Speaking from the Heart

When Kenneth Amaral visits with cardiology patients at Missouri Baptist Medical Center as part of the Mended Hearts volunteer program, he speaks from first-hand experience.

Considered one of the Missouri Baptist Heart Center’s biggest advocates by doctors and nurses alike, Amaral credits the hospital and its heart team with saving his life three times since 1996.

Amaral’s heart concerns first began being monitored by his Missouri Baptist cardiologist, Robert Lehman, MD, in 1989. And, since then, his three major heart procedures at Missouri Baptist have included a valve replacement in 1996, an ascending aortic aneurysm repair in 2008 and a MitraClip procedure in 2018.

“The surgeon who did my first two surgeries was Dr. J. Peter Murphy, and as far as I’m concerned, he and everyone at Missouri Baptist had saved my life twice at that point,” he said. “It was just after my second surgery that I became very grateful to the care and attention I had gotten from the cardiac group at Missouri Baptist. I decided then that I was going to volunteer because, to me, that was the payback.”

As a weekly volunteer, Amaral, 75, said he makes the rounds just letting patients know they will be OK because of the great nurses, doctors and other staff at the hospital.

“I enjoy making the rounds and talking to patients and family members, trying to ease their anxiety about the surgery they’ve either had or are preparing to have,” he said. “I end every chat with, ‘Don’t come back.’”

This past year, Amaral couldn’t even take his own advice, and he found himself back at Missouri Baptist as a patient.

It all began in May after a family vacation to Florida. Amaral, who is a retired advertising executive, and his wife, Sally, have four children between them and six grandchildren, so they lead a busy life.

“The day after I got back from Florida, I just started feeling lousy, sneezing, coughing, wheezing and getting short of breath, with my stamina starting to go,” he recalled. “I went to my primary care doctor, who thought it might be a respiratory problem. We tried several approaches, but nothing seemed to work.”

Amaral had an office visit scheduled with Dr. Lehman, and after a series of tests, it was determined that he might have congestive heart failure.

“That really knocked whatever wind was left right out of me,” Amaral said. “I started treatment for it, and for about a week or so, I started feeling better because I was getting rid of the fluid in my lungs.

“By August, I still wasn’t feeling well. I was getting frustrated, tired and depressed. I called Dr. Lehman’s office, but he was out of town. His office kept him up-to-date on my condition. Within 20 minutes, his office got back to me with instructions to go to the emergency room.”

Amaral went to the Missouri Baptist emergency department, where he met Dr. Linda Stronach, Dr. Lehman’s fellow cardiologist. She told him that after looking at his records and updated tests, she thought she knew what might be causing his issues.

She told Amaral she wanted to confer with her Missouri Baptist Heart Center colleagues, including interventional cardiologist Gus Theodos, MD; cardiothoracic surgeon James Scharff, MD; and cardiologist Michael Klein, MD.

“Mr. Amaral has a complicated past history, and he’d already had multiple complicated surgeries, but he was clearly in need of some further intervention,” Dr. Theodos said. “Dr. Stronach was not sure at the time if he should have another surgery or if there was something we could do that would be a little less invasive.

“We all work as a team, and with the combination of our specialties, we reviewed Mr. Amaral’s care together in a multidisciplinary fashion to come up with the best treatment for him,” Dr. Theodos added.

Following further evaluation, it was determined Amaral was experiencing mitral valve regurgitation — a condition where the heart’s mitral valve doesn’t close tightly, allowing blood to flow backward in the heart and often leading to symptoms Amaral had been experiencing, like shortness of breath and fatigue.

On Sept. 7, Amaral went in for a MitraClip procedure to reduce the mitral regurgitation and, after the more than three-hour procedure, found he was already feeling better by the time he was in recovery.

“I had lunch that afternoon, and by mid-afternoon, I started walking around the floor. I was feeling so good, I was breathing again and I didn’t have any of those awful symptoms,” Amaral recalled. “It was like coming through a light at the end of the tunnel.”

Dr. Theodos agreed that Mr. Amaral saw a really dramatic change following the procedure. He was a patient who could barely walk one lap around his room, and the next day, he walked more than 25 laps, he said.

“The MitraClip procedure has been around for awhile, but there are always slight nuances and improvements to it,” Dr. Theodos explained. “We were able to use the newest version of the clip, which has slightly longer clip arms, and so it gave us a nice grasp of the mitral valve and really reduced his regurgitation.”

Now, several months after surgery, Amaral is doing regular cardiac rehab close to his home at Barnes-Jewish St. Peters Hospital and has returned to volunteering, painting, reading and enjoying his family. He will continue to be monitored by Dr. Theodos for the next year and Dr. Lehman.

“Patients who have this procedure are enrolled in a national registry to ensure close follow-up and make sure these procedures are doing what we think they are doing,” Dr. Theodos said. “People can tolerate mitral regurgitation for a long time, but at this point in time this procedure should allow him to live an active, normal life for many years.”

And Amaral has nothing but praise for the Missouri Baptist heart team.

“I had a whole host of people from the Heart Center taking care of me. They are some of the most talented, proficient people I’ve ever dealt with, and we are lucky to have them here,” he said. “I’m a lucky guy. I was at the right place three different times and working with the right physicians. I’m totally sold on the place.”

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