Kenneth – Less Invasive Surgery Synchronizes a Heart and Restarts a Life

kenneth

Comparing my life before the surgery to after is like comparing night to day.  I’m active again and in good shape – with absolutely no heart arrhythmia.
-Kenneth

Atrial Fibrillation / TT Maze Procedure

“Bring it on,” said Kenneth, a recently retired 62-year old who swims for 50 minutes several times a week.  While that fitness level may be uncommon for men Kenneth’s age, it’s especially surprising for a man who had to rest after climbing a flight of stairs not long ago.

It was during the holidays in 2001 that atrial fibrillation began causing Kenneth’s heart to beat erratically.  The first serious bout sent him to the hospital, but he learned over time that sleeping usually restored the rhythm and he grudgingly adjusted his lifestyle to accommodate the breathlessness.  He also started taking medications to control the symptoms and prevent the atrial fibrillation from causing a stroke, but he didn’t like relying on the medications to work without causing other problems.

“I was getting ready to retire,” said Kenneth, “but my activity level had changed so dramatically that I wasn’t looking forward to it.”

Because the medications were not providing the relief Kenneth needed, electrophysiologist Larry Wolff, M.D. talked to him about volunteering as a study participant for a minimally invasive surgery that cardiovascular surgeon James Longoria, M.D. was pioneering.  He explained that instead of a traditional open heart Cox Maze III surgery used to correct atrial fibrillation; Dr. Longoria would perform a Totally Thoracoscopic Maze (TT Maze) procedure using probes placed through small incisions. Though Kenneth was an excellent candidate for the new procedure, which would involve smaller incisions and less scarring, less postoperative pain, and faster return to normal living than open heart surgery, Kenneth wasn’t ready to undergo any heart surgery.  After another year of feeling that his life was on hold, Kenneth celebrated his 60th birthday and decided it was time for a tune up.

“About a week before my surgery, I was rototilling my yard,” said Kenneth.  “I’d work for 10 minutes then rest, work for 10 minutes, then rest.  It took me four days to do what now takes four hours.”

While certainly less invasive than open-heart surgery, getting to the well-protected heart still requires that the ribs, muscles and nerves be separated for the probes to pass through.  Kenneth’s heart stopped misfiring immediately, and has remained steady since, but he had a bad reaction to the painkillers and the nerves and muscles took longer to heal than he hoped.  As the procedure has continued to be perfected, recovery times have shortened, but Kenneth knows his recovery was still nothing compared to a friend who underwent open heart surgery about the same time.

“Most important is how I feel,” Kenneth said.  “Comparing my life before the surgery to after is like comparing night to day.  I’m active again and in good shape – with absolutely no heart arrhythmia.”

Heart Failure / Left Ventricular Assist Device (LVAD

Steve was out of breath and tired…a lot. He knew his heart failure was like a ticking time bomb.

“We knew it may happen eventually,” said Steve, 50, who finally landed in the intensive care unit after collapsing at home. “My cardiologist told me it was time to get on the list.”

Gravely ill, and knowing it was the only option to save his life, Steve got on the list for a heart transplant. While he was waiting for a heart to become available, he also found out that he was a candidate for a new program that would better prepare him for a transplant. Steve became the first of two patients at Sutter Memorial Hospital to “bridge to transplant,” a long-term mechanical heart pump. The left ventricular assist device (LVAD) was implanted in Andersen”s abdomen and sewn into his left ventricle and aorta. Its function was to do most of the work of his heart and continued to do so until a donor heart became available.

The device works by taking over the pumping function from the left ventricle, delivering oxygenated blood from the lungs to the body via the aorta. In one study, the American Heart Association reported the pumps extended the average life span of heart patients from three months to more than 10 months.

The LVAD not only worked to keep Steve’s heart beating, it gave him a new outlook in life. He started walking daily and signed up for the American Heart Association”s Community Heart Walk in Sacramento with other members of the Sutter Heart & Vascular Institute walk team. And when the new heart became available – Steve was more than ready.

Last November, Steve got his transplant. And thanks to the LVAD his body was better equipped for surgery and recovery. He was back to work only a few months after the transplant and is now more active than ever.

Keeping Andersen”s heart pumping while he waited for a heart to become available meant that he could get his lifesaving operation without going far from home, said Dr. Robert Kincade, the surgeon who performed Andersen”s transplant.

“This program allows more patients to be eligible for heart transplants in our system,” he said. “Previously, a lot of these patients would have either died or gone to the Bay Area.”

 

Not too many people get second chances in life, I’m going to make the best of mine.
-Valentine

Heart Disease / Heart Transplant

For many people Valentine’s Day is a holiday filled with love, romance and affection. It’s a time for meaningful cards, flowers and sentimental gifts. But this year, one Sacramento Valentine received a gift like no other. He received the gift of life – a new heart.

“Not too many people get second chances in life,” Mr. Valentine said. “I’m going to make the best of mine.”

Valentine underwent successful heart transplant surgery at Sutter Medical Center, Sacramento two weeks ago after being placed on the organ transplant waiting list last July. The devoted husband and father had been suffering from chronic heart disease for the past seven years.

“I used to train horses at Cal Expo and I used to be tired every morning,” Valentine said. “I felt like I had the flu. After a while I couldn’t take it anymore, so I went to the doctor and I found out the left side of my heart didn’t work.”

