest. When deep breathing didn’t resolve the pain, I called a friend who took me to the emergency room at Huntington Memorial. Upon arrival, I was immediately placed in the ICU and things seemed to go from zero to sixty very quickly. Scans would reveal my condition. While my memories of this stressful time are quite cloudy, there was one moment of clarity that brought firmness to my understanding. I had a visit from several doctors – one of whom was Dr. Michael Bowdish. He said with unerring directness, “We have consulted and decided that we need to address your heart problems first. You have a defective aortic valve and aneurysms of the ascending and descending aortas. We have to operate – now.” Dr. Bowdish then told me that he wanted to transfer me to Cedars-Sinai where he had the right equipment for the type of surgery I needed.

It's easy to experience fear and confusion when hearing a diagnosis of heart valve and aneurysm disease. But I was immediately calmed by Dr. Bowdish’s manner of explaining things. He started by taking a piece of paper and drawing a picture of my heart and aorta for me. “This is what we need to do,” he said. “You need an elephant trunk procedure, which is a replacement of both your ascending and descending aortas, and the aortic arch that connects them.” Dr. Bowdish has a friendly and direct communicative style. He is authoritative without being bossy or condescending. He exudes just the right amount of confidence. And he is firm - but without brow beating or fear mongering. With the confidence he communicates, there was no question in my mind that we should proceed exactly as Dr. Bowdish explained. I immediately knew I was in good hands.

I was fortunate that in Dr. Bowdish I had a surgeon qualified to perform my surgery at the number two heart surgery hospital in the entire United States. The staffs at both Cedars and Huntington moved heaven and earth to transfer me to Cedars for my surgery with Dr. Bowdish. Having worked as a hospital volunteer in a surgical waiting area for families, I have come to understand how hospitals work behind the scenes. And I can tell you – the cooperation between Cedars-Sinai and its Huntington Memorial affiliate in Pasadena — is HUGE. Their collaboration means that with patient records shared through a program called EPIC, my transfer to Cedars would be immediate and seamless. This complete transparency between the two hospitals means that all the doctors at both hospitals have immediate contact with each other along with access to the same patient records. Throughout both my pre and post operative experiences, the ability of both hospitals to interact was awesome. I could not have asked for a better team arrangement.

And despite the gravity of my diagnosis, Dr. Bowdish helped me to feel safe, calm, and assured. When three of my siblings were with me in the hospital prior to my surgery, I had the physicians’ assistant bring Dr. Bowdish in to meet with them. As he explained the procedure, Dr. Bowdish said that he was going to make a “game time decision” as to whether a complete replacement of the ascending aorta, aortic arch, and descending aorta (elephant trunk) would be needed. Or, if the replacement of the ascending and descending aorta could be broken up into two separate surgeries, with the root, ascending aorta, and arch coming first; and the descending aorta being replaced through a minimally invasive procedure called a TEVAR, at a later date. This second option is what Dr. Bowdish and his team would opt for. The TEVAR is a minimally invasive procedure where a sheath is inserted into aorta with a catheter through the groin, leading to a shorter hospital stay and less discomfort for the patient. Throughout all my interactions with Dr. Bowdish, I appreciated his candor. In his presentation to my family, Dr. Bowdish didn’t pretend to know all the answers about exactly which procedure he would decide upon once his team had me opened up. But he did convey absolute confidence that he would be able to skillfully execute for any contingency once he and his team could have a closer look at my internal anatomy.

There is also a genetic aspect to my diagnosis. Aneurysms can run in families. One of my uncles died from an aortic aneurysm years ago. I had been diagnosed with a three-centimeter aneurysm two years ago. Surgery is recommended at 5 centimeters. Aneurysms like mine - while fatal if not treated - are often asymptomatic and can only be detected in two ways: either through scans confirming that the 5 cm threshold has been reached and that surgery is needed; or, through a sudden, painful episode in which one may have just minutes or hours before the aneurysm ruptures, causing fatal internal bleeding within just one to two minutes. In my case, I had not had a follow up scan of my aorta since the 3 cm aneurysm was detected a few years ago. My painful attack was my only and final warning. That is why I applaud efforts to encourage annual scans for patients with a known risk, including those from families with a history of aneurysms. I also support efforts to promote aneurysm education throughout the medical community, as awareness of this silent killer has only been emerging in recent years.

