The Beat Goes On
Roger Low had no idea he had a problem with the mitral valve in his heart. At 83, he had never had any heart issues — until one day in Spring 2019 when he stepped out of the shower, felt himself go faint and tumbled down. For about 10 minutes, he lost vision in one eye.
“It seemed like an eternity,” Low recalls. “I really hadn’t a clue what was going on.”
Roger immediately went to see his Eisenhower Health Internist, Amanda Curnock, MD, Board Certified in Internal Medicine and Geriatrics. She told him she had detected a heart murmur and sent him to Eisenhower Desert Cardiology Center (EDCC) and Board Certified Interventional Cardiologist Khoi Minh Le, MD.
“Our valves are not precision parts made in a high-efficiency factory,” says Dr. Le. “It’s quite common for a valve to leak, and a mild leak may be acceptable, but with a more significant leak, the heart’s pumping action becomes weak. The blood can even back up to the lungs, causing shortness of breath.”
The mitral valve serves as a small door between two rooms in the human heart — the upper left atrium and the lower left ventricle. Its important job: to open and close every time the heart beats to ensure blood flows in the correct direction. When that door doesn’t close completely, the blood flows backward into the atrium. The result is mitral regurgitation (MR), which reduces the forward output of the heart to meet the body’s needs.
Over time, the backflow can stretch the left atrium and create instability in the heart’s electrical system, sparking irregular or fast heart beats. Left untreated, MR can create other serious problems, even heart failure.
Mechanical problem: mechanical solution
Low soon learned that his MR could not be treated with medication. “A mechanical problem needs a mechanical solution,” says Dr. Le. Traditionally, that solution has meant surgery — opening the chest and stopping the heart — to replace the mitral valve. "That is a major operation even for healthy, middle-aged people,” he adds.
At EDCC, every mitral valve patient is evaluated by a cardiac surgeon to determine if their problem requires treatment and if they are a good surgical candidate. In Roger’s case, the surgeon’s answers were yes, his MR needed treatment, and no, given his age, surgery was not the ideal approach.
Fortunately, EDCC is home to a team of MitraClip™ cardiac specialists, which includes interventional cardiologists like Dr. Le who are trained in the only minimally invasive, transcatheter mitral valve repair (TMVR) device approved by the U.S. Food and Drug Administration.
For all MitraClip procedures, three cardiologists occupy the operating room — two called “the implanters” and one who controls the ultrasound imaging, which provides “stunning clarity,” says Dr. Le, “much like 4K HD television.”
For Low's procedure, the team started by making a small incision (less than one third of an inch) in the right groin, through which they passed a hollow tube into the femoral vein and up into the heart. A MitraClip was then delivered through this catheter and used to capture and repair the malfunctioning mitral valve leaflets. A second MitraClip was placed to further stem the backflow of blood.
Currently, the Eisenhower team is working with the fourth generation of the MitraClip device. The wider arms and ability to control each arm individually has led to even better valve repairs, shorter procedural times, and enhanced clinical outcomes.
Up-to-the-minute care
Dr. Le sees minimally invasive mitral valve repair as “just one part of a whole revolution taking place to correct heart problems without opening up the patient.” Being able to offer this cutting-edge program at Eisenhower Health — where patients can meet with experts close to home — is possible because of a commitment by the health system’s leadership and “our tremendous, supportive community of philanthropic donors,” says Dr. Le. “They enable us to invest in the latest technology for our patients.”
Immediately after Low woke from his mitral valve procedure, “I felt better than I had in some time — 100 percent,” he recalls. He spent one night in the hospital, then took part in EDCC’s eight-week outpatient rehabilitation program. He also attended its weekly nutrition and cardiac risk classes.
Now, three-and-a-half years later, Low, who turns 87 this February, is going strong. “His clip has stood the test of time,” says Dr. Le. “And his mitral valve looks great.”
Low is grateful to be “surrounded by such a wonderful medical community at Eisenhower Health.” His newly healthy heart has enabled him to do the things he loves — including volunteering for the past several years at the Living Desert Zoo’s Bighorn Railroad, where he helps drive the electric trains that travel on 980 feet of track.
“It’s a lot of fun for the kids,” he laughs, “and a lot of fun for old guys, too.”
For more information or to contact Eisenhower Desert Cardiology Center, call 760.346.0642 or visit EisenhowerHealth.org/DesertCard.
