Adam's Heart Valve Surgery Blog – Page 49

I recently received an interesting question from Rob about a post-operative cough following heart valve surgery.

Rob writes, “Adam, My wife — Gail — recently had a valve sparing aortic valve repair and had an artificial aorta. Gail has had a post-operative cough for about 5 days now.  Is this common? Are there any remedies to help it along? Thanks for all you do! Rob”

To ensure that Rob received an expert response to his question, I contacted Dr. Jeffrey Swanson, a leading heart valve surgeon from Portland, Oregon.

During his 20+ year career, Dr. Swanson has performed over 3,000 heart valve procedures at Providence St. Vincent Medical Center. (Not only is Dr. Swanson a highly-recommended surgeon – from many visitors of this website – he’s a very nice guy as well.)

Dr. Jeffrey Swanson – Heart Valve Surgeon, Portland, Oregon

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It’s always fun to hear from patients as they recover from heart valve surgery and return to their life passions. Today, I received a fantastic email from John Coleman in Arkansas. John writes:

Adam –  At 43 years old I was diagnosed with severe aortic stenosis. Like you, I elected to have the

Ross Procedure, a double valve replacement, in August, 2010 here in Arkansas. I read your book prior to surgery. It was really helpful in getting my mind and body prepared for the surgery and the recovery.

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Great news everybody!

I just learned that Dr. Tomislav Mihaljevic, a leading heart valve surgeon from The Cleveland Clinic, will host a live Internet chat on February 7, 2011. During the event, titled “Ask The Heart Surgeon”, Dr. Mihaljevic will answer your questions about cardiac surgery — including surgical techniques, minimally invasive surgery, off-pump bypass, and robotically assisted procedures. The online session will begin at 12pm EST and registration is now open.

I think this is a very special opportunity to chat with Dr. Mihaljevic as many members of our community, including Ashish Yaduka (mitral valve repair) and Anne Shannon (minimally invasive aortic valve replacement), have had excellent surgical results with Dr. Mihaljevic.

Again, the event is scheduled for Monday, February 7 at 12pm (EST).

I hope this helps!

Keep on tickin!
Adam

I recently received an anxious email from Ruth about mitral valve repair. Ruth writes to me, “I would like to learn more about a prolapsed ANTERIOR leaflet of the mitral valve. I have been told that repair may not be possible. I am terrified… Do you have any information on the risks involved with this type of repair? Thanks, Ruth”

Considering the urgent nature of Ruth’s question, I contacted Dr. David H. Adams — a leading mitral valve repair surgeon from The Mount Sinai Hospital in New York. What happened next is quite extraordinary… First, Dr. Adams quickly responded to Ruth with a comforting email. Then, Dr. Adams created a 22-minute video to help patients better understand this type of mitral valve surgery.

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During 2010, this global community of patients and caregivers actively discussed many topics that impacted our own, heart valve surgery experiences. That said, I just reviewed all 179 posts from 2010 to determine the “Top 10 Heart Valve Surgery Blogs of 2010”.

To develop this list, I used several factors including web traffic reports, your comments and your emails. As you might imagine, this was more difficult than expected. Similar to last year, we even had a tie.

So… Without further ado, here are the top ten heart valve surgery blogs of 2010:

10. The importance of second opinions and patient advocacy, revealed by Anne Shannon from Colorado, propelled “Remote Second Opinion Changes Anne’s Surgical Approach” to the tenth spot on our list.

9. We were, once again, perplexed by the lack of awareness to the patient benefits derived from cardiac rehabilitation programs — given a September, 2010 report in the Journal of the American College of Cardiology. That said, “Patient Concern: Cardiac Rehab Referrals Continue To Disappoint” arrives in the ninth position on our list.

8. The on-air announcement of Barbara Walters’ aortic valve replacement surgery resulted in an immediate traffic spike the moment we posted “Barbara Walters Recovering From Heart Valve Surgery”.

7.  Thanks to an email from Shirley, “Incision Site or Full Body Shave?” became a very active blog as we evaluated different patient experiences specific to this pre-operating room event.

6. An inspirational patient story about Ken rocketed “From Stroke… To Heart Valve Replacement… To The Gym” to the sixth spot on our list.

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With the exception of Barbara Walters’ heart valve surgery in May, this year was relatively quiet for public figures needing heart valve repair or heart valve replacement operations. However, our list of “well-known patients” did expand during the final week of 2010.

On Friday, December 24th, Charles Schwab, the chairman and founder of Charles Schwab Corp., underwent successful heart valve surgery.

Charles Schwab, 73, Heart Valve Surgery (Replacement) Patient

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Hi everybody,

Ethan, Robyn and I wanted to wish you all a very safe and very happy holidays!!!
 

Keep on tickin!
Adam

No need to preface this… Prepare for patient inspiration.

I feel honored to share with you that our website sponsors the Iron Heart Racing team. If you have a minute, you may want to learn about its extraordinary leader, David “IronHeart” Watkins, a former aortic valve replacement patient and endurance athlete.

Keep on tickin’ Iron Heart Racing Team & David!
Adam

It’s hard to believe that five years ago, at this precise moment, I was rolled into an operating room at USC Medical Center in Los Angeles, California. There, during a 3-hour procedure, Dr. Starnes performed an aortic and pulmonary valve replacement surgery that fixed my enlarged heart.

Patient, Caregiver & Surgeon Friends

It’s hard to believe that five years ago today, my life would slowly begin to transform.

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I just received a very appropriate question from Anne about minimally invasive approaches to heart valve surgery. Anne writes, “Adam – Like you, I was diagnosed with severe aortic stenosis. I need an aortic valve replacement. Why didn’t you get a minimally invasive surgery? Thanks, Anne”

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I just received an excellent question from Teri about heart valve surgery recovery, climbing stairs and recliners.

