One is known for his rainbow suspenders and famous comedic acts, the other for her often silent but stalwart support of her husband, our nation's 41st president. What both comedian/ actor Robin Williams and former First Lady Barbara Bush have in common, however, is a surgical procedure that dramatically improved their lives, if not saving them, a procedure in frequent use at the Heart Center at New Hanover Regional Medical Center.
In recent years, both high-profile personalities have undergone open heart surgery to replace a defective aortic valve. People needing aortic valve replacement usually suffer from one of two conditions, either valve leakage, called aortic regurgitation, or the narrowing and hardening of the valve's opening, known as aortic stenosis. A defective aortic valve may be present at birth or acquired because of disease or age.
"Most people who present with symptoms of aortic valve disease and may be candidates for aortic valve replacement are between 50 and 80-plus years old," said cardiothoracic surgeon Dr. Peter Kane of Coastal Thoracic Surgical Associates. "However, some patients in need of valve replacement may be younger, including those who suffer valve disease that is congenital, or present at birth."
Located between the left ventricle and the aorta, the largest artery in the body, the aortic valve helps control the outflow of blood from the left ventricle to the body. Comprised of three flaps, the aortic valve opens to allow oxygenated blood to leave the heart and closes to prevent its backward flow. A defective valve can cause undue stress on the heart, forcing it to pump harder to deliver blood to the body. As a result, the heart often gets bigger.
"Like any muscle in the body, when it's forced to work harder, it gets bigger," said Dr. Kane. "But in this case, when the heart muscle enlarges because of increased
demand resulting from valve failure, the additional size may compromise the natural flow of blood through the heart, compromising its ability to work properly. And that's a concern."
"Symptoms of poor or defective valve function may include shortness of breath, dizziness, chest pain, light-headedness or fainting," said Dr. Kane.
Traditional aortic valve replacement surgery, an open heart procedure, consists of making a long incision down a patient's sternum, or breast bone, to gain access to the heart and chest cavity. Over the course of about four hours, the diseased valve is replaced with either a mechanical (artificial) or biological (tissue-based) valve.
Alternatively, valve replacement can also be performed through minimally invasive techniques, of which NHRMC's Heart Center is a regional leader.
"Benefits of minimally invasive valve replacement surgery are many," said Dr. Kane, whose experience in this procedure is extensive.
"Generally, patients undergoing traditional aortic valve surgery require a six- to seven-day hospital stay, with minimally invasive surgery patients returning home between four and six days. For both procedures, a return to normal activities usually takes between 10 and 12 weeks," said Dr. Kane.
"Aortic valve replacement can dramatically improve quality of life by reducing debilitating symptoms and preventing irreversible heart damage," said Dr. Kane. "Anyone symptomatic of this condition should consult their primary care physician or a heart specialist as soon as possible."
Heart surgery, in addition to a variety of other surgeries, at NHRMC takes place at the hospital's 186,500-square-foot Surgical Pavilion, which opened in summer 2008.