Hear From Cardiac Surgery Patients
Many patients who come to the Steward Center for Advanced Cardiac Surgery have a story to share about their care, recovery, and success after surgery or other treatments.
Katherine K. - Minimally Invasive Robotic-assisted Mitral Valve Repair
As a professional writer, Katherine K., of Worcester, Massachusetts, can create a compelling story that will keep her readers engaged and entranced. And, while a happy ending isn’t always a guarantee, Katherine’s own personal story has its own happy ending thanks to Dr. Arvind Agnihotri, chief of the Steward Center for Advanced Cardiac Surgery and his team.
Until recently, the 65-year-old writer was successfully managing chronic mitral valve prolapse. With routine visits to her personal care physician and a focus on healthy living including walking for one- to two-hours several times a week, Katherine was not immediately concerned when her doctor detected that her heartbeat was louder than usual.
“I’ve been able to feel my heartbeat for my entire life,” Katherine says. “It’s part of the mitral valve prolapse condition. In retrospect, my thumps had become more forceful in recent months, but I’m very active so didn’t consider it an issue.”
Her physician ordered an echocardiogram and after a follow up with a local cardiologist, they found a ruptured mitral cord that needed repair. As this is significant surgery, with the potential of a long recovery and Katherine was readying to start a new book, her cardiologist recommended a robotic-assisted mitral valve repair procedure. Katherine was referred to Dr. Agnihotri, who determined that the robotic procedure would be medically appropriate.
“Katherine expressed a strong wish to avoid the side effects of a traditional mitral valve repair procedure, including the need to sometimes break bones to access the heart," says Dr. Agnihotri. "I counseled her that the procedure, while still invasive, would provide her with far less incisions, pain and recuperation time. She was thrilled with the option.”
According to Dr. Agnihotri, the procedure went exactly as planned. After a few days in the hospital, Katherine was discharged home for recovery and received home visits from the VNA.
“Dr. Agnihotri and the St. Elizabeth’s team were extraordinary. The explanations they offered were clear and thorough and I really understood every step of the procedure and care after the procedure,” she says. “I would recommend anyone who is a candidate for this procedure to strongly consider it. I wanted to get back to my regular life, my work, as quickly as possible, and I felt this procedure helped me achieve that goal.”
Richard A. - Minimally Invasive Robotic-assisted Bypass Surgery
2013 was a very happy 76th birthday for Richard A. of South Easton, Massachusetts. He celebrated his birthday without having had open heart surgery and experiencing six to eight weeks of recovery after a cardiac bypass threatened his life. Richard is one of a growing number of individuals who have opted for robotic-assisted bypass surgery performed by Dr. Arvind Agnihotri, chief of the Steward Center for Advanced Cardiac Surgery at St. Elizabeth’s Medical Center.
Richard’s story begins when he was on vacation in Maine. While enjoying the weather and the company of his wife, family and friends he began to experience intense shortness of breath and was taken by his wife to a local hospital. Finding water in his lungs, the emergency medical team immediately addressed the concern but also wanted to check him for cardiac blockage. After an echocardiogram, and confirmation of a blockage, the physicians in Maine contacted Richard’s primary care physician, Dr. John Dowling of the Steward Medical Group Newton Primary Care Practice.
"I've known Dr. Dowling for 35 years. I worked for UPS and Dr. Dowling used to do the company physicals,” says Richard. “I definitely wanted him involved. After speaking to the doctors in Maine, Dr. Dowling told my wife and I to get back to Boston immediately and come in because he wanted to evaluate me for a less invasive procedure.”
What followed was a series of immediately-scheduled appointments. Richard and Lois saw St. Elizabeth’s chief of cardiovascular medicine Dr. Joseph Carrozza who recommended that they consult with Dr. Agnihotri on a procedure he specializes in called robotic-assisted bypass surgery.
According to Dr. Agnihotri, by using robotic-assisted surgery, potentially traumatic procedures such as bypass can be performed through one- to two-inch incisions, without spreading or cutting the breastbone or ribs, thereby minimizing blood loss, pain and scarring.
"Dr. Agnihotri said the surgery was going to be less invasive," comments Richard. "I have friends who have had their chests cracked open and have much longer recovery times. I didn’t want that and my wife didn’t want that."
After the procedure, Richard had a brief hospital stay and was discharged home with simple care instructions and medications. Throughout it all both Dr. Agnihotri and Dr. Dowling visited with him, reassured him, and were both very calm and available.
“I left the hospital and refused the wheelchair. It’s really a miracle,” Richard proudly states. “I have talked with friends who have had the open surgery and they all had at least six to eight weeks recovery time. I was at home and within a few weeks my wife was telling me to slow down.”
