Back again with a double-header blog post: an HVI visit and a (rather unexpected) talking segment on TV. I made it on Good Day Houston in the end, and got to talk a bit about my involvement with the Heartwell Project. Besides those two things, I wanted to inform everyone that this blog might be dormant for the next two weeks- I'm on vacation and visiting with family in South Carolina. I might do an update for something, but it probably won't be as meaty as what I've been putting out in the past few months. I expect to return to a regular blog schedule around the week of the 24th- I'll try to make it something special! But, without further ado...
Valve conference was fairly standard today, except for a few critical AS cases- those patients had multiple stenosed valves, showing themselves to be presumptive wildcards for the OR teams. The comorbidities (additional factors that increase the risk of surgery failure or death) were easy to pick out for these patients, and as a result, almost all of the recommended procedure options were minimally invasive. Many were TAVRs, simply because that procedure would solve the first of many problems that needed to be addressed for these people. Did I ever mention that the aorta is the largest blood vessel in the human body? Well, it's pretty important that this super-artery (and its accompanying valve) stay functioning correctly. Healthy blood outflow is always nice to have.
Two commercial MitraClip candidates were discussed near the tail end of the conference- one with mild aortic sclerosis, mild tricuspid regurgitation, and moderate/high mitral regurgitation; the other another with severe mitral regurgitation, mild tricuspid regurgitation, aortic regurgitation, prolapsed anterior and posterior leaflets and a few other issues. As these patients were fairly high-risk, they were definite candidates for the MitraClip procedure, which stands as the only percutaneous (non-surgical) way to repair the mitral valve. It's pretty neat. A part of the discussion hinged around the decision of how to approach the second Mitraclip patient- the choice between transeptal and transapical entry points. Judging from the CR scan, both approaches were viable, but there were other things that weighed on the doctors' decisions. If the transeptal approach was chosen, it would be the first procedure of its kind, utilizing a new kind of catheter delivery system. It has only been tested on pigs so far, and because of that, some doctors were cautious about using it and wanted one or two successful cases to be available for reference. The patient's roomy left atrium would make the transapical catheter's entry easier, but Dr Nguyen voted transseptal- saying, 'we need to start [using the transeptal approach] sometime.' Transeptal was chosen in the end.
So, remember when I said I wouldn't be going on TV, and was relegated to an audience position with Matt? Well, that was true. But we got to do a lot more than we expected with said audience positions. When I arrived, Dr. Nguyen was still a few minutes from going on, and we had time to get comfortable; but, just as I was settling in and making small talk, a woman approached us- clip-on microphones in hand- and asked us to put them on. We did, and sat to watch Deborah Duncan's exchange with Dr. Nguyen on the stage in front of us. Soon enough, the topic of conversation turned to patient education, providing Matt and I with quite a foothold in the discussion. We both got to speak about what we had done for the project and how it had impacted us, and it became a really valuable experience. We were no longer just spectators, but a real part of the show. They also recruited me to do an Australian accent as part of another segment, which I'm glad none of my friends saw. Being on TV is a blast.
I hope everyone had a happy 4th of July!
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