Remarkable recovery after minimally invasive heart surgery

In Steve Bernstein, M.D.’s neighborhood, Halloween is a enjoyable time for youngsters and households. Dressed of their costumes, they go to neighbors’ properties; the refrain of “Trick or Treat” rings out as goodies are dropped of their baggage.

Halloween 2022 was notably exceptional for Dr. Bernstein, nevertheless. He’d undergone a minimally invasive aortic valve substitute surgery simply 4 days earlier however now felt nicely sufficient to hitch the trick-or-treaters.

Dr. Bernstein’s path to this exceptional recovery started a few years earlier.

An unlikely analysis

The 65-year-old is a urologist in Minneapolis, seeing sufferers with prostate, bladder or kidney circumstances. Dr. Bernstein additionally has a ardour for motion, from sailboat racing to vigorous bicycling, which at instances has led to an damage.

During an emergency division go to in 2015 for a damaged foot, he was identified with a heart murmur. Dr. Berstein was stunned. With no heart murmur signs, like shortness of breath, chest ache or dizziness, he had been unaware of the situation affecting his heart. The emergency division workforce really useful a follow-up appointment with a heart specialist.

The examination and testing by a heart specialist decided that Dr. Bernstein had aortic regurgitation and left ventricular hypertrophy. Aortic valve regurgitation causes the valve between the decrease left chamber and the body’s fundamental artery to not shut tightly. As a consequence, blood can lead backward out of the left ventricle, the heart’s fundamental pumping chamber.

Left ventricular hypertrophy develops steadily, and a few folks, like Dr. Bernstein, do not have signs. Symptoms can develop, nevertheless, because the thickening within the heart partitions makes it tougher for the heart to pump blood to the body successfully.

A holding sample

After the analysis of left ventricular hypertrophy, Dr. Bernstein continued along with his medical apply and enthusiasm for crusing and biking. His heart specialist monitored his situation for the subsequent seven years.

During that point, he knew he ultimately would want a process to handle the aortic stenosis. When the valve narrows, the heart should work tougher to pump blood into the aorta.

In 2022, Dr. Bernstein and his heart specialist determined it was time to take motion with an aortic valve substitute.

Researching one of the best therapy

During aortic valve substitute, a surgeon removes the broken valve and replaces it with a mechanical valve, or one created from cow, pig or human heart tissue. The valve substitute could also be carried out by means of conventional open-heart surgery, additionally known as a midline sternotomy, which includes an incision in the course of the chest and dividing the sternum or breastbone. A extra minimally invasive technique makes use of a smaller incision within the chest or a catheter inserted within the leg.

Bernstein started intensive analysis on aortic valve substitute surgery and known as on his colleagues for suggestions for a cardiovascular surgeon.

“Anyone who has kidney or prostate surgery is going to have trepidation about it; there’s no denying that,” says Dr. Bernstein. “The trepidation before open-heart surgery is even greater, and I had some of that.”

His analysis led him to Robert Wiechmann, M.D., at Mayo Clinic Health System in Eau Claire, Wisconsin. Dr. Wiechmann and the surgery workforce carry out a minimally invasive process to insert a mechanical valve by means of a small incision in the best chest, offering the identical consequence as conventional open-heart surgery.

“It wasn’t just that I got a thumbs up on Dr. Wiechmann, it was the credentials of the people who gave him a thumbs up,” says Dr. Bernstein. “It’s one thing to ask friends on Facebook, but when you talk to senior cardiac surgeons around the country, and they give a thumbs up — to me, that gives it a lot of clout.”

The popularity that Dr. Wiechmann and the Mayo Clinic Health System cardiac surgery workforce have established across the nation led Dr. Bernstein to find out he would have his surgery in Eau Claire.

“I made the decision to drive a few hundred miles to get the best possible treatment for my particular condition. I left a big city — with a big academic, highly regarded medical center — to go to the relatively small city of Eau Claire because I thought it was that important of an investment to make,” he says.

