Selected Podcast
Aortic Valve Surgery
Alexander J. Sbrocchi, MD, a cardiac surgeon on the medical staff at Baylor Scott & White Heart and Vascular Hospital - Dallas and Baylor University Medical Center, part of Baylor Scott & White Health, discusses aortic valve surgery, from symptoms and diagnosis to treatment, recovery and prevention.
Featured Speaker:
Alexander Sbrocchi, MD
Dr. Sbrocchi specializes in the entire spectrum of adult heart surgery, including acquired and congenital aortic disease, coronary artery disease, valvular disease, and heart and lung transplantation. His particular areas of interest are structural heart disease and minimally invasive approaches, complex aortic and mitral valve repair, and aortic dissection. Transcription:
Aortic Valve Surgery
Evo Terra: On Our HeartSpeak podcast today, the podcast from Baylor Scott & White Heart and Vascular Hospital, Dallas and Fort Worth, Dr. Alexander Sbrocchi, a cardiac surgeon on the medical staff at Baylor Scott & White Heart and Vascular Hospital, joins me to talk about aortic valve surgery, a procedure to treat a damaged or diseased, you guessed it, aortic valve in the heart.
I'm Evo Terra.
Dr. Serocki specializes in the entire spectrum of adult heart surgery, including a acquired and congenital aortic disease, coronary artery disease, vascular disease, and heart and lung transplant.
His particular areas of interest are structural heart disease and minimally invasive approaches. Complex aortic and mitral valve repair and aortic dissection dr. Sbrocchi, welcome to HeartSpeak.
Dr. Alexander Sbrocchi: Thank you for having me.
Evo Terra: We're going to focus this episode on a specific type of heart surgery, aortic valve surgery. So, maybe we should start at the job of the aortic valve.
Dr. Alexander Sbrocchi: Yeah. So, the aortic valve is kind of the main valve that allows blood flow basically from the heart to the body and also prevents that blood flow from getting back into the heart. So normally, it is three leaflets. It kind of looks like a Mercedes-Benz sign, if you will. Opens normally to let all the blood out and then closes after the heartbeats just to prevent it from coming back in.
Evo Terra: Got it. And what can damage this valve?
Dr. Alexander Sbrocchi: So, it can just be damaged as you age. It can become calcified as you get older. People with not so great diets, things like fatty foods, things like that can help deposit plaques and fatty buildup on the valve itself and cause it to get a little bit tighter. Some people, it can get leaky and that blood will flow backwards. And some people unfortunately are just born with valves that are either predisposed or don't work well from the get-go.
Evo Terra: And so, at some point in time, we have a valve that's no good. It needs to be fixed. Is surgery our only option?
Dr. Alexander Sbrocchi: Yeah. So, we look at basically two sides of treatment with any disease process. So, one of which is medical management. So some people that just have a very mild disease, you can treat medically with just medications, anti-hypertensives, statins, which many of our patients are already on, and that can prevent disease progression. But once it gets so bad that people are feeling symptomatic, either short of breath or passing out or feeling like they're going to pass out, that's when we look at surgical options.
Evo Terra: Let's talk about those options. Let's talk about the procedure specifically. Now, I don't have a medical degree and I don't think anybody listening has a medical degree.
Dr. Alexander Sbrocchi: Fair enough.
Evo Terra: But can you kind of run down what's happening while the patient is asleep? And I also want to get into how long this surgery's going to take.
Dr. Alexander Sbrocchi: Yeah. So, there are basically two main procedural options right now. One of which I'll leave out, and that's the transcatheter valves, which is basically a shorter procedure, which we go up through a major blood vessel and can percutaneously or just over wires, put a valve in, that we do with our interventional cardiologists as well.
But for this discussion, just surgical valves, the procedure itself takes about four hours or so. We make an incision down the center of the breast bone, use the heart-lung machine, stop the heart, do all the work of the heart for the body, cut out the bad valve roots and put in another valve, either pig or a cow valve or a mechanical valve. And then, restart the heart, take you off the heart lung machine, close up the incision and back to the ICU after that.
Evo Terra: And since we've got the chest open here and, you know, we've stopped the heart of all of those scary sounding things, let's talk about recovery, specifically when can I go back to playing ultimate frisbee?
