Ari's Patient Success Story: Shared Decision Making for Heart Valve Patients with Dr. Eric Roselli
ฝัง
- เผยแพร่เมื่อ 27 มิ.ย. 2022
- www.Heart-Valve-Surgery.com - There are many different treatment options for patients to consider for the lifetime management of heart valve disease. For that reason, the concept of "Shared Decision Making" is incredibly important for patients, surgeons and their medical teams.
In this special video, you will learn about the patient success story of Ari Mintzer, a two-time heart valve surgery patient, and his surgeon, Dr. Eric Roselli, the Chief of Adult Cardiac Surgery at Cleveland Clinic.
Key questions asked-and-answered by Ari and Dr. Roselli include:
1. What was wrong with Ari's heart valve? Which heart valve replacement option did Ari choose? Mechanical valve? Tissue valve? How long did that heart valve replacement last?
2. How common are tissue heart valve replacement failures?
3. What were Ari's options for his heart valve replacement re-operation? Mechanical valve? Tissue valve? TAVR valve-in-valve? Ross Procedure?
4. What is Shared Decision Making? How did Ari and Dr. Roselli use Shared Decision Making to pick the optimal heart valve reoperation?
5. Why is Shared Decision Making so important for the lifetime management of heart valve disease?
6. What is Ari's advice for patients? What is Dr. Roselli's advice to help patients use a Shared Decision Making approach with their surgeon and medical team?
To learn more or schedule a consult / second opinion with Dr. Eric Roselli, please call (866) 306-5846. To see patient reviews and a surgeon biography for Dr. Roselli, please visit www.heart-valve-surgery.com/s....
Dr Roselli repaired my dilated aortic root and aortic valve insufficiency via David Procedure at the Cleveland Clinic on 9/20/2015. I couldn't have been in better hands. He is truly a life saver. I've also had the pleasure of meeting Adam through a mutual friend over 20 years ago. Thank You Dr. Eric Roselli, Dr. Rob Light and Adam Pick.
Gene Germano MD
This is a great topic to cover! In many cases the patient is treated more like a number than a person. It's time for surgeons to slow down a bit and have real discussions with the patients. All of that said, I think that Ari's comments about warfarin can be extremely misleading for those watching. Ari's immediate "No" and supporting that 'no' by saying he has an active lifestyle with kids, a wife, dogs, and love of outdoors is actually unjustified. There are tons and tons of people on warfarin living active lifestyles with kids, dogs, spouse ... enjoying the outdoors, etc. All you have to do is visit the various valve replacement forums to see this. We have people doing jiu-jitsu, rock climbing, power lifting, mountain biking, etc. Once you find your stable dose, life just continues. Seriously. And when you self-monitor your INR you'll be in your effective range 95+% of the time. The data is very clear on this - the less open heart surgeries that you have the higher the chance at living longer. Mechanical valves last a lifetime. So getting a tissue valve specifically at an earlier age really sets you up for reduced odds of survival. Additionally, it puts extra stress on your family, your job, and your finances when you need OHS at later ages. I can't even imagine trying to do this in retirement on Medicare.
This is great info. I had Aortic valve replace, mitral valve repair and aneurysm repair along with Maze procedure last year, 2022 at Cleveland Clinic Main campus.
I not only Did Not have shared consultation prior to surgery, I met with the surgeon only once for maybe 5 minutes, if that prior to surgery.
And even at that the surgeon referred to me as a different patient until I stepped out of the room and got my chart and handed it to him and at the same time instructed myself.
The same surgeon I only saw once post op while in Step down hospital.
To say I was disappointed is an understatement.
I assume that the surgery was done well in that I have had no problems since.
I would add that during surgical prep my personal effects were take and subsequently lost, cash and credit cards by the clinic staff.
Thank you so much Adam for this wonderful interview. I appreciate Dr. Roselli and Ari for providing the knowledge and experiences as well.
Hi Mike, Glad you enjoyed the video with Ari and Dr. Roselli!!!
Thank you! This is very helpful. I'm new to this and trying to learn quickly. As recently a three years ago I was given a clean bill of cardiac health. Then I had a couple of TIAs. Three years and a couple of cardiologists later, it turns out I have a PFO and a mildy schlerotic and mild to moderately insufficient aortic valve. So far I have had difficulty getting cardiolgists to discuss the entire situation with me. I have ben referred to Sutter in Sacramento for possible PFO closure and hope to discuss both PFO closure and the aorta. I am an active 73 year old and, barring incidents, the aging trajectory should take me to at least 90. I don't "want" open heart surgery but accept that my best option may be an open closure and a large tissue valve.
It was very informative videos,but want to know ..hav surgeon did root enlargement and which size valve they hav preferred (Bigger size valve...)?
Wonderful information along with such an incredible caring element..Thank you. Knowledge is Power..Jan M.
Hi Jan, Great to hear you enjoyed the video with Ari Mintzer and Dr. Eric Roselli specific to shared decision making and heart valve disease. Yes, knowledge is power!
Excellent video!
My dad has just had vive replacement surgery and chose the tissue valve he is 57. I was wondering how you did the calculations for him to be able to live to 90? I’m guessing open heart surgery at over 75 to replace the valve again is a little delicate
I have a biscuspid valve (only diagnosed last year) and am scanned every six months because of th aneurysm. I know at some stage I will need the replacement aorta. The doctor has told me that alsthough it's not ideal my valve is working ok. So my question is, could I end up with aorta replacement whilst they leave the valve in place (if it's still functioning ok) or will they both need a replacement? Of course,the whole idea fills me with horror but I know one day I will have to face it. I'm 54, female and live in France.
Hi Teresa - Yes, there are certain procedures, known as "valve sparing" procedures, that can be performed. Here's a video specifically about bicuspid aortic valves and valve-sparing procedures with Dr. Eric Roselli - th-cam.com/video/k7KgttCXw2o/w-d-xo.html. Hope that helps!
There's also valve repair for bicuspid valves, but if yours is fine it might not be necessary
How old is Ari? Is he planning on his life long management to include another sternotomy?
Hi David - As for the next steps in Ari's treatment, he mentions (at the 9:08 mark of the video) that Dr. Roselli implanted a surgical valve with a wider opening so that a non-invasive Valve-in-Valve procedure may be used in the future (so as to potentially avoid another sternotomy.) We hope that helps!
so what valve Aris got in his second open heart surgery
Hi Dhony, For his second heart valve replacement, Ari got an INSPIRIS RESILIA valve. You can learn more about this valve at this link - www.heart-valve-surgery.com/heart-surgery-blog/2018/08/09/inspiris-resilia-fda-approval/. Hope that helps!
The dr also mentioned that he would take a bigger size tissue valve for more durability. What is the size that is should considered for more durability?
What was the valve decision?
Ari got a second tissue valve replacement to provide an opportunity for a TAVR if he needs it in the future.