Lynn Will get Profitable Mitral Valve Surgical procedure

I’ve mentioned it earlier than and I look ahead to saying it once more…

Listening to from sufferers about their coronary heart valve success tales stays my favourite a part of working this web site.  For instance, here’s a incredible affected person story from Lynn Friedman who overcame a really advanced type extreme mitral regurgitation due to Dr. Joanna Chikwe, Dr. Dominic Emerson and the complete crew at Cedars-Sinai Medical Heart in Los Angeles.

Lynn Friedman With Jim, Her Husband

My Analysis & My Signs…

I’m 73 and reside in Chicago. I used to be recognized on December 19, 2023 by way of a Transesophageal Echocardiogram (TEE) with extreme mitral valve regurgitation as a consequence of extreme P3 and P2 prolapse. I used to be extraordinarily fatigued and in need of breath on very gentle exertion.

A Delayed Surgical procedure?

I’ve rheumatoid arthritis and obtain an infusion each six months to maintain it beneath management. The docs suggested me to not have surgical procedure too near certainly one of my infusions, so the earliest I used to be eligible for surgical procedure was mid-March. That delay turned out to be a blessing, as a result of it gave me time to do a whole lot of analysis on mitral valve surgical procedure, the very best surgeons, the very best hospitals, and seek the advice of with numerous surgical groups.

A Regarding Complication… Mitral Annular Calcification

My exams revealed vital Mitral Annular Calcification (MAC) across the mitral valve. By means of intensive analysis my husband and I did, and suggestions we acquired from a number of coronary heart surgeons, I discovered that the calcium makes it very tough to repair the mitral valve. Trying to take away the calcium could be harmful, probably inflicting a stroke or worse throughout surgical procedure. We spent many sleepless nights from analysis by way of surgical procedure not understanding whether or not my mitral valve could possibly be repaired adequately, and whether or not changing the valve can be protected or not. I used to be informed that changing my mitral valve can be inherently riskier than a restore as a consequence of having to “mess with the calcium” with the intention to get the brand new valve to seat correctly, to not point out different disadvantages of a alternative vs. a restore.

Lynn’s Household

I Seek the advice of With 3 Completely different Surgeons

We despatched my check outcomes to a few well-known surgeons at three famend coronary heart hospitals for an analysis. The primary one mentioned that the mitral valve could possibly be repaired robotically, however it must be an “imperfect” restore because of the MAC. I used to be informed my extreme regurgitation could possibly be decreased to someplace between mild-moderate, and {that a} alternative can be much more problematic than a restore.

The second seek the advice of was adamant that my mitral valve couldn’t be repaired, and {that a} alternative, at considerably extra threat because of the MAC, was the one answer. I used to be additionally informed that average regurgitation as an end result of surgical procedure can be silly to just accept, and that I ought to think about an open-chest (sternotomy) operation.

The third seek the advice of was additionally from a widely known robotic surgeon at a top-rated hospital. I used to be informed the mitral valve couldn’t be repaired because of the MAC, and that they don’t do replacements robotically. Their solely suggestion was to contact a surgeon who would exchange the mitral valve by way of a sternotomy. My husband and I had been discouraged past phrases, and felt we didn’t have a sensible choice between any of the three consults.

We Discovered Our Surgical Staff!

After my third seek the advice of, I used to be prepared to surrender on my hope for a robotic restore. Thank goodness my husband made one final name, to the workplace of Joanna Chikwe, MD, Chair of Cardiac Surgical procedure at Cedars-Sinai Medical Heart in Los Angeles. His first query to the employees: “Does Dr. Chikwe do replacements robotically, or solely repairs?” He was informed she will be able to do both one with the robotic, however it will rely on a assessment of my check outcomes and pictures. They setup an account for me on their on-line medical file system whereas my husband was nonetheless on the cellphone, and by that afternoon my husband had uploaded all of my exams to Cedars-Sinai. Three days later, I acquired a name asking if I may meet with Dr. Chikwe in two enterprise days for a video seek the advice of.

Dr. Joanna Chikwe

Her seek the advice of was the one one which gave us hope. She mentioned she was “fairly assured, however not sure,” {that a} robotic restore could possibly be achieved, and that primarily based on my check outcomes, a robotic strategy must be fairly protected for me. She mentioned the restore wouldn’t shut the leak fully because of the calcium, however she thought she may get it to gentle. If she couldn’t get it to gentle, or if there have been indicators that the restore wouldn’t be sturdy (long-lasting), she mentioned she would decide throughout surgical procedure to interchange the mitral valve.

Dr. Chikwe mentioned if she needed to do a alternative, she would attempt to use the robotic, however that I would get up with a medium sternotomy. Her willingness to strive for a restore, and change to a alternative, both robotically or by way of sternotomy, primarily based on what she learns throughout surgical procedure, was precisely the strategy we needed, and is what set her other than the opposite surgical consults described above. She was extraordinarily compassionate and sincere in regards to the dangers concerned. When she expressed “cheap confidence” within the outcomes she thought she may obtain, and defined her flexibility to modify gears, if obligatory throughout surgical procedure, we knew instantly that we needed to be beneath her care. We’re so grateful that she was keen to take my case.

