Tom and Sue Olander know more about heart valve procedures than the average couple. Both were treated by Froedtert & the Medical College of Wisconsin heart valve experts using open-heart surgery. Today, the Brookfield couple is back to their regular schedules of traveling, exercising and enjoying life.
Several years ago, Tom was diagnosed with a heart murmur, an abnormal sound in a heartbeat caused by turbulent blood flow through a narrowed heart valve. It wasn’t causing any problems, but his doctor told him to keep an eye out for symptoms. In 2019, he noticed he was getting short-winded after exercise. He consulted Paul Pearson, MD, PhD, cardiothoracic surgeon and MCW faculty member.
“Meeting Dr. Pearson was like attending a crash course in anatomy,” Tom said.
Tom, now 73, needed an aortic valve replacement for a valve that had narrowed. He had several options but chose a mechanical valve, which is considered a “one-and-done” procedure. While he must take a blood thinner, Tom’s mechanical valve will last a lifetime.
In the meantime, Sue, now 72, started to notice shortness of breath and a racing heartbeat. She saw Dr. Pearson to discuss a problem with her mitral valve. An echocardiogram revealed mitral valve prolapse, which occurs when this important heart valve does not close and allows high-pressure blood from the heart’s main pumping chamber to leak backwards in the heart. She also had a leaking tricuspid valve and a hole between the right and left sides of her heart. Dr. Pearson was confident he could repair Sue’s two heart valves instead of replacing them. She had surgery to fix all three problems.
“She figured if I could have one valve replaced, she could have three things done,” Tom said.
The Mechanics of a Heart Valve
Dr. Pearson likes to educate patients so they understand their options and choose the one that works for them.
“The lungs send oxygenated blood to the left atrium of the heart, which pumps it through the mitral valve to the left ventricle, the main pumping chamber in the heart,” Dr. Pearson said. “The left ventricle then pumps the oxygen rich blood through the aortic valve to the rest of the body. If the mitral valve leaks, the blood can flow backwards in the heart, causing problems like heart failure. If the aortic valve is too tight, it can force the heart to work too hard and cause abnormally high pressures in the heart and lungs.
“The most common problem we see with the aortic valve is that the valve gets too tight. This is termed stenosis. The heart has to work harder just to eject blood to support a patient’s blood pressure.”
While leaking heart valves can be repaired, heart valves that are too tight must be replaced. Patients can often choose between a tissue or a mechanical replacement valve. The mechanical valve is built to last, but patients must take a blood thinner. The tissue valve does not require a blood thinner, but it also comes with a 10- to 15-year lifespan.
Open-Heart Surgery for Leaking Valves
While Froedtert & MCW experts can offer patients the most advanced nonsurgical treatments for heart valve problems, conventional surgery is sometimes the safest and best approach.
“We have a toolbox full of tools for valvular heart disease, and we can choose the tool that’s appropriate for each person,” Dr. Pearson said.
Leaking valves may not cause symptoms early on; the heart can adapt to a leaky valve. However, Dr. Pearson said if people wait for symptoms as the trigger for intervening, they may experience irreversible heart damage. Thus, surveillance with an echocardiogram is important.
The idea of open-heart surgery may be daunting, but people are often pleasantly surprised to discover that recovery isn’t as difficult as they expected. While an incision on the chest is required, techniques have evolved to minimize the impact of the surgery and maximize a speedy recovery. Following a cardiac procedure, patients are referred to cardiac rehabilitation where they undergo a comprehensive program of exercise, risk factor modification and heart health education. Dr. Pearson said these rehabilitation sessions may also lead to a special camaraderie among patients.
Seeking Treatment for Heart Conditions
Life is good now for the Olanders. They see cardiologists at the Heart and Vascular Center at Froedtert Menomonee Falls Hospital, part of the Froedtert & MCW health network. Tom works with Kevin Cohoon, DO, and Sue sees Subhashish Agarwal, MD, MS. The adage of “listen to your body” proved true for them, and it allowed them to seek help in a timely, efficient manner.
“I was able to pick my doctor, pick my timing and pick my hospital,” Tom said. “I would much rather do that than wait until I collapsed.”
Our heart and vascular team offers specialized programs to diagnose and treat the complete range of heart and vascular diseases. Call 414-777-7700 for an appointment, or visit froedtert.com/heart-care to learn more.
Do you repair rheumatic mitral valves?
Hi Rose,
Thank you for your question. We do offer treatment options for rheumatic valve disease. There are many factors that determine the recommended treatment options like affected valves and whether its stenosis (narrowed valve opening) or regurgitation (allows blood to flow backwards). For many patients with rheumatic mitral stenosis, a mitral balloon valvuloplasty (non-invasive procedure) is recommended. In other situations, mitral valve surgery or an investigative device trial may be the best or preferred option.