Adam's Heart Valve Surgery Blog – Page 76

I recently received a great question from Jennifer (a caregiver) who is researching heart valve surgery options for her mother-in-law. Specifically, Jennifer wanted to know more about valve reoperations due to undone (loose) stitches around a replacement valve.

Jennifer’s question was pretty technical and I did not have an answer. So, I contacted Dr. Eric Roselli, a leading heart surgeon from The Cleveland Clinic, to get his perspective.

As you might imagine, Dr. Roselli had a thoughtful response to Jennifer’s question. That said, I thought you might like to read this patient case that was discussed via email earlier today.

Patient Background: In 1982, my mother-in-law (the patient) had her mitral valve replaced with a silastic heart ball valve (star Edwards no.4, model 6120, size 32mm) at Royal Prince Alfred Hospital in Sydney. Unfortunately, some of the stitches holding the valve in place seem to have torn away or come undone (according to her specialists), during the past 26 years.

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Every few days, I see a picture or image on the Internet that REALLY captures my attention. Many times, those pictures are diagrams and illustrations that relate to heart valve surgery.

As I remember it, before my aortic valve replacement and pulmonary valve replacement surgery, I had a difficult time grasping what actually occurs during the operation.

That said, I have included many pictures, drawings and images in this blog (and in my book) to help you better contemplate what occurs during the pre- and post-operative heart valve replacement or heart valve repair experience.

Your responses have so far been very positive. So, I am going to continue posting many more pictures – including human heart diagram, animated anatomy of heart functioning, mitral valve replacement diagram and more.

Above, you will see a very interesting diagram of the patient’s chest following the incision and median sternotomy – the sternum is already broken. As you can see, the surgeon now has full access to operate on the heart once the patient is placed on the heart-lung machine (bypass) if required. Then, the heart can be stopped, cooled and then fixed!

I hope you don’t think this is too gruesome. I found it educational and thought you might like to see an open heart surgery illustration of the chest during surgery. If you would prefer not to see stuff like this, please leave a reply below.

Keep on tickin!
Adam

I don’t know about you…

But when my first cardiologist, Dr. Bad Bedside Manner, told me that I needed open heart surgery due to my defective bicuspid aortic valve… I went into mini-shock.

Then, the stoic doctor, with the red nose, rapidly spewed a flurry of foreign words at me: calcification, leaflets, narrowing valve stenosis, regurgitation, normal ejection fraction, blah, blah, blah, blah.

“Enough medical mumbo-jumbo!” I remember thinking as Dr. Bad Bedside Manner continued to tell me that death was lurking in my future. “Please show me what you are talking about!”

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Hey everybody,

Good news!

Leslie is home following her mitral valve repair. (You may remember a blog that featured Leslie as she was preparing for robotic mitral valve repair.)

After five days at UCLA Medical Center, Leslie has now entered the recovery phase of heart valve surgery. Below, you will find an interesting account of her surgery which was longer than most surgeries due to some cardiac surgery complications that were fixed during surgery. Great job Dr. Shemin! To learn more about Dr. Shemin, click here.

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After the annual check-up with Dr. Rosin (my cardiologist), it was time to venture back to USC’s Medical Center to see Dr. Vaughn Starnes (my heart surgeon), for part two of my annual check-up.

I have to admit…

The fact that Dr. Rosin was happy with my recent echocardiogram results made the sixty-minute drive to USC rather pleasant for a change. I can remember many, other drives to USC that were drenched in fear, anxiety and doubt due to my much-needed heart valve replacement surgery.

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So you know…. I am not the best when it comes to organized religion.

I would say that I am more spiritual than religious. I do believe there are higher powers that tie us all together. And, I do believe the molecular meatpack, we call our body, offers us a special opportunity to create something meaningful during the seventy or eighty years that most of us traverse the Earth.

Okay. I just wanted to make sure you knew where I was coming from before I dive head-first into the topic of prayer before heart surgery.