Dr. Alexander Sbrocchi: I like ultimate frisbee. Most people ask about golf.
Evo Terra: I wanted to be something a little bit different than that.
Dr. Alexander Sbrocchi: So, the biggest recovery thing for most people is about two months. We ask for sternal precautions, which is not lifting or pushing anything greater than a gallon of milk or about 10 pounds. That just lets that breast bone heal. For most people, the first month is a little bit of fatigue. You might need a nap in the middle of the day. But overall, most people get back to feeling like normal after two weeks to a month.
Evo Terra: All right. Now, let's say I don't want to have surgery. And I guess my question to you is, and I hate to talk about things that keep you out of business, but what should someone do to avoid the need for aortic valve surgery? Or is it just a thing we have to deal with sometimes?
Dr. Alexander Sbrocchi: Yeah, unfortunately, it's a thing that you just have to deal with sometimes. The biggest preventative things are the things that might be common sense to us, but maybe not for everybody, is things like don't smoke, live a healthy lifestyle, diet and exercise, lots of fruits and vegetables. You know, I know it's hard in Texas, but try to avoid the steak and the burgers all the time. Those are the only things really to be preventative. Some people, like I said, unfortunately, are either predisposed to having a valve go wrong, or sometimes an infection gets on the valve or something like that, and unfortunately you can't avoid that.
Evo Terra: Well, Dr. Sbrocchi, thank you very much for all of the information today.
Dr. Alexander Sbrocchi: Awesome. Thank you for having me.
Evo Terra: Once again, that was Dr. Alexander Sbrocchi, a cardiac surgeon on the medical staff at Baylor Scott & White Heart and Vascular Hospital. To find a cardiac surgeon on the medical staff at Baylor Scott & White Heart and Vascular Hospital, Dallas and Baylor University Medical Center, call 1-844-BSW-DOCS and ask for a cardiac surgeon with expertise in aortic valve surgery.
To learn more about the Center for Valve Disorders, visit bswhealth.com/dallasheartvalvecenter, or download the Baylor Heart Center app on your Apple device. Thanks for listening to HeartSpeak, the podcast for Baylor Scott & White Heart and Vascular Hospital in Dallas and Fort Worth. If you found this podcast helpful, please share it on your social channels and be sure to check out the entire podcast library for additional topics of interest. I'm Evo Terra. Thanks for listening.
Baylor Scott & White Heart and Vascular Hospital, Dallas and Fort Worth, joint ownership with physicians.
Aortic Valve Surgery
Evo Terra: On Our HeartSpeak podcast today, the podcast from Baylor Scott & White Heart and Vascular Hospital, Dallas and Fort Worth, Dr. Alexander Sbrocchi, a cardiac surgeon on the medical staff at Baylor Scott & White Heart and Vascular Hospital, joins me to talk about aortic valve surgery, a procedure to treat a damaged or diseased, you guessed it, aortic valve in the heart.
I'm Evo Terra.
Dr. Serocki specializes in the entire spectrum of adult heart surgery, including a acquired and congenital aortic disease, coronary artery disease, vascular disease, and heart and lung transplant.
His particular areas of interest are structural heart disease and minimally invasive approaches. Complex aortic and mitral valve repair and aortic dissection dr. Sbrocchi, welcome to HeartSpeak.
Dr. Alexander Sbrocchi: Thank you for having me.
Evo Terra: We're going to focus this episode on a specific type of heart surgery, aortic valve surgery. So, maybe we should start at the job of the aortic valve.
Dr. Alexander Sbrocchi: Yeah. So, the aortic valve is kind of the main valve that allows blood flow basically from the heart to the body and also prevents that blood flow from getting back into the heart. So normally, it is three leaflets. It kind of looks like a Mercedes-Benz sign, if you will. Opens normally to let all the blood out and then closes after the heartbeats just to prevent it from coming back in.
Evo Terra: Got it. And what can damage this valve?
Dr. Alexander Sbrocchi: So, it can just be damaged as you age. It can become calcified as you get older. People with not so great diets, things like fatty foods, things like that can help deposit plaques and fatty buildup on the valve itself and cause it to get a little bit tighter. Some people, it can get leaky and that blood will flow backwards. And some people unfortunately are just born with valves that are either predisposed or don't work well from the get-go.