Care like clockwork

After deciding to have Dr. Wiechmann carry out the aortic valve substitute, Dr. Bernstein was scheduled for a pre-op bodily examination and bloodwork.

“I drove to Eau Claire, and everything went like a Swiss watch. And that’s very reassuring for someone who’s going to have surgery,” he says. “The trepidation balanced with my confidence in the surgeon, his team and the health system.”

Several weeks later, Dr. Bernstein returned to Eau Claire for the surgery.

“The cardiothoracic surgery team at Mayo Clinic Health System is leading the field in bringing the latest advances in cardiac surgery to patients,” says Dr. Wiechmann. “The team specializes in performing minimally invasive surgical procedures, which provide a quicker, less painful recovery to help people, like Dr. Bernstein, get back to doing the activities they enjoy sooner.”

A exceptional recovery

Following the profitable surgery, Dr. Bernstein was moved to the ICU.

“The pain was well-controlled; it was uncomfortable, but not horrible. I was less uncomfortable than I expected,” he says.

Dr. Bernstein had been informed to count on to be within the hospital for 4 to 6 days to regain strength and monitor his heart. By Sunday, simply two days after surgery, he felt fairly good.

On Monday morning, Dr. Wiechmann checked on his affected person and, after the examination, did not discover a cause to maintain him within the hospital any longer.

“Dr. Bernstein’s active lifestyle and good physical health before his surgery played a role in his rapid recovery in the hospital,” says Dr. Wiechmann.

Although his inpatient keep was quick, Dr. Bernstein appreciated his interactions with the care workforce.

“All of the touchpoints that I had when I was there were outstanding, from the nurses at the bedside managing all the tubes and fluids, the X-ray people who took my picture every morning, Dr. Wiechmann’s nurse practitioner, physician assistant and the housekeeping and dietary people. All the people, without fail — everyone was professional and compassionate,” says Dr. Bernstein.

The at-home preparations carried out upfront for his recovery, together with acquiring a bathe chair, turned out to be pointless. Showering, dressing and transferring round the home proved to be simpler than he had anticipated.

Getting again on the bike

For the subsequent two weeks, Dr. Bernstein stayed lively by strolling within the native mall. Three weeks after the surgery, he was anxious to get again on his exercise bike.

Dr. Wiechmann agreed he may start slowly with a low-resistance, 20-minute journey. With no points from the preliminary biking exercise, Dr. Bernstein continued to extend his exercise degree and length.

By Thanksgiving weekend, simply 4 weeks after surgery, he was able to journey his snow bike with studded tires exterior within the crisp fall climate.

Although Dr. Bernstein felt nicely sufficient to return to work after simply six weeks, he took the really useful 12 weeks off. By then, he was again to 100% health with no deficiencies after the surgery and able to rejoin his busy medical apply.

While the routine post-op follow-up go to is usually carried out in person on the hospital, Dr. Bernstein was in a position to do his post-op appointment utilizing telehealth with Dr. Wiechmann’s nurse practitioner.

“The incision is basically invisible. It looks like a plastic surgeon closed it,” says Dr. Bernstein.

Going ahead

Dr. Bernstein continued his heart care along with his heart specialist after the surgery and recovery. A postoperative echocardiogram was carried out to have a look at his heart and set up a brand new baseline. The echocardiogram confirmed a typical consequence for heart operate.

“So the beginning of hypertrophy of the left ventricle has resolved, as Dr. Wiechmann suspected it would, and my heart is normal after the aortic valve replacement,” says Dr. Bernstein.

“Treating complex cardiac conditions with a minimally invasive approach provides the best outcome possible for candidates of the surgery,” explains Dr. Wiechmann. “The goal is to provide the highest-quality heart care for our patients.”

With his background in healthcare management, Dr. Bernstein is skilled in evaluating care to search for alternatives to extend effectivity, lower price or enhance affected person expertise.

“As I look back on my experience with heart surgery, I can’t find anything to improve. I couldn’t recommend Dr. Weichmann and his team more strongly for patients with surgical heart valve disease.”

This article first printed on the Mayo Clinic Health System blog.

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