Lynn & Jim Climbing

There’s a whole lot of info and many movies about Dr. Chikwe and Cedars-Sinai Medical Heart on-line, like those at HeartValveSurgery.com. One specifically that gave us nice confidence in her and her crew is a speech she gave on the 2023 Cardiothoracic Surgical procedure Symposium. Though it’s meant for an viewers of cardiac surgeons, it conveys a deep understanding of the essential components which are important for protected surgical procedures and contribute to profitable outcomes.

My Surgical procedure

Dr. Chikwe had a top-notch crew along with her within the working room. She was assisted by Dr. Dominic Emerson, Director of Robotic Surgical procedure, pursuant to their coverage of getting two attending surgeons scrubbed for robotic instances. Six or seven others had been additionally within the working crew as a part of their crew. In my case, Dr. Chikwe was the lead surgeon, however I imagine Dr. Emerson was eminently certified to have been the lead as properly.

I knew my case was advanced and would current an enormous problem to the surgical crew. After surgical procedure, I woke as much as study that the primary try and restore my mitral valve was suboptimal, leading to larger than gentle regurgitation. There was a dialogue amongst the crew within the working room about changing the valve, and a call was finally made to strive yet another time to reinforce the restore.

Thank goodness for the redundancy on my surgical crew. With out a number of certified surgeons within the working room, such a dialogue wouldn’t have been potential, and a call to strive for a second try at a restore might not have been made. The second try was profitable, leading to higher than gentle regurgitation (some mentioned it was “little or no leak,” or “trace-mild”), which is best than what I had hoped for. My surgical procedure was carried out robotically, with out the necessity for a sternotomy. They gave me a profitable restore with out touching the calcium, preserving security foremost of their minds.

Gratitude for Glorious Publish-Op Care

I spent in the future in ICU and was then transferred to a daily room.

I used to be discharged from the hospital after a complete of 4 nights. The care I acquired in ICU and in my common room was completely excellent in each respect. Dr. Chikwe got here to see me in ICU and daily after that. I used to be additionally capable of converse with Dr. Emerson and a number of the different individuals who had been on the crew within the working room.

Everybody, surgeons, nurses, nursing aids, and many others. had been so compassionate, caring, and respectful. There are not any phrases to explain the depth of my gratitude for Dr. Chikwe and the crew of individuals she has at Cedars- Sinai.

5 Classes Realized

There are various necessary classes my husband and I discovered from this ordeal:

• Lesson #1: If in case you have a posh case, or even when your case is straight-forward, take the time to analysis the very best surgeons and the very best surgical facilities. Get a couple of opinion. In my case, it took consults with 4 completely different surgeons to lastly get to Dr. Chikwe – the one crew I used to be keen to belief my life with.
• Lesson #2: If in case you have MAC, your end result might not be the identical as mine. Each case is completely different. MAC will increase the complexity of any mitral valve restore or alternative. It’s essential to have your case evaluated by a middle of excellence, like Dr. Chikwe’s crew at Cedars-Sinai, that has vital expertise with mitral valve surgical procedure within the presence of calcium. You’ll want an skilled crew with the technical data of what to do, how you can preserve you as protected as potential, and the flexibleness & willingness to alter course primarily based on what they study throughout surgical procedure.
• Lesson #3: If you need robotic-assisted surgical procedure, remember to focus on your case with a surgical heart with vital expertise doing robotic surgical procedures. Discover out if they’ve a coverage of redundancy within the working room, the place a couple of individual is certified to carry out the identical operate. Not everybody qualifies for robotic surgical procedure, and all coronary heart surgeons are usually not skilled sufficient to carry out it safely.
• Lesson #4: Robotic surgical procedure avoids slicing by way of the sternum, however it’s nonetheless open-heart surgical procedure. It’s no stroll within the park and isn’t risk-free. In my case, the place the surgeon needed to delicately work round a major quantity of calcium, I needed my surgeon to have the very best magnified view potential of my coronary heart, and the robotic gave her an unparalleled view. Different benefits of the robotic had been a barely sooner general restoration, much less probability for problems as a consequence of not slicing by way of the sternum, and fewer scarring. However to me, the first benefit was the surgeon’s superior view of my coronary heart that I assumed would possibly result in a greater surgical end result.
• Lesson #5: There is no such thing as a substitute for an skilled crew, the place every particular person has vital expertise, and so they even have expertise working collectively as a crew. It was value it to me to journey 2,000 miles to have my surgical procedure accomplished by probably the greatest surgeons, with an excellent crew, at probably the greatest facilities of excellence within the nation. It could have been extra handy and cheaper to have my surgical procedure accomplished in my dwelling metropolis of Chicago, however I’ll by no means remorse the additional effort and cash spent to get really excellent care.

That is my story, however each case is exclusive to every individual.

I hope this encourages you to do the analysis and get a number of opinions from skilled surgeons at facilities of excellence.

Lynn Friedman
Mitral valve restore affected person