Mending Hearts

Tracy Pick and her mom, Betty Mesplay, are no strangers to heart procedures. In 1959 when Tracy was six-and-a-half months old, she had her first open-heart surgery to repair a severe narrowing of her aorta (also called coarctation of the aorta), the largest artery in the body. This narrowing was blocking normal blood flow to her body.

"Her father and I were young parents," remembered Betty. "She was in the hospital for a month after surgery, and at that time, the outcomes for babies who had open-heart surgery were not as good as they are today. It was a scary time, and we were thankful when she came home."

Tracy recovered, but in 1976, during her annual cardiology appointment when she was 17 years old, her pediatric cardiologist couldn't feel pulses in her legs or feet and scheduled an urgent cardiac catheterization. During this procedure, a long thin tube, or catheter, was inserted into an artery in Tracy's arm and threaded through the vessels to her heart to locate blockages and check the heart's pumping function.

"After the procedure, I was told that the scar tissue from my first surgery was causing my aorta to narrow again, and I had open heart surgery the next day," Tracy recalled.

"Even though it was hard seeing Tracy going through another heart procedure, she's a fighter," Betty added.

Continued Heart Care

For the next 30 years, Tracy didn't have any heart problems. Then in 2005 at age 45, she experienced chest pain and shortness of breath and was admitted to the emergency room for evaluation. “Thankfully, my symptoms were caused by indigestion, which was a blessing in disguise," Tracy said.

After looking at her chest x-rays, the emergency room doctor saw a bulge around the area of her earlier operations and referred Tracy to BJC Medical Group cardiologist, Dr. Robert Kopitsky.

After Dr. Kopitsky performed further testing at MoBap, Tracy learned the bulge was an aneurysm in the wall of her descending aorta on the scar tissue from her childhood surgeries. Now retired cardiothoracic surgeon Dr. Kouchoukos repaired Tracy's aneurysm, and over the next 15 years, she saw Dr. Kopitsky for annual heart check-ups. She had a second aneurysm repaired in 2013.

During her recovery, Tracy enjoyed painting scenes on sawblades, baskets and other items.

"Like Tracy, many patients diagnosed with congenital heart defects may transition into adulthood with unique complications that require monitoring and treatment," Dr. Kopitsky said.

New Warning Signs

In August 2020, Tracy began experiencing tiredness and noticed that she was out of breath when walking from one end of her house to the other.

"I made an appointment with Dr. Kopitsky, and he scheduled an echocardiogram to look at how well my heart was beating and pumping blood," Tracy said.

The test showed her heart's tricuspid valve was not closing correctly and was leaking, causing blood to flow back into the heart's upper chamber (right atrium) instead of moving to the lower chamber (right ventricle).

Dr. Kopitsky referred Tracy to MoBap cardiothoracic surgeon, Dr. James Scharff. "When I met with Dr. Scharff, I learned that my tricuspid valve problem was related to the heart problems I had at birth."

A Coordinated Effort

"When a heart valve isn't working, it can be a complex condition, and the right treatment can involve a spectrum of care," Dr. Scharff explained.

Dr. Scharff, Dr. Kopitsky and the rest of MoBap's heart team collaborated on Tracy's case. "We evaluate all cardiac patients through a multidisciplinary approach to arrive at the best treatment plan." He added that for patients like Tracy, who are born with heart problems and have had previous heart surgery, the collaboration – and communication – between the heart care team is a real benefit.

On September 3, Dr. Scharff performed a tricuspid valve replacement, replacing Tracy's leaky valve with a porcine (pig) valve. A pig's heart is similar in size, weight and structure to a human's heart, and pig valves have been successfully used in humans for over 30 years.

Tracy spent a week in the hospital recovering. While she was at MoBap, she also worked with physical therapists who helped her regain strength.

"I am thankful for the wonderful care I received at MoBap," Tracy said. "I felt supported by the entire medical team, especially when I could only have one visitor a day because of COVID-19 precautions."

On the day Tracy was discharged to go home, she learned that her mom, Betty, had been having shortness of breath and was scheduled for a cardiac catheterization at MoBap the next morning.

Betty didn't share the news with Tracy right away because she wanted to support Tracy and let her focus on recovery. "I didn't want to worry her about my heart issues until she was through surgery," Betty said.

A Mother's Surprise Diagnosis

Betty is also a patient of Dr. Kopitsky and was seeing him for preventative heart care.

With her heart conditions under control, Betty can return to her favorite hobbies, collecting teapots and quilting.

After her scheduled stress test showed abnormalities, Betty had a cardiac catheterization on September 25. The test revealed that she had atrial fibrillation (also called AFib), an irregular heartbeat that can lead to heart failure, blood clots or stroke. Betty was also diagnosed with blocked coronary arteries and a leaky mitral heart valve.

Dr. Kopitsky referred Betty to Dr. Scharff, who collaborated with the heart team, and recommended a mitral valve repair with double bypass and Maze procedure.

"I was surprised at the diagnosis and never thought I'd need heart surgery," Betty said. "Even though I've had hip and knee surgeries, facing heart surgery made me nervous. But Dr. Scharff answered my questions to help put my mind at ease."

Tracy also encouraged her mom, telling her they would get through their recoveries together. "We are a close-knit family," she said. "After having mom's support for my heart surgeries, it was nice to support her through her procedure in return."

On October 8, just over one month after her daughter's heart surgery, Betty had open heart surgery, during which time Dr. Scharff repaired her mitral valve. To help correct her AFib, she also had a Maze procedure, which disrupts the electrical impulses that cause the heart to flutter.

Following her surgery, Betty spent a week in the hospital recovering. Like Tracy, she also started physical therapy to prepare for her return home.

"I was told before surgery about the importance of getting up and moving as soon as possible to help prevent blood clots after surgery, and that's what they had me do," Betty said. "I also had a heart-shaped pillow to hold to my chest as a sort of brace when I had to cough."

Betty gives credit to the nursing staff and therapists. "The nurses and therapists were compassionate and empathetic and really helped me move forward in my recovery," she said.

Treatment for Heart Conditions

While Betty's procedures are more common, Dr. Scharff said that Tracy's tricuspid valve replacement is not typical. "Many people who need a tricuspid valve replacement have had other heart issues, some of which they may have been born with, as was Tracy’s case."

Dr. Scharff added that adult congenital heart surgery is a specialized field where people who have had heart surgery in childhood need repairs and other surgeries in adulthood. "Missouri Baptist's heart team is experienced in treating these cases, which tend to be higher risk, as well as other heart issues that are more routine."

On the Road to Recovery

Both Tracy and Betty are cheering each other on through their cardiac rehabilitation. Betty said that she feels like a new person. "Now that I'm back home, I have more energy and enjoy being outside with Tracy and walking around the 'family estate'."

As they look back on their shared experience, mother and daughter both appreciate the care they received at MoBap. "The doctors are excellent, and the staff is fantastic,” said Tracy. "I tell everyone, 'if you have a health problem, go to MoBap'."

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