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Tina, a MoBap cardiac surgery patient, has always been active and enjoys walking, biking and being outdoors.

Repairing a Broken Heart: A New Diagnosis Helps Heart Pump at Peak Efficiency

Tina Lybarger Ledyard, a nurse at Barnes-Jewish Hospital and the hospital's stroke network consultant, has lived with a heart condition her entire life.

Tina with Rachel Sargent
In her professional life, heart patient Tina is a nurse at Barnes Jewish Hospital and the hospital’s stroke network coordinator (right). Here she consults with colleague Rachel Sargent, RN, BSN, stroke program manager at MoBap, as they demonstrate telemedicine.

Born with pulmonary valvar stenosis that prevented normal circulation of blood between her heart and lungs, Tina had open heart surgery when she was only three years old to repair the defective valve. During the surgery, doctors widened the valve's opening to improve blood flow. "At the time, it was a new procedure," Tina said. "There was significant risk, but the doctors told my parents that without the surgery I might not live to be a teenager."

Following the success of her surgery at a young age, Tina has enjoyed life without restrictions, although she's had periodic heart MRIs to make sure that everything continues to be okay. "I haven't had any real problems with my heart," she said. "I have always been active and enjoy walking, biking and being outdoors."

A New Diagnosis

In August 2018, Tina noticed that she was feeling more fatigued than normal. "Even my husband, Myron, commented that that my activity had slowed and was worried because I was laying down to rest on the weekends instead of taking part in some of my favorite pastimes."

Tina instinctively knew that something was wrong. Following the conversation with her husband, she made an appointment with her cardiologist, Missouri Baptist Medical Center's Dr. Linda Stronach, who scheduled an MRI of Tina's heart to identify any problems.

The MRI results showed that Tina had severe pulmonary regurgitation. The pulmonary valve that was repaired when she was a toddler was leaking and causing some blood to flow back into her heart chamber instead of being pumped to her lungs for oxygenation.

"The results of my previous MRI showed mild pulmonary regurgitation," Tina remembered. "I was surprised that the condition had progressed to severe."

Dr. Stronach referred Tina to MoBap cardiothoracic surgeon, Dr. Joshua Baker. "When I met with Dr. Baker, he put me at ease, listened to my concerns and answered my questions honestly," Tina said. "As a patient, having that kind of rapport is important to me."

Tina with Dr. Baker
Tina Lybarger Ledyard, a heart patient, consults with MoBap’s cardiothoracic surgeon, Dr. Joshua Baker. Tina has renewed energy thanks to a recent heart surgery she underwent.

Dr. Baker introduced Tina's case to other doctors who are a part of Missouri Baptist's heart team. "All cardiac patients are evaluated through a multidisciplinary approach," Dr. Baker described. "This collaboration between specialists is a real benefit to our patients."

Choosing the Best Procedure

Dr. Baker presented Tina with two options for correcting her pulmonary regurgitation. "He told me about a minimally invasive procedure that would have to be repeated in the future or they could perform open heart surgery, which would give them a chance to really fix the problem." After considering both options and thinking about her lifestyle, Tina chose the latter.

On the day of her surgery in late August, Myron, their children, and Tina's parents accompanied her to the hospital. "We knew what to expect," Tina said. "We were prepared for the surgery to last four to five hours, and then I'd be in the cardiac intensive care unit for a few days before being moved to a regular hospital room for the remainder of my stay."

The surgery went smoothly, and Dr. Baker replaced Tina's leaky valve with a porcine valve (pig valve), removed scar tissue and closed a ventricular septal defect, or hole in the wall separating the heart's lower chambers, that wasn't fully evident during preoperative imaging.

"He even fixed the scar on my chest that was left from my first surgery in 1959," Tina said. "That original scar had widened over time and was ugly. The scar I have now is thin and barely noticeable."

A Quicker than Usual Recovery

Because of the complexity of the surgery, Tina was expecting a longer recovery but was surprised at how quickly she bounced back. "I was transferred out of the cardiac intensive care unit ahead of schedule, didn't need cardiac rehab and was discharged two days sooner than planned," Tina recalled. "I took advantage of MoBap's home healthcare for two weeks after I was discharged."

"It's important to keep in mind that each patient's surgery and recovery are unique," Dr. Baker said. "I attribute Tina's quick recovery to her active, healthy lifestyle. Her heart is now working at peak efficiency, which is evident in how good she feels."

"It's been an incredible journey," she said. "The severe pulmonary regurgitation developed over a longer period as did my symptoms of fatigue. I didn't realize how poorly I felt until after recovery when I noticed how much energy I have and how much better I am sleeping and breathing."

Looking back on her experience, Tina stresses the importance of getting to know your doctors and asking questions. "I'm thankful for Dr. Baker and the entire heart team at MoBap and the great care I received," Tina said as she looks forward to the future. "Establishing good communication with your doctors, building a relationship with them and asking questions helps prepare one for whatever lies ahead."

Dr. Stronach and Dr. Baker released Tina to return to work three weeks after her surgery. Since then, she is back in her office full time doing what she loves – helping patients.

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