How To Repair The Heart

In the operating room, cardiac surgeon Joseph Woo, Medico, is poised to begin a challenging performance on a man whose aorta and aortic valve have been damaged by infection.

When the valve is damaged, surgeons typically supervene upon it, either with a mechanical valve or one taken from a sus scrofa or cow. Merely Woo, professor and chair of cardiothoracic surgery at Stanford, is a strong abet for natural valve repair, or the use of a patient'due south own tissue to reshape and rebuild the valve to restore it to normal office.

"We're always thinking, 'How do you use what's there and have advantage of information technology? That'southward the primal concept to natural valve repair – to utilize what's there in whatever creative fashion you can to design something that works," Woo told me.

For a newly published story in Stanford Medicine magazine, I observed Woo twice in the operating room as he performed valve repairs on several patients with different conditions.

2 of these patients had damaged mitral valves, which help regulate the flow of blood from the upper left to the left lower sleeping room of the middle. Mitral valve repair, which originated in the 1980s, has go a more common procedure in recent years, with multiple studies showing it has many benefits over valve replacement, as patients are more likely to survive, spend less fourth dimension in the infirmary and suffer fewer complications, such as infection and stroke.

But aortic valve repair is newer and less unremarkably performed, as this valve is a "hard nut to scissure," equally ane noted middle surgeon told me. For one, the aortic valve has three flaps, also known as leaflets, which all take to be evenly aligned for it to open and close properly. And there's less tissue to piece of work with in redesigning the valve, Woo says.

In the example of the patient with the eye infection, Woo opens his chest to find the aortic valve seriously dumb, with the leaflets flopping back and forth, instead of working in synchrony. He replaces the damaged aorta with a Dacron tube, then reimplants the valve back into the new vessel, using very fine sutures and tools. Most surgeons won't try this kind of repair, which is very challenging, only Woo knows the patient will do better if he retains his ain tissues, rather than having to live with mechanical or fauna parts.

Afterwards the five-hr process, he's satisfied with the results. "It's opening up nicely and closing beautifully. This patient volition go along his own valve over time," he said.

Though some conditions simply don't permit for repair, Woo takes an "all-repair" arroyo, trying to consider each patient a possible candidate. He often gives talks to cardiologists and heart surgeons throughout the earth, promoting this idea and repair techniques.

"We believe, in our hands, we tin try to approach anybody as potentially reparable," he told me. "No one should be automatically viewed as non existence a repair candidate. Everyone should have an opportunity."

Previously: Stanford Medicine magazine puts spotlight on pediatric care and Stanford report helps surgery patients make hard centre valve pick
Photo by Leslie Williamson