One Surgery Fixed Two Heart Problems

Two for one – Robert Flammer of Bethlehem, Pa., is enjoying the outdoors with his wife, Esther, again. During one surgery, his leaky heart valve was repaired and a Maze procedure was performed to correct his irregular heartbeat.

Robert Flammer could have read Time or National Geographic while waiting for his wife at the doctor’s office last spring. Instead, the Bethlehem, Pa., man happened to pick up a brochure called “What You Should Know About Heart Failure.” It probably saved his life.

While Flammer’s wife, Esther, was being checked by cardiologist Robert Malacoff, M.D., of Lehigh Valley Hospital and Health Network, Flammer read about the signs of heart failure—shortness of breath, swollen ankles, occasional racing of the heart, general fatigue. He had several of them.

As a young man, Flammer had had a heart murmur detected. But he’d never been treated for anything except high blood pressure. “I thought I was just tired from taking Esther to her doctors’ appointments,” says the vibrant 80-year-old, who thinks nothing of chopping wood for his fireplace and working a 38 by 50-foot garden every summer.

When Malacoff casually asked Flammer how he was doing, he pointed to the brochure and said, “I have many of these symptoms.” To his surprise, the cardiologist immediately checked his pulse and ordered an EKG.

Further tests confirmed that Flammer was suffering from heart failure—a weakening of the heart muscle that prevents it from pumping enough blood—caused by a leaky mitral valve. He also had atrial fibrillation, a disorganized quivering of the heart.

Within days, Flammer was in Lehigh Valley Hospital—Muhlenberg for surgery to repair his leaky valve and correct his heart rhythm. With a procedure called Maze, scar tissue was created on Flammer’s heart to rechannel his heart’s electrical impulses in an orderly and organized route.

Flammer was out of the hospital and recovering from surgery in good time to plan this year’s garden. Given the increased energy he feels today, it’s bound to be a bumper crop.

All About Your Heart Valves

There are four of them: two on the left and two on the right. The left valves (mitral and aortic) are the ones that most often have problems. “A structural defect or infection allows blood to leak through the valve (called regurgitation),” says cardiac surgeon Gary Szydlowski, M.D., of Lehigh Valley Hospital and Health Network. “Or, valves can become narrowed (called stenosis), and it’s hard for the heart to pump blood across a narrowed passage.” Flammer had a severely leaky mitral valve.

What causes valves to malfunction?

An infection can do it, but usually the problem is gradual deterioration. Valve problems can lead to heart failure, as in Flammer’s case.

The most common symptom of a bad valve is heart murmur. Just because you have a murmur, it doesn’t mean you have a valve problem. And not all valve-related murmurs require surgery, Szydlowski says: “The need for surgery increases with age.”

One-third to one-half of all heart surgeries are for faulty valves. In the past, surgeons replaced the valve rather than repairing it. However, physicians now know that a natural valve functions better than a prosthetic in the heart.

The surgeon cuts out the portion that is leaking, sews the remaining functioning valve back together and reinforces the repair with a ring to keep the valve from dilating. The supportive ring stays in place permanently.

Is there any way to prevent valve problems?

ARTICLE TOOLS: