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Andrew Williams

Heart Valve Surgery Gives New Lease on Life

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While vacationing in New Orleans in 2001, Connie felt an achiness in her chest that she thought was due to a pulled muscle from not sleeping well. After returning home, the pain did not subside, and she went to the emergency room to have it checked. The doctor ordered an echocardiogram.

An echocardiogram (also known as an "echo") is a procedure that shows pictures of the heart's valves and chambers and helps evaluate the heart's pumping action.

Connie's echo showed that her heart was functioning without problem, but her heart's aortic valve was starting to show signs of stenosis. "The ER doctor referred me to a cardiology group close to our home in Jerseyville, Illinois, for follow-up care."

When Connie saw her new cardiologist, he told her that the echo also revealed she had been born with an aortic valve heart defect.

The heart has four chambers separated by valves with flaps that open and close, regulating the amount of blood entering each chamber at a time. Instead of three flaps, Connie's aortic valve had only two.

Missouri Baptist Medical Center cardiothoracic surgeon Dr. James Scharff explained, "It’s not uncommon for some people to find out that they were born with a heart defect until later in life, especially if they aren’t experiencing symptoms." He added that some aortic valve conditions eventually require surgery to reduce the risk of heart failure.

Because Connie had mild aortic valve disease without symptoms, she saw her cardiologist for regular echocardiograms to monitor her condition. While worsening stenosis was noted on later exams, continued observation was the plan because she wasn't experiencing any symptoms.

For years, Connie enjoyed an active life with her husband, Arlin, and their three children.

New Symptoms Lead to New Diagnosis

In 2021, Connie noticed she was tiring more quickly. "My fatigue gradually worsened to the point where lifting my arm was difficult."

Connie's cardiologist ordered an echo and a heart catheterization to check her heart valves and blood vessels. The test results showed that Connie had severe aortic valve stenosis that prevented her valve from fully opening and reduced blood flow from her heart to the rest of her body. "They also found a blockage in one of my heart vessels, but I didn't have shortness of breath or chest pain, two of the main symptoms of aortic valve stenosis."

When asked about who she'd like to see for surgery and further treatment, Connie said, "I knew I wanted to come to Missouri Baptist and Dr. Scharff."

Choosing the Right Surgeon

Connie met Dr. Scharff in 2012 when Arlin needed a cardiothoracic surgeon to repair a leaky mitral valve in his heart. "I was nervous about Arlin's surgery because my mom had open-heart surgery, and my dad had complications after a cardiac catheter procedure performed at another hospital." She explained that they interviewed several surgeons before choosing Dr. Scharff. "When we met Dr. Scharff and his nurse Carol, we immediately liked them. Having heart surgery can be scary, and Dr. Scharff always takes time to answer questions."

Connie's cardiologist arranged for the referral to Dr. Scharff. During her first appointment, Dr. Scharff ordered an additional test to determine if the blockage in her vessel was severe enough to need a bypass procedure. The bypass would be performed during the same operation as her valve replacement if necessary.

Dr. Scharff collaborated with MoBap cardiologist Dr. Jeremy Tietjens about the test results. Because the results showed that Connie had good blood flow to her heart, they agreed that she didn't need a coronary bypass grafting procedure, which would require a large incision to open her chest and a longer recovery.

"We decided on a minimally invasive approach with one small incision on her upper chest to replace her aortic valve, which would help Connie's heart pump blood more easily from the heart to the rest of her body," Dr. Scharff explained. He added that minimally invasive heart surgery typically has a shorter hospital stay, fewer complications, a quicker recovery and less pain than traditional open-heart surgery.

Heart Surgery at MoBap

In preparation for surgery, Connie came to Missouri Baptist on October 20, 2021, to complete preoperative testing. "I had a heart catheterization, chest x-ray and an ultrasound of the vessels in my neck. Even though it was a long day, I'm grateful that the heart team coordinated all my testing, so we only had to make one trip from Jerseyville."

On October 25, Connie had heart surgery, and Dr. Scharff replaced her damaged aortic valve with an bovine valve made from cow tissue. During her two-hour surgery, Connie was connected to a heart-lung bypass machine which kept blood moving through her body during the procedure. Dr. Scharff explained that Connie's new valve has an expandable frame, so a catheter approach would be more feasible if the valve wears out and needs replacing in the future.

Recovery

After surgery, Connie spent three days in the hospital. Now that she's home, Connie still has some pain, which is normal, but feels great overall and takes daily walks around the lake near their house. "My fatigue is gone, and one of the biggest changes I've noticed is that my feet are warm now because of the improved blood circulation to my body."

Shortly after returning home, Connie experienced a brief episode of dizziness, and she called the MoBap cardiothoracic surgery physician assistant on call. "Thankfully, I was just dehydrated, and the physician assistant reassured me that I had done the right thing by calling."

After her surgery, Connie and Arlin decided to consolidate their heart care through Missouri Baptist and now see cardiologist Dr. Jeremy Tietjens. "We love MoBap and trust all the doctors there. We also like how closely everyone on the heart team collaborates and works together. It's truly impressive."

Looking forward to resuming their active lifestyle in 2022, Connie and Arlin have two trips planned early in the year. Connie said that her heart surgery has given her a new lease on life. "Every time I'm at Missouri Baptist, I feel cared for, listened to and taken seriously. I always tell people that if you have heart problems, go to MoBap."

Missouri Baptist's Heart Center

Cardiothoracic surgeon Dr. James Scharff and cardiologist Dr. Jeremy Tietjens are part of the heart team at MoBap that also includes specialized cardiac nurses and physicians who only care for cardiac and thoracic patients, like Connie. Offering several screening services and specialized treatments, the Heart Center provides a comprehensive cardiac program to treat a range of heart conditions.

"By drawing upon the vast knowledge and experiences of each member of our heart team, we feel that we can provide optimal individualized care to all of our patients," said Dr. Scharff.

For more information about the Heart Center, visit MissouriBaptist.org/heart.

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Appointments are also available on Tuesdays at the BJC Outpatient Center at Sunset Hills, 3844 South Lindbergh Boulevard.

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