Cardiac Surgery Repairs Rescue Swimmer’s Mitral Valve


May 4, 2009
Robotic surgery gets patient back to his active lifestyle

San Diego – As a military rescue swimmer, 36-year-old Ronny German was in the best shape of his life and had no previous health problems. However, shortly after a routine dental cleaning, Ronny began to experience significant swelling in his joints, which his doctors initially diagnosed as rheumatoid arthritis — a condition that runs in his family. As his symptoms worsened, further examinations and testing revealed a heavily leaking mitral valve in Ronny’s heart.

Ronny was told that he would need an operation to repair his mitral valve and chose to have the procedure using minimally invasive robotic surgery. During the robot-assisted surgery, his surgeon discovered that Ronny’s mitral valve was extensively infected.

After surgery Ronny was informed that the infection was the cause of his leaking mitral valve, and it was likely the result of the dental cleaning he received before the onset of his symptoms.

“I was shocked to learn that a routine dental cleaning could have such a serious complication,” said German. “When I was diagnosed with a heart murmur, I was never told that I should be taking antibiotics when I was having even simple dental work done.”

A recent study from the University at Buffalo in New York linked bacteria commonly found in the mouth to an increased risk of coronary heart disease and other cardiac complications.

After a successful robot-assisted mitral valve repair, Ronny recuperated at home, and within two weeks was back at his job with the U.S. Coast Guard. He received medical clearance three months after returning to work and quickly passed his rigorous monthly fitness test. Since his surgery Ronny has taken up paddle surfing and currently participates in five- to nine-mile races, with hopes to complete the Catalina Crossing in the future.

Minimally-invasive surgery offers quicker recovery
“A leaking mitral valve is more common in older adults, but we do see patients with the condition as a result of infection,” said James Hemp, M.D., cardiothoracic surgeon with the Scripps Minimally Invasive Robotic Surgery Program. “Open cardiac surgery requires a significant amount of recovery time, but we were fortunate to be able to offer Ronny an option that would allow him to continue his very active career and lifestyle.”

Minimally invasive robot-assisted surgery provides access to the heart through five small incisions, eliminating the need for surgeons to split the breastbone and spread open the ribcage in order to gain access to the heart. During robot-assisted surgery, tiny instruments and a three-dimensional camera are inserted through the incisions, and the surgeon controls the instruments from a console that provides a magnified view of the surgical field.

This system enhances surgical capabilities by offering even greater precision during surgery. A patient typically stays in the hospital for three to five days after minimally invasive cardiac surgery, compared to five days or more after traditional heart surgery. While the average recovery time after open-heart surgery is six to eight weeks, recovery time with robot-assisted cardiac surgery is between two and four weeks.

About Scripps Health
Founded in 1924 by philanthropist Ellen Browning Scripps, Scripps Health is a $2 billion nonprofit community health system based in San Diego, Calif. Scripps treats a half-million patients annually through the dedication of 2,600 affiliated physicians and 12,300 employees among its five acute-care hospital campuses, home health care services, and an ambulatory care network of clinics, physician offices and outpatient centers.

Recognized as a leader in the prevention, diagnosis and treatment of disease, Scripps is also at the forefront of clinical research and graduate medical education.

Contact: Kristin Reinhardt
Phone: 619-686-3787
E-mail: reinhardt.kristin@scrippshealth.org

Scripps Mercy Hospital, Scripps Clinic, Minimally Invasive Robotic Surgery, Minimally Invasive Robotic Surgery

Advertisements

More Exercise May Provide Greater Gains in Heart Disease

Taken from http://www.clevelandclinicmeded.com/news/Article.aspx?AID=626959&visitfrom=twitter

Overweight patients with heart disease saw better gains compared to standard cardiac rehab.

THURSDAY, May 14 (HealthDay News) — A program featuring greater amounts of exercise and energy expenditure may be preferable to standard cardiac rehabilitation exercise in overweight patients with coronary heart disease, according to research published online May 11 in Circulation.

Philip A. Ades, M.D., of the University of Vermont College of Medicine in Burlington, and colleagues analyzed data from 74 overweight individuals — mean age of 64 years and mean body mass index of 32 — with coronary heart disease. Patients were randomized to high-calorie-expenditure exercise (3,000 to 3,500 calories weekly) or standard cardiac rehabilitation exercise (700 to 800 calories weekly).

At five months, the researchers found that those in the high-expenditure group had twice the weight loss (8.2 versus 3.7 kilograms) and fat mass loss (5.9 versus 2.8 kilograms). This group also had larger decreases in insulin resistance, total to high-density lipoprotein cholesterol ratio, and elements of the metabolic syndrome. No exercise-related cardiac events were noted, and adherence to the interventions was good, the authors write.

“Considering the negative consequences and increasing prevalence of obesity and metabolic syndrome, high-calorie-expenditure exercise training, combined with a hypocaloric diet, should be considered the exercise approach of choice for overweight patients with coronary heart disease,” the authors conclude. “Some individuals with no exercise experience whatsoever may initially benefit from a standard cardiac rehabilitation exercise protocol and then gradually evolve to four to six sessions per week as they improve their fitness.”

Last Updated: May 14, 2009

Abstract

Full Text (subscription or payment may be required)

Copyright © 2009 ScoutNews, LLC. All rights reserved.