Religion, Prayer & Heart Surgery

Just before my aortic valve replacement, my Uncle Marc advised me that prayer before surgery was not a bad idea. Marc is more than an uncle to me. Marc is a mentor in many aspects of my life.

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As you may be learning or have already learned…

Finding your surgeon is a critical process that requires due diligence and, at times, tenacity. That said, there are many tactics you can use to locate and select the right heart valve surgeon for you.

In my opinion, one key ingredient in the surgeon selection process is the heart surgeon interview. Personally, I interviewed several heart valve surgeons prior to picking Dr. Vaughn Starnes for my aortic valve replacement.

Recently, I was reading the Wall Street Journal when I came across an interesting article about the challenges of asking surgeons tough questions.

This article was appropriately titled Asking Your Surgeon The Tough Questions. It’s a pretty good article that provides some interesting thoughts and references, so I linked over to it for your review (if you like).

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I will be the first to admit… The rewards from publishing this blog and my book are more positive than anything I have ever experienced before.

Actually, it is a privilege to help patients and their caregivers through their heart valve repair or valve replacement surgery experience.

That said, I recently received an email from Debbie Hurd. Debbie is now six weeks post-surgery. As you can read below, Debbie is doing very well even though she has experienced some patient complications following heart surgery.

Still, Debbie’s attitude is positive and her will is strong. I found her words insightful, so with her approval, I have posted them here for us all to consider and learn from.

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This is just great.

Earlier today, JD emailed me several questions about aortic root and aortic valve replacement. As many of you know, I did not have aortic root replacement (I had the Ross Procedure), so I couldn’t really comment on all of JD’s questions.

However, a friend of mine, Taylor Browning, had an aortic root and an aortic valve replacement in 2007. That said, I forwarded JD’s questions over to Taylor.

Wow! Talk about a response! Taylor went above-and-beyond the call of duty to support J.D. as he prepares for surgery. First, I will post JD’s email and then I will post Taylor’s reply about about this unique, heart valve surgery that Taylor personally experienced just one year ago.

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Yesterday, I received a fearful email from Janice – a very concerned caregiver and mother. Janice’s daughter is preparing for heart valve surgery.

In her email, Janice noted that her daughter is planning on returning to work just 3-4 weeks after surgery. She also noted that her daughter is nervous that she might lose her job because of the medical leave-of-absence.

I wasted no time in immediately responding to Janice for several reasons:

First, I have been through double heart valve replacement. That said, I know that the recovery from cardiac surgery should not and can not be rushed. Healing is a very personal and individual process.

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I’m not sure about you…

But, as I prepared for my heart valve surgery, one of the many critical questions I wanted to answer was, “Which are the best heart care facilities?” and “Who are the best heart valve surgeons?”

I did ALOT of research on the topic of cardiovascular disease treatment – best hospitals and surgeons. (So you know, I consider heart valve disease in the realm of cardiovascular disorders although others may consider the term isolate to arteries and veins.)

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One of my readers / friends, Taylor Browning, is traveling to Hawaii for a vacation with his wife Michelle. (If you want to learn about an amazing recovery from aortic valve & root replacement, click to read Taylor’s inspiring heart surgery recovery.)

That said, Taylor just asked me about taking care of his chest incision in the hot, sunny and tropical weather of Hawaii after heart surgery. Specifically, Taylor noted in his email, “I plan on applying some heavy-duty sunscreen to the incision scar itself but wanted to see what you did given your proximity to the beach!”

First off, I’m jealous. I need a vacation!!! “CAN I COME TAYLOR?”

Second, here’s a picture of me ten months after my double heart valve replacement surgery.

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Recently, I received an interesting question about bacterial endocarditis. The question was, “Adam: Do you know of any celebrities with endocarditis?

It’s a good question. I remember when I first learned that I would need heart valve replacement surgery, it helped to know there were many, many, many, many public figures who had experienced heart valve surgery and continued to live a full, dynamic life afterwards.