The following five years were a roller-coaster ride for Valentine. The once strong, energetic man found himself regularly in and out of hospitals, often going to the emergency room three days a week to have his swollen legs drained. It wasn’t until 2009 that Valentine heard about the Sutter Heart & Vascular Institute and his luck began to change.

After meeting with John Chin, M.D., medical director of the Heart Transplant Program and Robert Kincade, M.D., surgical director of the Heart Transplant Program & Ventricular Assist Device Program at Sutter Medical Center, Sacramento, and Jeffry Jones, M.D., medical director of Cardiac Critical Care Medicine & Ventricular Assist Device Program, Valentine was told he was a candidate for a long-term mechanical heart pump. The left ventricular assist device (LVAD) was implanted into his abdomen and sewn into his left ventricle and aorta. Its function was to do most of the work of his heart until a donor heart became available.

“Mr. Valentine came to us literally dying of heart failure,” Dr. Kincade said. “He was so short or breath he had to sleep sitting on his knees. We implanted a Heartmate II left ventricular assist device as a bridge to transplant.”

After the successful LVAD surgery, Valentine was able to go on a walk with his family for the first time in years.

“It was a beautiful alternative,” Valentine said. “The LVAD helps, it really does. I didn’t know a machine could help you like that.”

On Jan. 24, 2011, 14 months after receiving his mechanical heart pump, Valentine got the call that a heart match had been found for him. He underwent the heart transplant surgery the same day and spent the next two weeks in the hospital recovering.

“I feel a big difference already,” Valentine said. “Last time with the LVAD surgery it took me 20 days to get out of bed. This time I was walking the next day.”

Valentine said his long journey to a heart transplant has been worth it and said it was the staff at Sutter that helped make it possible.

“The people here, from the head janitor to the cook … they are the best. I can’t imagine people who love their job so much,” Valentine said. “I couldn’t get better doctors than Dr. Chin, Dr. Kincade and Dr. Jones.”

Valentine went home on Tuesday, and his wife who said having him home with a new heart is the best gift she could receive.

 

Dr. Ingram was incredible. At my pre-op appointment, he invited my dad, my sister and my fiancé to talk about my situation with him. He was very accommodating.
-Linda

Aortic Stenosis / Valve Replacement Surgery

Since her twenties, Linda felt like she had the word “smoker” tattooed on her forehead whenever she”d see a doctor.  Her symptoms – shortness of breath, dizziness, fatigue – were always chalked up to her smoking habit.  “Of course, I knew that my smoking contributed to my symptoms, but I wished I had a doctor who would be proactive about my health, even though I”m a smoker,” she said.

As Linda got older, she became increasingly concerned about her health. “I was diagnosed with mitral valve prolapse,” she said. “It’s a common condition that explained a lot of my symptoms. But I found out later that was a misdiagnosis – my condition was much worse.” Around her 50th birthday, suspected she may have a lung condition. She learned of a clinical study focusing on early detection of lung cancer.  Since Linda had received only minor diagnostic examination from any of her physicians, she signed up for the study.

Those running the study were extremely concerned for Linda”s health when they received the results of her first body scan.  They suspected aortic stenosis – a condition in which the aortic valve does not function properly.  After sharing this news with her primary care physician and asking to see a specialist, Linda”s doctor referred her to the Sutter Heart & Vascular Institute at Sutter Medical Center in Sacramento for more testing.

“As soon as I got there, I felt like I was in good hands,” Linda said.  “Even the tech who did my test was very friendly, we had a great conversation.”  After her first test, the tech brought in Dr. Edmond Lee, a cardiologist, to look at Linda”s results.  “I knew my results didn”t look good,” she said.  “Dr. Lee grilled me with all sorts of questions about my symptoms and my lifestyle. I was grateful – finally, a doctor who really cared,” she said.  “He even drew a little sketch to explain what was going on with my heart!”

Within a week, Linda was scheduled for heart surgery with Dr. Michael Ingram, cardiovascular surgeon with the Sutter Heart & Vascular Institute.  “Dr. Ingram was incredible,” she said.  “At my pre-op appointment, he invited my dad, my sister and my fiancé to talk about my situation with him. He was very accommodating.”   Linda also gained a little redemption when Dr. Ingram confirmed what she had expected all along: that her health problems did not stem from her smoking habit alone.  “Dr. Ingram said that the smoking may have exacerbated my symptoms, but that I was born with a faulty heart valve.”

Dr. Ingram successfully replaced her heart valve using minimally invasive valve replacement surgery.  “My scar is technically four inches long, but you can really only see one inch of it,” said Linda, who is extremely grateful to her surgeon.  “I can”t say enough about Dr. Ingram and his staff.  They are wonderful people who really care about their patients.”

As part of her post-operative treatment, Linda participates in cardiac rehabilitation at Sutter Roseville Medical Center.  “I can now do 30 minutes on the treadmill and 20 minutes on the bike,” she says proudly.  “I feel so much better.”  In addition to her physical symptoms, Linda claims that her mental aptitude improved after the surgery.  “I don”t know why, maybe more blood is running to my head,” she laughed.  “My memory is better.  I”m not foggy-headed anymore, I”m awake and alert!”

Life today is much better for Linda.  “For most of my life, my symptoms were dismissed or misinterpreted by other doctors. I’m really lucky the doctors at Sutter Heart & Vascular Institute figured out what was wrong with me. If it weren’t for them, I probably would not be here today.”