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Your Healthy Family: Visit to family practitioner key to uncovering patient's heart condition

Posted at 2:49 PM, Dec 11, 2019
and last updated 2019-12-12 08:55:58-05

As we told you in Part 1 of Duane Myers’ story, when Duane was ready to have his arthritic hip replaced, he visited his primary care physician, Dr. Mark Bodman with UCHealth Aspen Creek Medical Dr. Bodman ordered a cardiac check to clear Duane for his hip surgery. And that’s when all of Duane’s plans changed.

Instead of getting a new hip with an orthopedic surgeon like he had expected, Duane was scheduled for open-heart surgery with Dr. Peter Walinsky, a cardiac surgeon with UCHealth Memorial Hospital.

Dr. Walinsky knew going in there was a lot of work to be done. “By the time he (Duane) saw me he had also had a cardiac catheterization to look at the coronary arteries. He incidentally had been found to have significant four-vessel coronary artery disease, so he was going to need his aortic valve replaced and three or four bypasses.”

Dr. Walinsky says when he opened Duane’s chest, there was more going on. “It was clear that he had significant aortic valve stenosis, which means the aortic valve was very, very narrowed, and not just a little bit. He was on the outside edge of severe, basically the most critical. What we found at surgery was that the fibrous skeleton of his heart had become completely calcified. What that means is that tissue that should be supple and pliable and easy to work with was like rock.”

Duane says he was told initially his surgery would be a few hours, but that changed once the procedure began. “I had a 90% blockage of my four arteries and calcium surrounding my heart - so it was an eight-hour surgery.”

Duane says he was lucky on a couple of counts. First, he was lucky his heart problems were discovered before he suffered a massive heart attack. “Apparently it was luck I made it that far. It was one of those situations where I could have had a massive heart attack – at any time. So I was very lucky and very fortunate that the circumstances played out the way they did.”

Duane was also very lucky that he had a very skilled heart surgeon for his case in Dr. Walinsky. Dr. Walinsky explains, “Normally in terms of doing two valves and bypass surgery, it's a big operation but it's well within the realm of what I do on a daily basis. Here at Memorial we do a very high volume of very complex valvular heart surgery and a lot of patients who have valve disease have coronary disease as well. So the bypasses and the valves together, while a very large operation, is not out of the ordinary.

Dr. Walinsky says where Duane’s case became more challenging, was the amount of calcium encasing his heart. “When you're dealing with calcification especially in the mitral annulus - the danger is that when you remove that calcium the heart can just come apart because there's no more structural integrity because there's no fibrous skeleton left. Especially when dealing with the aortic valve and the mitral valve, that are separated by a curtain of fibrous tissue, which is normally supple and easy to work with. His was a complete continuous sheet of calcium rock, hard calcium. That necessitated an even larger operation, where we had to take that calcium out, reconstruct that fibrous skeleton and then instead of using a standard aortic valve, we used a cadaver valve to replace the entire first part of the aorta.”

In our next story, we’ll talk about how Duane is doing these days, and the lessons he and his doctors hope can be learned from his experience.

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