Lucy M. - Transcatheter Aortic Valve Replacement (TAVR)
Last year, when Lucy M. began experiencing problems with her breathing, she chalked it up to complications stemming from her asthma. She followed up with her pulmonologist who adjusted her medications. When the breathing problems persisted, she consulted with her primary care physician who referred her to a cardiologist. A heart catheterization revealed a narrowed heart valve, a condition called aortic stenosis.
In June of 2015, Lucy, 84, underwent a transcatheter aortic valve replacement (TAVR) at St. Elizabeth’s Medical Center. The procedure is one in which the technology allows physicians to replace a severely narrowed aortic valve due to aortic stenosis without a conventional chest incision or having to be placed on a bypass pump. In this much less invasive approach, a new valve is implanted either through a catheter that is inserted through the vein in the groin area and then carefully passed up into the heart, or through a tiny incision in the chest wall and implanted directly into a patient’s heart.
“I feel good, really good,” Lucy, of Haverhill, Massachusetts says. “I’m surprised I feel as well as I do.” Without the TAVR, she faced an uncertain future and is pleased she underwent the procedure.
“I’m 84 years old. I felt either it’s going to do good for me or it’s not going to do good for me, so I thought I would take the chance,” she says. “I want to prolong my life. I still feel young.”
She encourages others who need this procedure to give it a try. While she misses working, she doesn’t miss her commute. Faced with several other health issues, Lucy is content to spend time with her adult son and daughter and do “ordinary things,” including grocery shopping, laundry and cooking.
“If anyone has the opportunity, regardless of what age they are, they should take the chance. Always take a chance,” she says.
Manuel G. - Convergent Hybrid Ablation
For the past 50 years, engineer Manuel G. has routinely worked seven days a week and played racquetball and competitive soccer. About 18 months ago he began needing naps to get through the day, doubling over to catch his breath while playing sports and experiencing heart palpitations.
“I felt like an old man. I didn’t have any energy,” Manuel, 71, of North Dartmouth, Massachusetts, said.
In May of 2014, he was diagnosed with persistent atrial fibrillation, a condition where a patient has a sustained heart rhythm disorder for more than seven days. A procedure called a cardioversion got his heart beating normally again, but only for a few days. A second one lasted about a week. His cardiologist then reached out to Dr. Michael Orlov, director of the Electrophysiology Laboratory at St. Elizabeth’s Medical Center. He underwent a third procedure called an ablation where Dr. Orlov used radiofrequency to produce scar tissue on Manuel’s heart to block abnormal electrical signals that cause his rhythm disorder. In less than two weeks he was back in atrial fibrillation and by the end of the year he had undergone a second cardioversion and another ablation, however, in his case, they did not correct his condition.
“I really, really, didn’t want a pacemaker,” he said. “That was out of the question for me.”
On the advice of Dr. Orlov, Manuel met Dr. Stanley Tam, a cardiac surgeon who had recently joined St. Elizabeth’s Medical Center from the University of Massachusetts Memorial in Worcester where he had served as chief of cardiac surgery. After consulting with Dr. Tam and Dr. Orlov, Manuel decided to undergo an ablation procedure called the “Convergent Approach” where the cardiac surgeon and electrophysiologist work as a team to perform a cardiac ablation. Using a minimally invasive approach with a small incision in Manuel’s abdomen, Dr. Tam performed an ablation across the backside of his heart. Dr. Orlov, the next day, threaded an ablation catheter through Manuel’s femoral vein in the groin to reach the inside of his heart to ensure the lesions were completed and connected, and then used electrophysiology diagnostics to confirm the abnormal electrical signals were interrupted.
“I’ve been in normal sinus rhythm since,” Manuel said. “I’m feeling the best I have felt in two years.”
Manuel, who has been married for 50 years and is a father and grandfather, is doing just that. In the summer heat and humidity, he was building a patio at his house and is once again playing racquetball.
“I’m really thankful to my doctors for giving me back my life,” he said.
Timothy G. - Minimally Invasive Robotic-assisted Mitral Valve Repair
When Timothy G., 63 years old, went for his routine physical, finding himself a patient of Dr. Arvind Agnihotri, chief of the Steward Center for Advanced Cardiac Surgery at St. Elizabeth’s Medical Center, approximately 80 miles from his home in Keene, New Hampshire, was not even a thought.
According to Timothy, he was feeling ‘good’ before his yearly physical and was surprised that his doctor found a heart murmur. Neither was immediately overtly concerned but his doctor wisely wanted him to explore the murmur further and sent him to have an echocardiogram. What they found was serious – a mitral valve that was not closing as it should.
