{"id":29262,"date":"2024-06-10T10:07:12","date_gmt":"2024-06-10T16:07:12","guid":{"rendered":"https:\/\/www.uchealth.org\/today\/?p=29262"},"modified":"2024-09-18T11:57:01","modified_gmt":"2024-09-18T17:57:01","slug":"heart-valve-surgery","status":"publish","type":"post","link":"https:\/\/www.uchealth.org\/today\/heart-valve-surgery\/","title":{"rendered":"Heart valve surgery saves older adults from common, but little-known disease"},"content":{"rendered":"
<\/div>
\"Photo:
Photo: UCHealth.<\/figcaption><\/figure>\n

The walls of Bud and Emily Warner\u2019s home in Black Forest are adorned with photos of a safari in Africa.<\/p>\n

In one photo, an elephant fills the frame.<\/p>\n

\u201cThat little guy was heading toward our Jeep,\u2019\u2019 says Bud, who turned 90 years old in July.<\/p>\n

Married 67 years, Bud and Emily have raised three sons, have three daughters-in-law and six grandchildren. They live an exhilarating life, traveling the world \u2013 Africa, Ireland, New Zealand, Playa del Carmen \u2013 and hiking Colorado\u2019s mountains. On weekends, they watch football, cheering for the Ohio State Buckeyes and Air Force Falcons.<\/p>\n

They walk about 30-45 minutes several times a week in picturesque Black Forest and snowshoe in the winter. On Christmas, they travel here and there to visit their children and grandkids.
\n

\n

Related<\/strong><\/h3>\n

Five signs of heart valve disease: What is it and when do you need help?<\/b><\/a><\/p>\n

After age 65, three things to ask your doctor about heart valve disease<\/strong><\/a><\/p>\n<\/div>\n

A Vietnam veteran, Bud was awarded the Distinguished Flying Cross in 1968 while flying as a crew member in the RF-4C photo reconnaissance aircraft. He and Emily are a blend of gift and grit \u2013 smart, charming people living their dreams because they earned it through hard work. Staying in shape and having a sense of humor have kept them strong.<\/p>\n

\u201cWe have lots of funny stories \u2013 at his expense,\u2019\u2019 Emily quips, her eyes twinkling at Bud.<\/p>\n

It was the spring of 2017, before Bud\u2019s 82nd<\/sup> birthday, Emily begins. Bud had been feeling a little weak and dizzy and even had some coughing and nausea. He and Emily weren\u2019t sure what was going on, so they made an appointment with his doctor who started down the path of discovering what was wrong.<\/p>\n

\u201cOn his birthday, we went out to dinner with good friends and Bud was sitting there, and he loves Fat Tire beer and ordered one. He was sitting there with his Fat Tire, and he drank only half of it,\u2019\u2019 Emily said.<\/p>\n

\u201cWe were all there looking at him and afterwards, our friends asked: \u2018Is Bud OK?\u2019 That\u2019s when I thought, \u2018Oh my, this is worse than I thought.\u2019\u2019\u2019<\/p>\n

Air Force physical exam finds heart murmur<\/strong><\/h2>\n

The very first doctor who examined Bud back in June 1956, as he was about to enter the active duty Air Force, pressed his stethoscope to Bud\u2019s chest and blurted out: \u201cYou\u2019ve got a heart murmur.\u2019\u2019<\/p>\n

\u201cWhat\u2019s that?\u2019\u2019 Bud asked.<\/p>\n

\u201cYou\u2019ve got a mitral valve problem,\u2019\u2019 the doctor said.<\/p>\n

Bud went on to spend 26 years in the Air Force, retiring as a colonel. Emily retired from her elementary school teaching job and they moved to Colorado in 1996. Though Bud had never been stationed in Colorado Springs, home to five military bases including the Air Force Academy, they had relatives who lived here and wanted to live in the Rocky Mountain West.<\/p>\n

About three years ago, when Bud started to have shortness of breath, he went to his primary care physician. The Warners weren\u2019t ready to accept that Bud\u2019s symptoms were part of growing old. Initially, Bud had low red blood cells. He got some iron pills but by summer of 2017, he wasn\u2019t feeling any better so he saw a hematologist. In Vietnam, he had been exposed to herbicides like Agent Orange, so doctors explored every avenue.<\/p>\n

\u201cWe would go down different paths and we kept going down all these routes until our primary care doctor said none of it was adding up,\u2019\u2019 Emily said.<\/p>\n

A referral to heart specialists\u00a0<\/strong><\/h2>\n

The doctor sent him to a UCHealth cardiologist, Dr. J. Russell Strader<\/a>, who ordered two echocardiograms that revealed that Bud\u2019s mitral valve was deteriorating.<\/p>\n

\u201cThat ended up being the explanation of why I was having all of these problems physically,\u2019\u2019 Bud said.<\/p>\n

Strader sent him to UCHealth\u2019s Dr. Peter Walinsky<\/a>, a preeminent heart surgeon with extensive experience in complex heart valve disease. The Warners had pages of questions and high expectations.<\/p>\n

