Shipley Cardiothoracic Center Advances Treatment, Patient-Centered Care

The award-winning cardiothoracic team at Shipley Cardiothoracic Center refuses to rest on its laurels.

Despite developing a national reputation as a pioneer in minimally invasive heart valve surgery in Florida, earning recognition as an IBM Watson Top 50 Cardiovascular Hospital four years running (the only program in Florida honored as such), receiving a 3-star program rating by The Society of Thoracic Surgeons (that’s rare, only five other facilities in 2018 earned it), the team keeps striving for excellence.

Take the new Heart Valve Center, which opened July 1, as an example of Shipley’s devotion to quality of care and innovation.

The center represents a coordinated effort between Shipley Cardiothoracic Center and the cardiologists of HealthPark Medical Center to bring a comprehensive, multidisciplinary approach to valve disease, says Dr. Michael DeFrain, a double board-certified cardiothoracic surgeon.

“In a single center, patients and their referring physicians will have access to a complete array of valve therapies including all transcatheter therapies, minimally invasive surgical approaches and traditional open-heart options,” Dr. DeFrain says.

One highlight of the center is the weekly valve conference that brings together Healthpark Medical Center’s premier medical staff treating valve disease: cardiologists, anesthesiologists, cardiac surgeons, operating room staff and nursing. 

“The experts at the conference discuss treatment plans that address each patient’s unique needs to optimize the management of each patient,” Dr. DeFrain says. “Also, the referring physicians of patients are invited to participate in their patient’s evaluation and receive immediate feedback regarding the interventional plan.”

Dr. DeFrain says patients will benefit not only from the comprehensive and cohesive multi-disciplinary team approach but also the opportunity to participate in new therapies on the horizon by enrolling in clinical trials available at Shipley. 

What is Heart Valve Disease?

As we get older, we may not have as much energy. We may lose our breath more quickly. We may even be unsteady on our feet. These are all situations associated with normal aging.

But for some of us, they’re also symptoms of heart valve disease, which affects millions of Americans who are unaware they may have the disease.

“Because symptoms of heart valve disease can be subtle, they’re often dismissed as normal signs of aging,” says Dr. DeFrain. Each year, more than 25,000 people in the U.S. die from heart valve disease.

Fortunately, heart valve disease can usually be successfully treated with valve repair and replacement in patients of all ages, Dr. DeFrain says.

“Heart valve disease can be present at birth or develop damage later in life from calcification and other conditions,” he notes. “Age is the greatest risk factor with 1 in 10 people ages 75 and older are estimated to have moderate to severe heart valve disease, which can gradually worsen without notice.”

The heart has four valves: the tricuspid, pulmonary, mitral, and aortic valves. Valve disease can affect any one of these.

Valves have tissue flaps that open and close with each heartbeat. The flaps make sure blood flows in the right direction through your heart's four chambers and to the rest of your body.

Birth defects, age-related changes, infections, or other conditions can cause one or more of your heart valves to not open fully or to let blood leak back into the heart chambers. This can make your heart work harder and affect its ability to pump blood, Dr. DeFrain says.

Shortness of breath and/or difficulty catching your breath is a common symptom of valve disease. This can occur during daily activities or when lying down flat in bed. Some people are unable to lay flat in bed and may need to prop themselves up on pillows to facilitate breathing.

What are the symptoms of HVD?

Although some people with valve disease may not experience any signs of the disease for years, the condition will eventually worsen. The main sign of valve disease is an unusual heartbeat sound known as a heart murmur.

“Many people who have valve disease don't have any symptoms until they're middle-aged or older,” Dr. DeFrain notes.

Other common signs and symptoms include:

• Unusual fatigue (tiredness)
• Shortness of breath, especially when you exert yourself or when you're lying down
• Swelling in your ankles, feet, legs, abdomen, and veins in the neck
• Chest pain that may happen only when you exert yourself. You also may notice a fluttering, racing, or irregular heartbeat
• Some types of heart valve disease, such as aortic or mitral valve stenosis, can cause dizziness or fainting

Source: National Heart, Lung, and Blood Institute

How is valve disease diagnosed?

Your heart doctor can tell if you have valve disease by talking to you about your symptoms, performing a physical exam, and giving you other tests that may include:

• Electrocardiogram (ECG) records the electrical activity of the heart.
• Transesophageal echocardiogram (TEE) uses sound waves to create high-quality moving pictures of the heart and blood vessels.
• Echocardiogram uses sound waves to create pictures of the heart. The picture and information it produces are more detailed than a standard X-ray image. An echocardiogram doesn’t expose you to radiation.
• Chest X-ray is a type of X-ray used to create pictures of the inside of your body. The images show the parts of your chest in different shades of black and white.
• Cardiac catheterization involves passing a tiny, hollow tube (catheter) through a large artery in the leg or arm leading to the heart to provide images of the heart and the heart’s blood vessels. This procedure is helpful in determining the type and extent of certain valve disorders.
• Magnetic resonance imaging (MRI uses powerful magnetic fields and radio waves to create pictures of the chest (thoracic area). It does not use radiation (X-rays).

Source: National Library of Medicine

How is valve disease treated?

Some heart valve problems are minor and don’t require treatment. Yearly check-ups with your health care provider or cardiologist, living a healthy lifestyle, and medication may be all that’s needed.

In some cases, you may need surgery to repair a damaged valve or have it replaced with a new one.

Your doctor can help you understand the best option for you.

The board-certified cardiothoracic surgeons at Shipley Cardiothoracic Center are award-winning experts at performing minimally invasive valve surgery to improve the quality of life of their patients. Their vast experience includes robotic heart surgery, transcatheter valve therapies and hybrid surgical programs.

Shipley Cardiothoracic Center, along with Lee Health’s dedicated cardiac anesthesiologists and surgical teams, consistently ranks in the top tier of cardiovascular treatment, education, and research programs in the United States.

The addition of the Heart Valve Center is a continuation of the quality and expertise that has made Shipley Cardiothoracic Center the premier SWFL cardiac surgery program. 

For referrals, call 239-343- 6341.