Two Minimally Invasive Procedures Repair Woman’s Heart

Deb-Hart_Barnes-Jewish-HospitalWhen Deborah Hart’s doctor told her she needed heart surgery, she initially found it difficult to believe. Hart, 58, is an active and otherwise healthy person, who had never been diagnosed with a serious illness. “I don’t drink alcohol or smoke. I eat healthy foods. I’ve always exercised regularly. Heart disease was the furthest thing from my mind,” said Hart.

Hart and her husband, Rick, raised five children outside of Farmington, Missouri, which is about 50 miles south of St. Louis. When Rick retired in 2007, the couple moved to Alabama so he could spend his retirement close to his favorite bass fishing streams. Her children and 14 grandchildren all live in the St. Louis area, and the Harts visit often.

When Hart began to feel short of breath in October 2013, her primary care doctor initially diagnosed the symptoms as bronchitis. But two rounds of breathing treatments didn’t improve her symptoms and she began to experience irregular or chaotic heart rhythms, a condition known as atrial fibrillation. When the medication she was given in two consecutive trips to an emergency room in Alabama didn’t correct her heart’s rhythm, further tests identified mitral valve regurgitation as the cause.

When functioning properly, the mitral valve closes tightly as the heart beats. This allows blood to flow in the proper direction to the left ventricle, which in turn supplies the body with oxygen-rich blood. Mitral valve regurgitation is a condition in which the valve leaflets do not close completely when the heart contracts. As a result, blood flows backward into the heart, leading to inefficient heart function. Mitral valve regurgitation can often result in heart rhythm problems (like atrial fibrillation), as in Hart’s case.

“It was a scary time,” said Hart. “You think ‘how is this happening to me?’ I felt my heart beating wildly, and for a while, my doctors didn’t know why.”

Hart’s cardiologist in Alabama recommended she seek a surgical specialist who could repair her mitral valve and address the atrial fibrillation using minimally invasive techniques. Hart chose Ralph Damiano, Jr., MD, Washington University chief of cardiothoracic surgery at Barnes-Jewish Hospital, as her surgeon. “There was no doubt in my mind that I needed to go to Barnes-Jewish Hospital. Being from Missouri, I knew their reputation. After reading several reviews, it was pretty obvious Dr. Damiano was the only person I wanted to do the surgery,” said Hart.

To put Hart’s heart back into rhythm, Dr. Damiano performed a Cox-Maze procedure, a minimally invasive treatment that corrects irregular electrical impulses in the heart. During this procedure, the surgeon makes a series of scars in the heart muscle. This scar tissue redirects the heart’s electrical impulses to travel in the right direction, allowing it to return to a normal rhythm. James Cox, MD, first performed the Cox-Maze procedure at Barnes-Jewish Hospital in 1987.

Dr. Damiano further advanced the procedure in 2002, when he introduced a treatment that uses waves of energy instead of traditional incisions to create the needed scar tissue. This innovation reduces a patient’s recovery time and lowers the risk of complications. More recently, he created a minimally invasive approach for Cox-Maze, which allows the surgeon to use a small two-and-a half-inch incision to perform the surgery.

While Hart was in the operating room for the Cox-Maze procedure, Dr. Damiano used the same small incision to perform a minimally invasive mitral valve repair to fix her leaky mitral valve. Mitral valve repair is used as a safer alternative to a much riskier valve replacement operation.

After the successful surgeries, Hart said her nurses and staff made her recovery much easier. “Everyone I encountered from the Heart & Vascular team genuinely cared about how I was doing. They never hesitated to answer my questions or go over something twice if I didn’t understand,” said Hart.

Now, more than a year after the minimally invasive Cox-Maze procedure and mitral valve repair, Hart said she feels better than ever. Her heart function has returned to normal, which Hart said is important when you’re keeping up with 14 grandchildren. “When it comes to your heart, it’s so important to get the best treatment you can. Because I chose Dr. Damiano, I got the gold standard of heart and vascular surgical care.”

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Category: Heart & Vascular

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Barnes-Jewish Hospital at Washington University Medical Center is the largest hospital in Missouri and the largest private employer in the St. Louis region. An affiliated teaching hospital of Washington University School of Medicine, Barnes-Jewish Hospital has a 1,800 member medical staff with many who are recognized as "Best Doctors in America." They are supported by residents, interns and fellows, in addition to nurses, technicians and other health-care professionals.

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