\u201cWe talked, and I wanted to make sure that he understood that Bud was in really good condition. I said, \u2018I want you to know that if we go into this surgery with you, we expect to come out and do these things on the other end,\u2019\u2019\u2019 Emily said.<\/p>\n

\u201cAnd he looked at me smiling, and I thought this was kind of his disclaimer,\u2019\u2019 Emily said. \u201cHe said, \u2018You know, when you go into the body of an 83-year-old person, you can\u2019t change much else that is going on. He\u2019s still an 83-year-old person.\u2019\u2019\u2019<\/p>\n

Walinsky encouraged the Warners to make sure to ask questions of the surgeons who m<\/p>\n

\"\"
Bud and Emily Warner have been married for 67 years. Photo courtesy of Bud Warner.<\/figcaption><\/figure>\n

ight do the operation.<\/p>\n

Heart valve surgery<\/strong><\/h2>\n

\u201cOne of the points that he made when we were talking about this, he said, \u2018When you\u2019re talking to someone else about this make sure you find out about how fast they do things. It\u2019s not the speed of things, to do it right, the point is, are you going to be on the heart-lung machine longer than you need to be?\u2019\u2019\u2019 Bud said.<\/p>\n

\u201cI had not really thought about that. I\u2019m thinking the machine does its thing and your heart takes a little vacation and it starts up again. It was a critical thing, and he pointed it out. I thought, \u2018that\u2019s got to be absolutely correct.\u2019\u2019\u2019<\/p>\n

Walinsky, a master at efficiency in the operating room, said he gets people on and off the heart-lung machine quickly, even during big operations.<\/p>\n

\u201cThat\u2019s important for a number of reasons. If something out of the ordinary happens, you can deal with it and you\u2019re not going to be on the bypass machine all day. The longer you are on the machine the more complications happen. So you can do bigger operations and you can take on bigger operations if you do them efficiently.<\/p>\n

\u201cFor someone like Bud, who is in his 80s, if you screw around and you have him on the bypass machine for hours, he\u2019s going to go into renal failure, he\u2019s going to be on the ventilator for a week. He\u2019s going to have a stroke \u2013 all of those things. If you can get in and out quickly, he\u2019s got a good chance of being OK.\u2019\u2019<\/p>\n

Decision time<\/strong><\/h2>\n

By December, the Warners were convinced Walinsky should do the heart valve surgery.<\/p>\n

\"Dr.
Dr. Peter Walinsky said he gets people on and off the heart-lung machine quickly during heart valve surgery, which is important for a number of reasons.<\/figcaption><\/figure>\n

\u201cHe does about 300 operations (a year), and Emily and I looked at each other and said, \u2018Who could we find that would be more qualified than Dr. Walinksy?\u2019”<\/p>\n

Heart valve disease<\/strong><\/h2>\n

An accomplished surgeon, Walinsky believes heart valve disease is one of the most significant public health issues facing the U.S. Heart valve disease occurs when a heart valve narrows, blocking the flow of blood from your heart to your body, or the valve leaks because it does not close tightly. Eventually, valve disease limits how much blood the heart can pump. Over time, the heart muscle can weaken and if left untreated, the risk of death and the need for hospitalization increases.<\/p>\n

Walinsky said that in people over age 70, more than 10% have moderate or severe heart valve disease. This is an independent risk factor for major morbidity and mortality. In the case of severe aortic valve stenosis, half of symptomatic patients will die within two years. Nearly all those patients could be saved with surgery.<\/p>\n

Soon after deciding to have mitral valve surgery, Bud came down with an infection in the pulmonary valve of his heart.<\/p>\n

\u201cHere I was going to have the mitral valve either repaired or replaced and then all of a sudden, we are facing two valves,\u2019\u2019 Bud said.<\/p>\n

It was time to proceed, and on Jan. 16, 2018, Walinsky replaced Bud\u2019s mitral and pulmonary valves in four hours.<\/p>\n

\u201cWe thought that was really impressive,\u2019\u2019 Bud said.<\/p>\n

Before each heart valve surgery, Walinsky reviews the patient\u2019s medical record, lab work and images at least three hours before surgery. He said Bud\u2019s case was unusual.<\/p>\n

\u201cMost of the time, you don\u2019t replace the pulmonary valve in adults unless they have had previous congenital surgery. He just got unlucky. He had endocarditis, so he had an infection in his heart valves and the valves that it happened to infect were the mitral valve and the pulmonary valve.<\/p>\n

\u201cIt\u2019s a lot of surgery for someone his age \u2013 two valves \u2013 but he did great.\u2019\u2019<\/p>\n

A note to the family of his donor<\/strong><\/h2>\n

Because the pulmonary valve came from a donor, Bud sent an email to the family thanking them for his new heart valve. He wanted the family to feel good about their gift.<\/p>\n