I was nervous as I awaited surgery. But the environment in the cardiac unit at Cedars gave me comfort. My room had a view of the large glass bridge structure that unites the main hospital with the critical care tower on floors three through eight. As I lay there looking out, I was impressed at the processions of entire OR teams accompanying patients emerging from surgery and then handing them off to the waiting ICU teams. It was so meaningful to me to see the OR team going to debrief the ICU teams in the patient transfer process. Every team member looked so focused and committed. It was as if the OR team was saying to the ICU team, “we’ve done our job, now here’s what you need to know to do yours.” Witnessing these processions made me feel that patient care is the highest priority of every team member in every department at Cedars. And then, on the day of surgery as I was on my way to Pre-Op, Moxi, the robot, gave me heart and star eyes as I was wheeled onto the elevator. This thoughtful gesture from the little cyber creature that rolls through the hallways at Cedars made my day. Moxi normally hands out medications to patients. But for me - Moxi was dispensing good will. It was the humorous touch that I needed as I mentally prepared for the operation.

After a seven-hour surgery on June 13, I woke up at about 2 am the next day. Still intubated, I would remain that way until extubated at 3 am. Within another twelve hours, I was up walking in the halls of the ICU. During my stay in the ICU, I experienced post operative A-fib, which the doctors told me is not unusual. I also needed to have fluid withdrawn from my lungs with a procedure called “thoracentesis,” which is also not uncommon. After three days in the ICU, I was transferred to a regular hospital room. Dr. Bowdish visited me a few times after my surgery and stayed on top of everything. He was constantly aware of my progress. He and the staff monitored my wound recovery very closely. By June 21, eight days after the surgery, I was released from Cedars and sent to an acute rehab clinic at Huntington Hospital. I did well there until I had trouble with bleeding from a stomach ulcer that was unrelated to my valvular and aortic surgery. Units of blood were administered to replenish what I had lost. By July 12, one month after my surgery at Cedars, I was released from the rehab at Huntington. Throughout my stay at both hospitals, the doctors, nurses, and physicians’ assistants were all wonderful and fully attentive to every one of my needs.

Two months after my surgery, I feel much better. With my heart valve replaced with a cow valve, my energy has improved, and I am getting around quite well. I wore a ZIO Patch for two weeks to monitor my heart rhythm to ensure the resolution of my post operative A-Fib. My only concern is weight loss due to decreased appetite. Now, I am anticipating the minimally invasive TEVAR procedure needed to replace my descending aorta. I am comforted that Dr. Bowdish will be present for this surgery. Dr. Bowdish’s continued involvement shows that he is vested in his patients. And this is just one of the many reasons that I can recommend Dr. Bowdish so strongly to others who are in need of a surgeon for their valvular and aortic diagnoses.

As I look back, I think of Dr. Bowdish as one who communicated with me in the way that I needed. I handle difficult news and make decisions best when I am provided with lots of facts without sugar coating. Dr. Bowdish’s warm personality, and his confidence and assurances helped me along with his careful descriptions of my procedure and his treatment plan. All the members of Dr. Bowdish’s care team have great bedside manners and I felt they had a truly vested interest in making me better. I know that they’re a team because a seven-hour operation to perform delicate tasks can only be accomplished through collaboration and harmonization with people that a world class surgeon can have confidence in. Yet, when they say, “we do lots of cases like these,” there was never a sense that mine was just the next numbered ticket being called. At all times, Dr. Bowdish and his team made me feel that my case – not the hundreds of others they have done – was the most important case in the world and the only one that mattered. And this perspective summarizes how Dr. Bowdish and the care teams at Cedars and Huntington make their patients feel. For the feeling of being the most important patient of all — is the feeling that matters most."

-- Marcia G., Aortic Valve, Valve Replacement, Median Sternotomy, Root Replacement, 06/13/2024

"Five years prior to my surgery, I was having a routine blood panel done every six months when my doctor asked if I knew that I had a heart murmur. My primary care doctor then authorized an echocardiogram. This is when I learned that I was born with a bicuspid aortic valve, meaning that my aortic valve had two leaflets, instead of the normal three. It can take years for this congenital defect to finally produce symptoms. My symptoms came from aortic stenosis, a narrowing of the aortic valve due to calcification, which is common in people with bicuspid aortic valves.

With aortic stenosis, not enough oxygenated blood is circulated throughout the body, leading to the feelings of weakness and being out of breath. I knew that someday my symptoms would get worse as my valve started to leak more and that I would eventually need surgery. For the first few years after my diagnosis, my cardiologist kept telling me that my valve was getting narrower, but that I had not yet reached the point of needing surgery. And there was another danger: the increased pressure of the blood flowing through my defective heart valve had caused a dangerous expansion of the aorta, the large blood vessel carrying blood away from my heart. This expansion is called an aneurysm and can lead to a sudden, fatal bursting of the great vessel. And so, I kept having that feeling in the back of my mind that I would someday need surgery. I managed that feeling by telling myself, “I am cool.” But as the years passed, I stated getting winded walking up hills. Unsettling experiences began to accumulate. I would have trouble climbing stairs. Even walking was taxing, and would leave me needing to rest a few minutes just to catch my breath. I had reached a point where I no longer wanted to live this way. It was then that my cardiologist looked me in the eye and said, “the time for surgery has come.”