Teri writes to me, “Hi Adam – I want to know if I can climb stairs after heart surgery – once I return from the hospital. Our bedroom is on the second floor. Is that too much to expect? I am ordering an electric easy chair and need to know if I should have it delivered down stairs or up stairs in our bedroom — which is also close to a full shower. I really appreciated the great information in your book! Teri”

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While the patient benefits of attending cardiac rehab after heart valve surgery are well documented, the utility of these post-operative programs remains disappointing — as only 20% of patients who could benefit from cardiac rehabilitation are referred to outpatient facilities.

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As a follow-up to our recent discussion about re-operation rates, I just received an interesting question from Steve about tissue valve replacements and the potential reasons for premature failure.

Steve writes to me, “Hi Adam – It has been 16 months since my aortic valve replacement. I am being told I need another bovine valve replaced. This is not due to infection. How often does this happen? Why does this happen? Thanks for all you do! Steve”

Tissue Heart Valve Replacement

To get an expert response to Steve’s question, I contacted Dr. Junaid Khan and Dr. Allan Stewart — two leading heart valve surgeons.

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Robyn, Ethan and I want to wish all of our friends in the United States a very “Happy Thanksgiving!”.  And, even if you’re not from the U.S., we want you to know how grateful we are for you and your contribution to this caring community of patients, caregivers, cardiologists and surgeons.

So you know, Thanksgiving is my favorite holiday.

May you have a wonderful day!

Gobble! Gobble!
Adam

Recently, I spent two days at Inova’s Heart & Vascular Institute in Falls Church, Virginia — which is about 10 miles from downtown Washington, D.C. in Northern Virginia. It was my first visit to the new $150 million facility that (i) holds a #1 ranking from HealthGrades for Virginia hospitals and (ii) a 5-Star excellence rating for heart valve replacement surgeries.

Dr. Paul Massimiano, Me, Dr. Niv Ad

I have to admit… The four-story cardiac center was immaculate… and BIG. To give you some idea about the facility size, consider that it maintains 13 catheter labs, 6 cardiac operating rooms, over 200 patient rooms and an impressive cardiac rehab center.

However, what struck me most about the Inova Heart & Vascular Institute had little to with architectural design or hospital feng shui. Instead, I was most impressed by a unique approach to cardiac care nurtured by Dr. Niv Ad, the chief of cardiac surgery, and Dr. Paul Massimiano, the president of CVTSA, the private surgeon group at Inova.

Let me explain…

CONSIDER THAT INOVA IS A MAJOR CARDIAC SURGERY CENTER

During my brief 48-hour stay in Falls Church, I observed a (i) stand-alone mitral valve repair, (ii) a stand-alone MAZE procedure, (iii) a minimally invasive mitral valve repair and MAZE procedure, and, of all things, (iv) an actual heart transplant.

Needless to say, seeing a transplanted heart (shown below) beat for the first time is something I will never forget. I’ll also never forget seeing the patient’s old heart and dissected pump that was keeping him alive.

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I just received an interesting question from Frank about heart rhythms after heart valve surgery. Frank writes, “I had a tricuspid valve repair, a Patent Foramen Ovalve (PFO) repaired and a Maze procedure performed in July.  Now, it appears I will need to have a pacemaker put in next week. I was told that my Atrioventricular (AV) node may have been damaged and I am now in “heart block”.  I was wondering if this is common?  Thanks Adam!”

Diagram of Pacemaker Implant

Frank raises a great question. As we have seen in prior blogs, several patients receive pacemakers after heart valve surgery. However, Frank’s question addresses two, other surgical considerations which you may not be familiar with — The Maze procedure and heart block.

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[Update: Please note that Dr. Allan Stewart is no longer performing surgery at NewYork-Presbyterian Hospital and Columbia University Medical Center.]

I’m very happy to announce that Dr. Allan Stewart has been named our Heart Valve Surgeon of the Month at the Heart Valve Surgeon Finder for November!

As many of you know, Dr. Stewart — who is the Director of Aortic Surgery at NewYork-Presbyterian Hospital and Columbia University Medical Center — has been an incredible supporter of our growing community. In addition to answering many of your questions, Dr. Stewart has teamed up with several, former patients to promote awareness to heart disease and recovery.

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I just received a very interesting question from Bernie about the pericardium and heart valve surgery.

Bernie writes, “Hi Adam – At 51 years old, I need to replace my disease aortic valve due to a stenotic bicuspid valve. I’m curious to know about the pericardium. I know the sac has to be opened. But, then what? Do they stitch-up the pericardium after the valve is fixed? Or, is it left open? Thanks, Bernie.”

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Robyn, Ethan and I want to wish everybody a very happy and very safe Halloween!

For his 2nd Halloween, Ethan is dressing up as “DJ Lance Rock” from the hit television show Yo Gabba Gabba.  The show has become a morning staple for Ethan as he gulps down his first glass of milk. Ethan loves running around, screaming “Yoooooooo” as waves his hands in the air like DJ Lance Rock.

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As many of you know, I’m fascinated with technology.

That said, when I’m invited to see a clinical application of a new heart valve technology, I jump at the opportunity. So, last week, I found myself in a hybrid catheterization laboratory / operating suite at the University of Virginia in Charlottesville, Virginia. Dr. Scott Lim, Associate Professor of Pediatrics and Medicine, Division of Cardiology, was performing a MitraClip procedure.

Dr. Scott Lim, M.D. And Me (Adam)

“We’ve been investigating the MitraClip therapy in select patients as an alternative, less-invasive therapy for mitral regurgitation,” Dr. Lim shared with me. “By clipping the mitral leaflets into a double-orifice configuration we can reduce leakage across the valve – without inducing stenosis.”

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