Evo Terra: And so, at some point in time, we have a valve that's no good. It needs to be fixed. Is surgery our only option?
Dr. Alexander Sbrocchi: Yeah. So, we look at basically two sides of treatment with any disease process. So, one of which is medical management. So some people that just have a very mild disease, you can treat medically with just medications, anti-hypertensives, statins, which many of our patients are already on, and that can prevent disease progression. But once it gets so bad that people are feeling symptomatic, either short of breath or passing out or feeling like they're going to pass out, that's when we look at surgical options.
Evo Terra: Let's talk about those options. Let's talk about the procedure specifically. Now, I don't have a medical degree and I don't think anybody listening has a medical degree.
Dr. Alexander Sbrocchi: Fair enough.
Evo Terra: But can you kind of run down what's happening while the patient is asleep? And I also want to get into how long this surgery's going to take.
Dr. Alexander Sbrocchi: Yeah. So, there are basically two main procedural options right now. One of which I'll leave out, and that's the transcatheter valves, which is basically a shorter procedure, which we go up through a major blood vessel and can percutaneously or just over wires, put a valve in, that we do with our interventional cardiologists as well.
But for this discussion, just surgical valves, the procedure itself takes about four hours or so. We make an incision down the center of the breast bone, use the heart-lung machine, stop the heart, do all the work of the heart for the body, cut out the bad valve roots and put in another valve, either pig or a cow valve or a mechanical valve. And then, restart the heart, take you off the heart lung machine, close up the incision and back to the ICU after that.
Evo Terra: And since we've got the chest open here and, you know, we've stopped the heart of all of those scary sounding things, let's talk about recovery, specifically when can I go back to playing ultimate frisbee?
Dr. Alexander Sbrocchi: I like ultimate frisbee. Most people ask about golf.
Evo Terra: I wanted to be something a little bit different than that.
Dr. Alexander Sbrocchi: So, the biggest recovery thing for most people is about two months. We ask for sternal precautions, which is not lifting or pushing anything greater than a gallon of milk or about 10 pounds. That just lets that breast bone heal. For most people, the first month is a little bit of fatigue. You might need a nap in the middle of the day. But overall, most people get back to feeling like normal after two weeks to a month.
Evo Terra: All right. Now, let's say I don't want to have surgery. And I guess my question to you is, and I hate to talk about things that keep you out of business, but what should someone do to avoid the need for aortic valve surgery? Or is it just a thing we have to deal with sometimes?
Dr. Alexander Sbrocchi: Yeah, unfortunately, it's a thing that you just have to deal with sometimes. The biggest preventative things are the things that might be common sense to us, but maybe not for everybody, is things like don't smoke, live a healthy lifestyle, diet and exercise, lots of fruits and vegetables. You know, I know it's hard in Texas, but try to avoid the steak and the burgers all the time. Those are the only things really to be preventative. Some people, like I said, unfortunately, are either predisposed to having a valve go wrong, or sometimes an infection gets on the valve or something like that, and unfortunately you can't avoid that.
Evo Terra: Well, Dr. Sbrocchi, thank you very much for all of the information today.
Dr. Alexander Sbrocchi: Awesome. Thank you for having me.
Evo Terra: Once again, that was Dr. Alexander Sbrocchi, a cardiac surgeon on the medical staff at Baylor Scott & White Heart and Vascular Hospital. To find a cardiac surgeon on the medical staff at Baylor Scott & White Heart and Vascular Hospital, Dallas and Baylor University Medical Center, call 1-844-BSW-DOCS and ask for a cardiac surgeon with expertise in aortic valve surgery.
To learn more about the Center for Valve Disorders, visit bswhealth.com/dallasheartvalvecenter, or download the Baylor Heart Center app on your Apple device. Thanks for listening to HeartSpeak, the podcast for Baylor Scott & White Heart and Vascular Hospital in Dallas and Fort Worth. If you found this podcast helpful, please share it on your social channels and be sure to check out the entire podcast library for additional topics of interest. I'm Evo Terra. Thanks for listening.
Baylor Scott & White Heart and Vascular Hospital, Dallas and Fort Worth, joint ownership with physicians.