Adam's Heart Valve Surgery Blog – Page 74

Over the past few weeks, I have received two emails from heart surgery patients which experienced interesting, allergic reactions while in the hospital during their valve replacement surgeries. As you will read below, Jeff had an allergic reaction specific to the adhesives used in the surgical patches.

Here is Jeff’s account of the situation:

Hi Adam,

Thanks for writing. I did get a lot of useful support and information from you book, and do appreciate your concerns and interest.

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This is a tough moment.

I just learned that one of my readers, Connie Stone, did not make it through her mitral valve replacement surgery. Her husband, Mike, shared with me that there were heart surgery complications during her operation – specifically uncontrollable bleeding. Connie was having her second, heart valve surgery to replace a diseased mitral valve. Connie had previously had an aortic valve replacement twenty seven years ago.

Connie was 49 years old when she passed on April 24, 2008.

My thoughts and prayers are with Connie’s husband Mike and the entire Stone family.
Adam

Selecting the right heart valve replacement is not and should not be easy to do. There are many factors that need to be considered including your age, your lifestyle, your overall health, your like / dislike of ongoing drug monitoring.

G.I. Bill is getting ready for aortic valve replacement surgery due to aortic valve stenosis. While his surgery is three weeks away, he is still trying to determine the best valve replacement type (mechanical valve or tissue and biological valves) for him.

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As we have already discussed, there is much interest in stem cells and heart valve replacements these days. Here’s an interesting report about heart valve tissue generation in sheep.

A Wake Forest University researcher has successfully created eighteen types of tissue, including a sheep heart valve, in his laboratory.

Dr. Anthony Atala, who is studying the science behind growing new organs, uses cells in a laboratory and an ink-jet printer for the purpose.

“When people ask me ‘what do you do,’ we grow tissues and organs. We are making body parts that we can implant right back into patients,” the Environmental News Network quoted him as telling CBS. He believes that soon researchers will start growing organs like human hearts in laboratories from a patient’s own cells, doing away with the need for organ donors. Atala even hopes that the injection of stem cells will facilitate the healing of damaged organs internally, reducing the need for open-heart surgery and other invasive procedures.

Keep on tickin!
Adam

If there is one question I alllllllllllllllll-ways ask patients preparing for heart valve surgery, it is the following, “Did you get a second opinion?”

I can not emphasize this enough.

Recently, I had a discussion with Neil (a forty eight year old husband, father and very smart businessman from the East Coast). As our discussion began, Neil jumped right to the topic of valve selection – mechanical versus tissue.

I said, “HOOOOOLLLLD ON!!! Did you get a second opinion?”

Neil said, “Ummm. No… My cardiologist is one of the best around!”

I said cautiously, “Hmmm. Okay… But it might be worth it to get some extra feedback.”

Guess what?

Neil took my advice. He got a second opinion.

Another… Guess what?

The second cardiologist noticed something different from the primary cardiologist. Now, Neil may delay his heart valve replacement surgery AND he may be able to have an aortic valve repair instead of a valve replacement!!!

So you know, this does not always happen. In my case, my second opinion completely agreed with my cardiologist. (In fact, Dr. Chaikin accelerated the timing of my surgery.) However, knowing that both cardiologists agreed on my aortic stenosis diagnosis put my mind at ease.

Remember, as the graph above shows, about 35% of patients do not get second opinions. Please do not be one of them!

Keep on tickin!
Adam

Again, I find myself touched by another heart surgery success story. Last week it was eighty-three year old John DeFalco that inspired me after his aortic valve replacement operation. This week, it is all about Taylor, a two-year old with that needed cardiac bypass surgery.

Her mother, Michelle, tells the story best…

Dear Adam,

My daughter was 18 months old and had ASD repair. There is potential she may need a valve replacement. After surgery, July 5, 2006, she had a small valve leak. As of Fall of 2007 it is a moderate leak, but no heart enlargement.

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Looking back on my aortic valve replacement procedure, I remember several, distinct moments of physical and mental confusion. I might even consider that confusion as “dislocating” considering the process of having heart surgery is so foreign to regular, every-day life.

Sometimes, that dislocation evolved into fear (e.g. cardiac depression). At other times, that dislocation actually transformed into tremendous joy (e.g. taking my first shower after surgery).

One of my “dislocating moments” was entering the pre-operating room. I’ll never forget that final hug with my family after the nurse called my name. I’ll never forget the nervous tremors in my hands as I pushed the door open.

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If anyone knows that laughter is the best medicine, it might just be Joanne Harris.

Over the past few months, Joanne and I have emailed back and forth regarding her heart valve surgery. Joanne had a mitral valve repair with maze procedure. She suffered from mitral valve regurgitation (leaking heart valve).

Anyways, I recently received a note from Joanne that really shows her incredible attitude towards her cardiac bypass surgery, her broken sternum recovery and her innovative ways to trick the incentive spirometer used to defend against fluid in her lungs.

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I just received a great, often-overlooked question from Tim who asks, “Hey Adam – I just saw the pictures of your chest scar after heart surgery. I’m curious to know… Did you use any special creams or gels to assist in the incision healing?”

The answer to that question is a definite “Yes!” I used a product called Mederma. The gel is an over-the-counter product that does not require a prescription. You can purchase Mederma at most pharmacies. If you are interested, they have a $2 off coupon at the Mederma website. 🙂

However, please make sure that you ONLY USE MEDERMA as directed. Do not use Mederma right away. I think you need to wait two weeks after your surgery. And, I made sure it was okay with my surgeon, before I started using it. My surgeon, Dr. Vaughn Starnes, looked at the Mederma ingredient listing on the package and said, “This looks pretty good. Go ahead and try it out!”

Keep on tickin!
Adam

A little over a month ago, I visited Edwards Lifesciences to tour its heart valve manufacturing museum and learn more about Edwards’ heart valve replacement devices (pig valve transplants, cow valves, minimally invasive technologies).

After reading my blog, Debbie (a recent heart valve surgery patient) decided she wanted to visit Edwards as well. A few emails later, Debbie was on her way to Edwards’ headquarters in Irvine, California to visit the world’s largest heart valve manufacturer. Considering that Debbie’s cow valve replacement was manufactured by Edwards, I guess it was sort of a homecoming for Debbie’s new pulmonary valve.

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As you read the success stories of heart valve surgery patients (Veronika Meyer, John DeFalco, Taylor Browning, Leslie LaFayette, Raye Gilliamsen, John Turan), it is great to see that medical care can have an incredibly positive impact on heart valve disease.

However, it seems like everywhere I turn these days, reports of bad medicine are all around me. In the past few days, I’ve read or watched terrible stories about:

• Trasylol and heart surgery
• Drug administration mishaps that endangered and/or resulted in the unfortunate passing of several children
• Negligent surgical preparations alleged to be the source of Stephanie Kuleba’s recent fatality

During a 60 minutes report about Dennis Quaid’s children, I heard a troubling statistic. The actor revealed that over 100,000 hospital deaths occur each year as a result of human error. That’s more fatalities than AIDS, breast cancer and auto accidents combined.

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Prior to heart valve surgery, patients are faced with many, many, many questions. One of those questions is specific to potential blood loss during the operation. That question is, “Would you like to donate your own blood or use blood from the hospital blood bank?”

I’ve written about this topic of blood banks and heart surgery before.

However, I just read an interesting article at the Mercury News which reveals that heart surgery patients treated with donated blood older than two weeks were more likely to die or suffer problems than those treated with fresher blood.

Which makes these findings — about blood bank safety — even more problematic is that blood supply is chronically low.

“If the shelf life was reduced from 42 to 14 days, we just wouldn’t have enough blood around,” said Dr. Ross Herron, medical director of the American Red Cross Bay Area, which sends blood to hospitals throughout the East Bay and South Bay. “We need to have that shelf life to move blood around.”

I did not donate my own blood prior to my aortic valve replacement operation. Luckily, Dr. Starnes did not need a transfusion during my surgery. However, given these findings I would probably change that approach if I was to need heart surgery again. To learn more about aortic valve replacement, click here.

I hope this helps you better understand blood bank safety.

Keep on tickin!
Adam

A few days ago, I posted a blog about what normal heart valves look like.

