We just came back from a doctor’s appointment with Dr. Ramsey Deeik, a cardiac surgeon in Napa who specializes in mitral valve repair and replacement. We went to see him for a second opinion, and he was able to provide us with some great information, recommendations, and opinions on Michael’s situation. So while it’s fresh on my mind, I thought I’d try and update as many of you as possible.

First of all, Dr. Deeik is a VERY young surgeon (probably in his late 30’s!!) He performed a mitral valve replacement on our neighbor’s friend 3 weeks ago. When he found out that Michael’s passion is soccer, he smiled and told Michael that he played collegiate soccer at USF, one of the top soccer programs in the country! So talk about an instant connection!! Dr. Deeik then went on to explain exactly what he thinks happened to Michael’s heart valve.

-When Michael got sick in February, his body got infected with some kind of bacteria. This bacteria then did its thing on his lungs, kidneys, liver, and heart valve. Once he started getting better, the antibiotics completely rid his body of the infection. His lungs got better, as did his kidneys, and liver. The mitral valve, however, suffered a residual effect of the infection. Michael’s valve has what Dr. Deeik calls “vegetation.” He describes it as “stuff” that kind of stuck to his valve as Michael got better. This “stuff” is now affecting how his mitral valve opens and closes. In the left side of his heart, the mitral valve allows blood to flow from the upper left chamber into the bottom left chamber. The mitral valve has 2 leaflets that open and close. There is an Interior leaflet and an Exterior leaflet. Since Michael’s valve has “stuff” on it, it is not closing properly, and, thus, is allowing blood to flow back into the upper chamber. They call this “regurgitation.” According to Dr. Deeik, the exterior leaflet looks fine. The interior leaflet, however, is the tissue that has “stuff” on it which is not allowing the valve to work properly. On a scale of 1 to 4, (which is how the leak is rated) Michael’s leak is a 4 plus. He needs to have surgery. All the doctors we’ve talked to, however, don’t think that Michael is in any kind of immediate danger. He’s not retaining water, he’s not in any kind of pain, and he does not have any shortness of breath. His surgery can wait until we find a surgeon!

An important point from Dr. Deeik is that if the damaged valve was the Exterior leaflet, he could say with 100% certainty that the valve could be repaired. Since, however, it is the Interior leaflet that is damaged, this valve is much more difficult to repair. It can be done, but it requires a high level of expertise. He also told us that it would be important to have a TEE (transesophageal echocardiogram) done on Michael. This procedure requires a “camera tube” to be put down Michael’s esophagus to take pictures of his heart valves. According to Dr. Deeik, this procedure would allow a surgeon to make a much more educated guess as to whether the valve can be repaired! The procedure is a quick, in and out procedure (typically a couple of hours), where Michael would be sedated (sleep). I am checking to see how soon this could be done.

Dr. Deeik also gave us his professional opinion. He said that if it were his 17 year old son, he would try to find a surgeon who is an expert at repair. He says that even if the valve cannot be repaired to 100% perfection, there is a tolerable level that possibly the surgeon could repair the valve to. This tolerable level is a 1 plus! He says there are thousands of people that live normal lives who have very small leaks in their valves. If Michael’s valve could be repaired to a 1 plus, Dr. Deeik says this may “buy” him 5, 10, 20, 30 years or possibly a lifetime. He was very optimistic about this point. Michael could play sports, he could lift weights, he could be NORMAL!!!!

Dr. Deeik then went on to give his opinion IF THE VALVE NEEDS TO BE REPLACED. He says that if indeed, Michael’s valve needs to be replaced, he would HIGHLY recommend Dr. Frank Hanley, the exact doctor who is most likely going to do Michael’s surgery (assuming we don’t have a better option.). Dr. Frank Hanley is with the Stanford Medical Group and Children’s Hospital in Oakland, and we have had many doctors and medical experts recommend him to us. Dr. Deeik says he is the best at replacing valves. He was not sure if Dr. Hanley was also an expert at valve REPAIR!

After meeting with Dr. Deeik, Michael and I felt so much better about his surgery. Dr. Deeik says this surgery is VERY common now, it is done all the time, and the success rate for mitral valve repair or mitral valve replacement is almost 100% assuming you have a highly skilled surgeon. Dr. Deeik recommended that as we move forward, make sure we consider all our options, especially finding a surgeon who specializes in VALVE REPAIR!! Michael’s records and last echocardiogram have already been sent to the following places which ALL have a very high valve repair success rate (80 – 95%):

- Mt. Sinai Hospital in New York (Dr. David Adams)
- University of Maryland Heart Center (Dr. James Gammie)
- Cleveland Clinic (Dr. Muhammad Mumtaz)
- Hoag Heart Center Newport Beach (Dr. Aidan Raney)
- Dr. Leland Siwek, Spokanne, Washington - robotic repair specialist (Being recruited by the Cleveland Clinic!)

So, in closing, let me just say that our “plan of action” is to aggressively look for a surgeon who specializes in VALVE REPAIR!! Sherrill and I (and we know everyone who knows Michael!!) have been praying that we find the right surgeon to do this operation! Thank you all for your support and prayers!!

Stewart and Sherrill