That is when I found Dr. Bowdish. My cardiologist referred me to the Cedars-Sinai affiliate, Huntington Health, where Dr. Bowdish was the team member selected due to his combination of aortic and valvular expertise. And as heart surgery goes, it was great. But to be clear – this was a scary experience. The fears mounted: the fear of a big operation; anxiety about the future of my family; and the fear of death – all built up in inside of me. But as these feelings churned inside me, I came to an epiphany: and that was the realization that we are all so fortunate to live in a time and place where we can go through surgeries like this and expect not only to survive – but to thrive. I knew that I had at least a 99% chance of surviving and having a much, much better life. I kept telling myself, “Don’t be a baby.” And I could center myself around the realization that “it’s not going to be so bad.” I decided to live in the 99% (or greater) chance of a successful outcome, instead of the 1% (or less) chance of mortality. And I appreciated the way that Dr. Bowdish spoke with me. He gave me the facts in a straightforward way that projected confidence without condescension. Dr. Bowdish gave me a really strong sense of the deep experience of his team, and that “we know how to do this.” Dr. Bowdish’s clarity and confidence really helped.

Two and a half months after being told that the time for surgery had arrived, I had my surgery. The worst part of the experience was waking up with a tube in my throat. I had been told to expect this. Being heavily drugged probably helped. During these first hours following surgery, I was tapping Morse Code to the nurses and my family. I was also in pain just from lying down and could not wait to sit up. But I didn’t have to wait long to have my wishes granted. The tube was out later that first day, and the very next day I was up and walking two to three laps around the ward.

Arriving for my surgery on a Tuesday, I was released home on Saturday with orders to start walking. I was told that my post operative fever that weekend was not unusual, and it did go away soon, as promised. Six days after my surgery, on the following Monday, I was walking on a treadmill. Within a few weeks, I was able to walk a couple of miles.

Now, five months after my surgery, my symptoms are all gone. I had forgotten how good it feels to have a normal life. I recently visited a town in South Carolina and asked my wife, “weren’t these sidewalks steeper last year?” Now, as I climb the stairs within my home office, that feeling of windedness simply never comes. It’s an amazing feeling to have the years of accumulating worry behind me, and to finally know that my heart is healthy. And so, I feel very strongly in recommending Dr. Bowdish and his entire team. I also must give a special shout out to the nurses in the ICU. Dr. Bowdish’s nurse practitioner, Sunita, is especially great. The entire staff in the ICU is simply wonderful. They always made me feel so well cared for - as if I was never out of sight or mind. I am glad that I came to the realization that we live in times when the greatest healthcare is now possible, and that people can survive great challenges and go on to live fulfilling lives. For it is a realization that Dr. Bowdish and his team justify with every patient they treat."

-- James McCarthy, Aortic Valve, Valve Replacement, Median Sternotomy, Root Replacement, 04/16/2024

"Dr. Bowdish was just incredible! He was very informative as to why I needed surgery and instilled confidence in me that this was the right thing to do and that I would be fine. I owe Dr. Bowdish my life and can never thank them enough for the great work he does."

-- Joseph Scott, Aortic Valve, Valve Replacement, MitraClip, Root Replacement, Coronary Artery Bypass, Maze Procedure, 03/25/2024

"I can truly say that Dr. Bowdish brought me back from the brink. Life is good in the Tennessee countryside about an hour south of Nashville. But in the spring of 2023, I endured an experience that nearly cost me everything. I was in LA on business back in April when I started to realize that I wasn’t feeling well. I became so sick that I was delirious and disoriented. It reached the point where my colleagues found me on a bench at LAX when I made an unsuccessful attempt to return home. I am grateful that they knew to ask the ambulance driver to take me to Cedars-Sinai. It was then that doctors realized that the culprit behind this was MRSA, a bacterial infection that can be hard to treat. To make matters worse, my MRSA had entered my bloodstream and became sepsis - a general infection throughout my entire body. The condition can be fatal if not treated properly and immediately.