\u201cYou can\u2019t connect with them directly unless you have permission to do that, so I wrote a nice little email and, I have to admit, I exaggerated how good I was: \u2018Outstanding career in the Air Force. Wonderful father and person. Volunteer who does church work.\u2019 By the time I was done, I hardly recognized me,\u2019\u2019 Bud said, tongue in cheek.<\/p>\n

Bud said his story is not dramatic or unusual. Many people in their 80s have heart valve disease and many have surgery. Still, Bud has high regard for the people skilled enough to perform such heart valve surgery.<\/p>\n

\u201cIt\u2019s kind of a miracle. I have a lot of admiration for a guy like that,\u2019\u2019 Bud said. \u201cWhat makes him tick? Guys like that, how does he do this? What is he thinking about? Does he do it just as a routine thing?<\/p>\n

\u201cWhen you consider what can happen to the heart and how he can replace these things, I think it\u2019s a miracle,\u2019\u2019 Bud said.<\/p>\n

Walinsky is a perfectionist who prepares for surgery with discipline and attention to miniscule details.<\/p>\n

\u201cWhen you are doing heart surgery, you can\u2019t just go into the operating room with one good plan and a bunch of mediocre plans. You have to go in with three or four good plans. \u2026 And you have to make decisions very quickly,\u2019\u2019 he said. \u201cSo I think about that a lot.\u2019\u2019<\/p>\n

On a recent Wednesday, for example, Walinsky began preparing for a surgery scheduled the following Tuesday.<\/p>\n

\u201cI\u2019ll start looking at their records a week before. I\u2019ll look at their catheterization, their echocardiogram<\/a>, and their labs. I\u2019ll review everything again over the weekend and I\u2019ll do it again the morning of surgery so by the time I go into surgery, I\u2019ve reviewed their films at least three or four times before we get into the operating room.<\/p>\n

\u201cIt makes me more comfortable that I\u2019ve gone over it, have done multiple reviews, and I know what we are doing.\u2019\u2019<\/p>\n

If it\u2019s a complex case, he reviews literature from medical journals, watches videos of the surgery and consults with other master, high-volume surgeons to learn what they might do. Walinsky and his colleagues, who also call him for advice, are always on the same page.<\/p>\n

The recovery from heart valve surgery<\/strong><\/h2>\n

Following surgery, Bud felt good. He was in the intensive care unit for four or five days and said he \u201cdidn\u2019t feel a thing.\u2019\u2019<\/p>\n

Being in good physical condition before surgery paid dividends. All those years of living an active lifestyle \u2013 running cross-country in high school, marathons as an adult, and hiking Pikes Peak with Emily \u2013 had paid off.<\/p>\n

When he got home and began his recovery, he knew what he could and couldn\u2019t do physically.<\/p>\n

\u201cBecause I walked all the time, I was used to listening to my body. I think some people, when trying to recover, are trying to prove something. I didn\u2019t fall into that problem because I was used to really being attuned to by body and I think that helped,\u2019\u2019 Bud said.<\/p>\n

By March 2018, a couple of months after heart valve surgery, Bud and Emily would go down to Discovery Canyon High School and walk around the track. He walked slowly at first, went as far as he could go \u2013 about a quarter of a mile in the beginning \u2013 and gradually built up his strength.<\/p>\n

Bud said it took about a year to get back to full strength and he and Emily now walk about two to three miles most days in Fox Run Regional Park.<\/p>\n

\u201cI feel great, and I am very thankful for the overwhelming support of family and friends before, during and after my surgery, I am very humbled by it,\u201d he said.<\/p>\n

 <\/p>\n","protected":false},"excerpt":{"rendered":"

The walls of Bud and Emily Warner\u2019s home in Black Forest are adorned with photos of a safari in Africa. In one photo, an elephant fills the frame. \u201cThat little guy was heading toward our Jeep,\u2019\u2019 says Bud, who turned 90 years old in July. Married 67 years, Bud and Emily have raised three sons, […]<\/p>\n","protected":false},"author":20,"featured_media":29264,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_relevanssi_hide_post":"","_relevanssi_hide_content":"","_relevanssi_pin_for_all":"","_relevanssi_pin_keywords":"","_relevanssi_unpin_keywords":"","_relevanssi_related_keywords":"","_relevanssi_related_include_ids":"","_relevanssi_related_exclude_ids":"","_relevanssi_related_no_append":"","_relevanssi_related_not_related":"","_relevanssi_related_posts":"","_relevanssi_noindex_reason":"","footnotes":""},"categories":[7],"tags":[3512,82,9167,1898],"class_list":["post-29262","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-stories","tag-heart-and-vascular-care-cardiovascular","tag-heart-and-vascular-care-cardiology","tag-specialized-services","tag-veterans"],"acf":[],"yoast_head":"\nHeart valve surgery could save older adults with undiagnosed heart problems- UCHealth Today<\/title>\n<meta name=\"description\" content=\"In the case of severe aortic valve stenosis, half of symptomatic patients will die within two years. 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