Posts Tagged ‘Heart Valve’

Why the guidelines were changed

September 25, 2009

The American Heart Association has long had guidelines for dealing with Endocarditis – a problem not faced by the majority of people, but threatening to those of us with Congenital Heart Defects (CHDs). Endocarditis can occur when bacteria in the blood settles on a damaged heart valve. This can cause an infection of the Endocardium (the inner lining of the heart) or can damage or destroy a heart valve.

For years the guidelines stated that if you had any kind of problem with your heart (defect, bypass surgery, had a valve replaced, etc.) you should take antibiotics to protect yourself from Endocarditis when you went to the dentist. But the guidelines have recently changed: Now, antibiotics are only recommended for certain people, and for certain procedures.

The guidelines have been changed because researchers have found that Endocarditis itself is changing. Studies in Europe have shown that the Antibiotics may not be that much of a preventative, and health care Endocarditis – Endocarditis caused by “in hospital contamination” – is rising. Also, surgery (if needed) is seen as being more effective the earlier it is done, so you need a whole team approach – Cardiologists, Cardiac Surgeons, Infective Disease Specialists, and a major cardiac surgical center, all working together.

One of the ways Endocarditis is diagnosed, especially if you have a medical device implanted in your body, is by Trans-Esophageal Echocardiography (TEE). It’s usually not pleasant: A tube with an ultrasound probe on the end is passed down your throat to give the doctors a good look at the heart from as close as possible. Ouch!

Mayo Clinic is working with new computer software to diagnose Endocarditis without the TEE. Designed to work like the human brain, the software literally has to be “taught” what to look for and how to respond. It’s complicated, but the software has made the correct diagnosis most of the time. (72 out of 73 times for all infections; and 12 of 13 Endocarditis cases in particular.)

New valve, no surgery!

August 18, 2009

So you need a new heart valve. Oh, boy. I bet you are just looking forward to the prospects of open heart surgery: having your chest split open, the pain when you cough (and if you think coughing hurts, just wait until your first post surgical sneeze!) and spending two to three months recovering. Or maybe you are like me… after all the problems with the scar tissue tearing and nearly bleeding out during my last operation, the docs aren’t going to go back in my chest any time soon. So what now?

The answer used to be “Just do the best you can,” because there were no other options. But now inserting a heart valve via catheterization is becoming more and more common – New York’s Presbyterian Hospital has implanted its 100th heart valve – and they never split anyone’s chest!

Before you pick up the phone and call the hospital, there is one problem – all 100 were done as part of a clinical trial. Most likely, they’ll have to turn you down, because these are tests of new valves carried out under controlled conditions. But every time they implant a valve, hopefully they learn something new. Presbyterian is replacing Aortic valves; a Pulmonary valve replacement was introduced a few weeks ago. It’s new to us, but they have been using it in Europe for some time.

So perhaps one day – not too far into the future – valve replacement by catheter will be the way things are done!

News and Notes

September 13, 2008

A very short post tonight, as I’m pretty busy, but I did find several articles that you will find interesting: There’s yet another report showing that Adult Stem Cells taken from heart muscle can regenerate damaged hearts. But this time the news is even better: Doctors have found a way to boost their effectiveness.

A member of the Adult Congenital Heart Association is once again in the news, as Jim Langill took on the Boston Heart Walk today (September 13, 2008). I hope it went well, Jim!

Has your doctor ever described you as a “difficult patient”? That’s a good thing!

And finally, things are really happening down at Emory University Hopsital, where I go for Adult Congenital Heart Defect care.  Emory is one of only ten hospitals nationwide that is testing a new procedure to insert heart valves without cutting the chest open!