We also then learned that the cause was from a mechanical heart valve implanted in Nashville fourteen years before. The valve had become infected. And with each beat of my heart, the infection was being spread throughout my entire body. This is when Dr. Bowdish became involved. Although Dr. Bowdish wanted to save my life by replacing the infected heart valve as soon as possible, a life-threatening stroke occurred because of the infection, and this got in the way of the heart surgery that I so desperately needed. For the infection had caused dangerous swollen areas on my heart valve and aorta called abscesses. An abscess is a swollen area filled with pus. Every time my heart would beat, it would throw off tiny clots of blood, pus and fat, called emboli, which then clogged my brain causing a stroke. The infection then traveled to my brain, causing abscesses to form there, as well.

My situation was dire and required the best medical team possible. The infection had to be treated in two ways and on two fronts: both with antibiotics and with surgery- and in both my brain and my heart. Miraculously, the antibiotics were successful in reducing the infection, which is never assured with an infection as dangerous as MRSA. Secondly, the stroke needed to be treated with blood thinners. But it had to be just the right amount of blood thinners, as bleeding in my brain made too much anti- coagulation equally dangerous. And third, I needed brain surgery to remove the infected tissue from my brain that was continuing to spread the infection just as the heart valve was. My first surgical salvation was a procedure called a craniotomy to open my skull so that the surgeon could remove two infected clumps of brain matter. This procedure was performed by Dr. Michael Alexander. I feel extremely blessed that this surgery was a success, as it finally cleared the way for Dr. Bowdish to perform my heart surgery.

I was treated in the intensive care unit for the infection, stroke, and brain bleeding for five weeks before Dr. Bowdish could finally perform my heart surgery. Understandably, the ongoing ordeal took a toll on my entire family. I do not think I could have made it through without the support of my loving wife, who tended to me each day, both remotely from Tennessee, and then in person when she arrived in Los Angeles. My mother and my 19-year-old son also traveled to Los Angeles to be with me. Perhaps the hardest part of all of this was my son being afraid about the possibility of losing his father. For when I was first admitted, it was a very real possibility that I might not survive that first weekend. I was so grateful that my mother was there to talk my son through it. Because it was a lot for my son to handle.

To make matters worse, during the time that I was infected, the delirium prevented me from being myself. At first, I was angry. I was angry at the delays due to the bleeding in my brain, the stroke, and the infection that were preventing me from getting the surgery with Dr. Bowdish that I so desperately needed. My condition was also compounded by kidney damage, which may have been a side-effect of the antibiotics. I lay there in the intensive care unit for five weeks wishing that I could go outside. But what got me and my family through it all was the Cedars nurses, who were so constantly good to me.

The nursing staff helped me work through my anger. I met so many wonderful nurses in the different rooms that I stayed in. I cannot remember all their names. But they all kept me hopeful that I would get better and get out of the hospital. Throughout the entire experience, Dr. Bowdish came to visit me each day to check on me. Both Dr. Bowdish and the nurses constantly assured me that I was “trending upward.” And after five weeks in intensive care, after antibiotics and brain surgery reduced the infection and blood thinners reduced the stroke, my surgery with Dr. Bowdish could finally be set for May 26.

As Dr. Bowdish was finally able to perform my heart surgery, he realized that my heart infection had spread beyond the aortic valve to the entire aortic root and the ascending aorta above my heart. This meant that a much more comprehensive heart procedure would be needed to remove the infected tissue. First, because I had a heart valve replacement in 2014, I would need a redo-sternotomy, meaning that prior scar tissue over my sternum would have to be cut through to gain access to my heart. This often adds one hour to the length of the operation. Second, to prevent the infection from recurring, Dr. Bowdish wanted to replace my mechanical aortic valve with a cow valve called a bovine valve. Further, because my heart infection had become so advanced, small, infected growths called vegetations had formed on my tricuspid valve in addition to the swollen, pus-filled abscesses that had formed on my aortic valve, root, and ascending aorta. The tricuspid vegetation had to be removed by a surgical process called debridement. And the infected aortic valve, root, and ascending aorta would need to be replaced altogether. This is a highly complex operation that not all surgeons are capable of performing. But my google search prior to surgery had told me that Dr. Bowdish is one of the top heart surgeons in the world. I knew I was in good hands. And I prayed that I was in God’s hands, as well.

Having been through heart surgery 14 years before, I knew how to be a partner in my own care, and I knew what to expect. I knew that I would wake up with tubes in my chest. Part of the initial recovery process is to reach certain benchmarks that justify the removal of the tubes. After just four days, I was ready to have the tubes removed. And that was a turning point in my recovery. Two days later, I was miraculously up and walking again.