According to Timothy, in hindsight, he had a few mild symptoms. “I felt shortness of breath and occasionally felt like I overexerted myself but really just chocked it up to getting older. On a day-to-day basis, I was feeling fine.”
Timothy’s physician immediately sent him to a cardiac surgeon in Boston but Timothy had other ideas. After researching surgical options online, he learned about robotic-assisted mitral valve repair. He was interested in learning more about the procedure and if he was a candidate because of the minimized recovery time. Timothy, still active and employed in maintenance, wanted to be back on his feet as quickly as possible.
“What I found on the Internet is that the robotic procedure had a recovery time of one month while traditional surgery was more like two or three months,” Timothy explains. "I found Dr. Agnihotri myself. My primary care doctor was supportive and with his blessing I went to see him at St. Elizabeth’s.”
According to Dr. Agnihotri, Timothy was an ideal candidate for robotic-assisted mitral valve repair surgery.
“Robotic surgical technologies are very attractive to many patients who want to minimize and even eliminate some of the post-operative healing,” he says. “For Timothy, I was able to minimize incisions, blood loss and ultimately speed his road to recovery.”
After the procedure in early February 2013, Timothy’s only hiccup was the delay in his release due to the Blizzard of 2013.
“I spent an extra day in the hospital but I didn’t mind," he says. "I was treated really well by all the nurses.”
When he was discharged from the hospital, he was sent home with after-care instructions and stated that he didn’t need much pain medication. He completed a regimen of cardiac rehabilitation close to his home and his scarring is minimal – the biggest scar being two inches long below his right armpit.
“I would recommend this surgery,” Timothy says. “Recovery was even quicker than I had expected. Once I was home I expected to be down and out and bedridden for a couple of weeks, but it really was only a handful of days.”
Charles E. - Taking advantage of modern procedures - Minimally Invasive Aortic Valve Replacement
Since birth, Charles E. knew that his bicuspid valve, a congenital heart defect, would eventually need to be replaced. The 60 year old from Newton, Mass., recognized the time had come when he tired quickly while running and going up stairs. Knowing the next step was a surgical procedure, his cardiologist, Dr. Lana Tsao, referred him to Dr. Arvind Agnihotri and the Steward Center for Advanced Cardiac Surgery to discuss a minimally invasive aortic valve replacement.
Prior to meeting Agnihotri, Charles sought a second opinion at a large teaching hospital in Boston. At this appointment, he learned they didn’t offer the cutting-edge procedures that the Center for Advanced Cardiac Surgery was providing, which was what he wanted. During his initial consultation at the center, Agnihotri spent a lot of time with Charles and his wife discussing the differences between the types of valves to use for the replacement.
“Dr. Agnihotri did his research and explained what he felt would work best for my specific situation,” says Charles. “It was very appealing to know I wasn’t going have my chest opened with the procedure he offered.”
Charles’ surgery went exactly as planned and he was discharged within three days on July 4. That evening, he was able to watch the Boston Esplanade fireworks in the comfort of his own home. By Saturday, he even felt up for going out with his wife to a lovely waterfront restaurant.
“It was unbelievable that I had a heart procedure just five days prior and was already getting out,” says Charles. “In this day and age, any type of cardiac surgery is such a big deal, along with the recovery. You need to take advantage of these modern procedures. It makes a big difference for the recovery.”
Brian B. - Patient’s sense of adventure continues after robotic-assisted mitral valve repair
At age 43, Brain B., of Pepperell, Mass., who has a great sense of adventure with four wheeling and racing motorcycles, was diagnosed with a heart murmur by his primary care doctor. The news came as no surprise as “bad” hearts run in his family. Over time, his murmur worsened and he was diagnosed with mitral valve regurgitation, which prompted his cardiologist to refer him to see a cardiac surgeon.
After meeting with Dr. Arvind Agnihotri at the Steward Center for Advanced Cardiac Surgery, it was determined that Brian would have a robotic-assisted mitral valve repair. The father of four, and owner of a truck mechanic shop, went in for his procedure on Sept. 18, 2013.
“Before I had the operation I honestly didn’t feel too bad but my heart was enlarging,” says Brian. “Well, the next day after the procedure, I could feel a big difference. I felt like I had more oxygen going to my brain and a lot more energy.”
Brain’s recovery went very smooth and he didn’t even ask for any pain medications during his hospital stay. According to Brian, “I was in hospital for four days and realistically I felt I could have left after two days. I was climbing stairs without a problem and the nurses were amazed. I am determined and I do push myself, with everything, in my life.”
And, once Agnihotri gave him the “green light” to resume normal activities, what do you think he did first? He hit the road on his motorcycle and took to the trails on his ATV.