Well… Here’s a quick, interesting follow-up to that story about each of the four heart valves.

I was just on Youtube.com and came across a very neat video which shows each of the four heart valves opening and closing within during heartbeats – the aortic valve, the mitral valve, the tricuspid valve and the pulmonary valve.

It’s a pretty fascinating video that shows not one but each of the four heart valves, so I thought I would share the link.

I hope this helps better explain how the four heart valves open and close.

Keep on tickin!
Adam

The incision on my chest was throbbing.

It was two weeks after my aortic valve operation and I had taken my last Vicodin several hours earlier. While we had a refill, it was late at night (around 9pm) and our local Rite-Aid was closed.

Robyn (my wife) frantically searched Rite-Aid’s website to find a 24 hour pharmacy. Luckily, there was an all-night pharmacy about twenty-five minutes away. In a split-second, she kissed me good-bye and was out the door.

She returned about an hour later with my pain medication. (Robyn is my guardian angel.)

My point of this little story? Be prepared. If possible, find out (in advance of your heart valve surgery) where a local 24 hour pharmacy is. You may need it for pain medication, severe constipation, etc.

Keep on tickin!
Adam

Given my recent blog about heart valve surgery in patients over eighty, I thought you might like to read about John DeFalco from Ponte Vedra Beach, Florida.

His daughter, Coreen writes to me:

My father, John DeFalco, is 83 years old. Due to his age, our doctors told us he was at high risk for aortic valve replacement surgery. (Click here to learn about AVR.)

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This is the courageous, patient story of John Turan. As you will read, John had a triple-whammy heart surgery – a Ross Operation (aortic and pulmonary valve replacements) AND his ascending aorta was replaced due to an aneurysm.

I could go on-and-on about John, Mercy (his wonderful mother) and Dr. Bleiweis (his incredible surgeon), however, I think it’s best to hear his side of the story.

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I met Carolyn, a heart valve surgery patient, last Tuesday. We chatted on the phone about her bicuspid aortic valve and her upcoming surgery. Carolyn is currently doing her diligence on surgeons. That said, we talked alot about the process of how to find the right surgeon and how to interview your surgeon.

A few minutes after we hung up the phone, I received a follow-up email from Carolyn.

“Adam, I forgot to ask you something. We live in a two-story home. There is no bedroom on the first floor. Will I have trouble walking up and down the stairs after surgery? I imagine I will have to stay upstairs for a while? After my back surgery (a few years ago), I came down in the morning and went up at night for a while. Any thoughts?”

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As a follow-up to my post about pig valve transplants, I received a specific question, “Do you know exactly how long a pig valve might last in the human heart?”

It’s a good question for patients to consider as they determine which is the best valve type for them – biological (pig valve, cow valve) or mechanical.

According to Dr. Isadore Rosenfeld, “Pig heart valves do not last as long as mechanical valves and for that reason are not usually implanted in patients much younger than 60 years.”

Dr. Rosenfeld continues, “Although recent reports from The Cleveland Clinic (whose surgeons have a great deal of experience replacing heart valves) suggest that the newer biological valves often last 17 years or longer, they frequently must be replaced after 15 years. So, except in unusual circumstances, younger patients still are given a mechanical valve.”

I hope that helps explain more about how long pig heart valves last in the human heart.

Keep on tickin!
Adam

Like many heart valve surgery patients, I was born with a bicuspid aortic valve. However, unlike many of you, I was not diagnosed with the bicuspid aortic valve defect as a newborn baby. It wasn’t until I was five years old that my family doctor heard my heart murmur. After that, diagnosis of the bicuspid valve was formally issued following my first visit to the cardiologist.

After I had an aortic valve replaced, I was curious to know, “How do bicuspid aortic valves impact newborns?” and “What other problems can bicuspid valves cause in newborns and children?”

I knew that the bicuspid aortic valve occurs when the aortic valve does not develop normally while the baby is in the womb. However, I wanted to know more.

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I just received a question that reads, “Adam, can you tell me more about pig valve transplants? My surgeon thinks that is the best valve choice for me.”

Sure thing. However, I want to make sure you know there are other options for tissue (also called biological) valve replacements besides pig valve transplants. The four key types of biological valve replacements are:

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