As for a particular celebrity with endocarditis (the heart valve disease), I unfortunately do not know of any. Sorry.

That said, I didn’t give up. So, I did what most people would do – I “Google’d” it.

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There’s nothing better than helping patients and caregivers prepare for and recover from heart valve surgery. The stories of Jim Bonk, Taylor and Michelle Browning, and Kathy Benson are both inspirational and heart-warming.

Over the past two months, Leslie Lafayette (pictured below) and I have emailed back and forth about the fears, the risks and, of course, the pain of cardiac surgery.

Together, we have settled those fears and doubts – even the overwhelming concern about the vent tube post-surgery, right Leslie?

Well…. I just want to let you all know that Leslie has selected a heart valve surgeon, a heart valve procedure and an official date for her mitral valve repair. I have to give Leslie a lot of credit. Her research, specific to her upcoming operation, has been incredibly detailed.

Early this week, I received another interesting email from Leslie that shares her unique, patient perspective about her mitral valve surgery. I thought you might like to hear some of the steps that Leslie is taking to prepare for heart valve surgery.

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Many patients and caregivers say that heart valve surgery can be similar to a roller-coaster. There are emotional and physical “ups”. And, there are emotional and physical “downs”.

Looking back on my surgery, I completely agree with that roller-coaster analogy.

In addition to the fear… In addition to the uncertainty… In addition to the doubt.

I, like many patients, experienced waves of the “F” word. Ahem! Not that “F” word. The “Frustration” f-word.

I was frustrated with my insurance company. I was frustrated with my first cardiologist and his horrible bedside manner. I was frustrated with the heart surgeon selection process. I was frustrated with the valve selection process too.

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Happy Holidays Everybody!

This is way off-topic and a little (well more than a little) distasteful…

But…

One of the best cliches you will ever hear in life is, “Laughter is the best medicine.” I completely agree with it. That said, I thought you might enjoy some holiday humor if you are currently experiencing heart valve surgery recovery or just need a good chuckle!

I hope you enjoy!

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In the next revision of my book, I am going to provide even more information about the different types of heart valve replacements.

Over the past few months, I have met with several heart valve replacement manufacturers. Needless to say, I am learning a lot about the new technologies and the old faithfuls of the industry.

One of the tissue valve replacement types that I constantly receive questions about is the Biocore Aortic Valve from St. Jude Medical.

As you may have seen, St. Jude just received FDA approval for its Epic Stented Valve. It’s interesting to note that the Epic Stented Valve is built upon the architecture of the Biocore Aortic Valve.

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If you are looking for inspiration about life after heart valve surgery…

You have come to the right place!

Here is an amazing follow-up, patient success story on Teppo Numminen. Teppo is a NHL hockey star who recently had mitral valve repair surgery at The Cleveland Clinic.

 
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Earlier today, I received an email from Brad Mueller. Brad is preparing to have the Ross Procedure (aortic and pulmonary valve replacement) in early January, 2008.

Dr. John Oswalt (from Texas) will be performing the operation.

Brad wrote to me, “After surgery, did you regain your stamina. I’ve never been able to run a significant distance and when doing cardio exercises, I get tired relatively quickly. I’m wondering if I’ll see any improvement with a fully functioning three leaflet valve?”

Brad Mueller – Heart Valve Surgery Patient

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As the leading cardiac care center in the world, The Cleveland Clinic Cardiac Care Center is known for its leading edge research and treatment of valvular problems and disorders. I have been very lucky to meet several members from the TCC team including Dr. Gosta Pettersson and Dr. Eric Roselli.

Here is an interesting video with Dr. Mihaljevic about robotic mitral valve repair that I thought you might like. So, without further ado… Click on the link above if you would like to see this mitral valve repair video from The Cleveland Clinic. Or, click here to learn more about repairing diseased mitral valves.

Keep on tickin!
Adam