February 5th, 2020
Denise Case wasn’t overly concerned when she went for a routine exploration of a heart murmur that had been identified at age 24. Though the Waterloo woman, then 52, had led a normal, active life since diagnosis, a new family doctor wanted a cardiologist to assess her status.
She could hardly believe it when the assessment revealed that the aortic valve in her heart was deteriorating and would eventually need to be replaced with open heart surgery. “I was shell shocked” Denise recalled.
Heart valves are flaps within the heart that control the flow of oxygen-rich blood to the body. The aortic valve is the main work-horse, handling all of the blood being pumped back out to the body. When this valve becomes damaged, the heart may need to work harder and it often can’t do so effectively.
Within two years of that assessment, Denise started experiencing shortness of breath. “I had an episode where I felt faint after climbing a few stairs. I told myself I was just tired, out of shape.” She had always loved to sing, but was struggling to find the breath for it.
At her next cardiologist appointment she learned her condition had progressed from moderate to severe. She was referred to Dr. Kassem Ashe, a cardiovascular surgeon at St. Mary’s Regional Cardiac Care Centre. Dr. Ashe described the traditional options, replacement with a tissue valve or a mechanical valve, or a procedure he had recently introduced at St. Mary’s in late 2018 called the Ross Procedure. This procedure is for select patients under age 60 who meet specific criteria.
During the Ross Procedure the patient’s pulmonary valve is removed and replaces the diseased aortic valve. A donor valve replaces the pulmonary valve. The pulmonary valve’s ability to adapt to moving massive amounts of blood for circulation through the body make it superior to any mechanical, donated tissue or commercial valve “like a Lamborghini compared to a Mercedes,” said Dr. Ashe. As blood circulates it delivers oxygen and nutrients to cells, which supports cardiovascular performance, making the Ross Procedure particularly beneficial for young athletes.
The procedure is more complex than the other alternatives, but Denise Case was an ideal candidate. Now age 55 she chose to undergo it on April 29, 2019.
“Using nature’s own valve designs gives our deserving young adult population, like Denise the opportunity of a normal, active life and normal life expectancy,” said Dr. Ashe.
“The Ross Procedure greatly reduces the likelihood of these younger patients needing a replacement valve in the future and frees them of the need for blood thinners which carry their own risks,” he added. Research shows that 20 per cent more Ross procedure patients are alive 20 years after their surgery than those who receive mechanical valves. And there is less risk of infection.
St. Mary’s has completed 19 Ross procedures since the program began in late November of 2018, the second highest number of any cardiac centre in Canada during the same period. A few months after her surgery Denise was able to return to work, and her favourite activities such as singing lessons, ballet & jazz dancing, swimming and ice skating.
She is grateful to have “the best cardiac centre in our own back yard. The entire team at St. Mary’s was amazing, truly world class,” she said.
To read the story published in The Record, click here.