Twelve days after the surgery, I was finally ready to be released from the hospital. My top priority was to remain hyper-vigilant to ensure that the infection had been treated and had not returned. I was released to a hotel across the street from Cedars-Sinai, where I would stay for an additional ten days before returning to Tennessee. I would spend 14 days on antibiotics after being discharged and my wife had to learn how to administer treatment through the PICC line (peripherally inserted central catheter) in my chest. As I recovered from the surgery, my anger also subsided, and my wife was relieved that I was able to be myself again.

During the first month following my return to Tennessee, physical therapy helped me to get my strength back. I truly enjoy therapy, as each session helps me to affirm that I'm getting back into shape. I lost 45 pounds during the ordeal. For my revenge meal, I indulged at Chick-Filet and started putting some healthy weight back on again. For I believe that revenge is a dish best-served deep fried on a bun! And I might even return to Chick-Filet and do it again! I think I’ve earned it! Thanks to Dr. Bowdish and the entire team at Cedars-Sinai, I have so much to look forward to now. Having come so close to losing everything, I live each day with newfound appreciation. My 19-year-old son is one of a kind. I pray for him as he pursues his future at a local Community College here in Tennessee and I cannot wait to see what he accomplishes with his future. I also built a new house with my mother, and I can now look forward to living in it.

Moving forward, I will have to deal with some long-term side-effects from the stroke. I have a blind spot in one eye and some weakness in my left side which may prevent me from being able to drive again. But my employer has been very understanding and supportive, and has arranged for me to do my job remotely from home. So many of us are fortunate that technology now enables us to work remotely.

Dr. Bowdish and the care team at Cedars-Sinai saved me under the most imposing of circumstances imaginable. It is impossible to measure the depth of my gratitude for my doctors and nurses, all of whom who kept encouraging me and providing the most advanced treatments available for challenges that most other hospitals likely could not have treated. They are truly miracle workers. I can only give two thumbs up for Dr. Bowdish. And I would recommend him with a hundred more thumbs if I had them!"

-- Josh Gregory, Aortic Valve, Tricuspid Valve, Valve Repair, Valve Replacement, Reoperation, Root Replacement, 05/26/2023

"My challenge began with an infection of the lining of my heart chambers and valves called “endocarditis.” The infection had ravaged my heart, causing me to need new aortic and mitral valves, as well as a patch repair of my ascending aorta, which is the large blood vessel branching off the top of the heart as it carries blood to the entire body. My pacemaker and the pouch where it had been implanted had also become contaminated by the infection. I am lucky that the infection did not kill me — which it nearly did. The bacteria causing the infection entered my heart from my bloodstream. And it may have entered my bloodstream from an infection somewhere else in my body. When I was first treated in a hospital in my home community, a pic line had carried antibiotics directly into my chest. Over five to six weeks, I lost twenty pounds. Although the infection started to recede with treatments, I still needed surgery to repair the damage to my heart. The surgery to repair all the damage was too complex to be done at the hospital in the smaller community where I live. And so, my cardiologist referred me to Cedars-Sinai and to Dr. Michael Bowdish for a higher level of care, which is common with more advanced cases like mine.

I could not have had a better referral. Dr. Bowdish has a way with patients that is very concerned, thorough, friendly, and direct. He was very honest that there is a 6-9% risk of complications and mortality for my kind of surgery. At one point, when I just ran in to Dr. Bowdish as I was walking into a building at Cedars, he took thirty minutes just to talk with me. Dr. Raymond Schaerf, who helped with my pacemaker, also had a very pleasant bedside manner. The nursing staff at Cedars was also wonderful.

After the surgery, I was surprised that I wasn’t in much pain. When I had a question about some tingling in my chest following surgery, it was investigated during a visit to the ER. It was determined that it was an issue with the new pacemaker adjusting. The tingling soon went away. An issue with post-operative edema was also addressed and resolved quickly by the clinicians at Cedars, who treated my concerns with the upmost urgency and respect.

Three months after the surgery, I feel great. I can say that I am 95% back to normal, and expect to be 100% normal, soon. I am very grateful to Dr. Bowdish and to his staff of physicians and nurses for taking on my complex case, and for making a life-threatening situation both survivable and manageable. Their friendly and supportive way coupled with world-class surgical skills enabled me to recover and get back to the life I so enjoy living."

-- John Langpap, Aortic Valve, Mitral Valve, Valve Replacement, 07/22/2022

"Born with a bicuspid aortic valve, I met Dr. Bowdish, who was referred to me by my cardiologist, the same day that I scheduled my surgery. He was very professional and answered all of my and my family's questions before and after surgery as well as my follow up visit. Doctor Bowdish obviously enjoys what he does and takes a lot of pride in his work. I would highly recommend him to anyone needing surgery."

-- Renee Wicker, Aortic Valve, Valve Replacement, Median Sternotomy, 03/12/2010