Aortic Valve Root Reconstruction and Aneurysm Repair

I am excited to post this new video of a complex aortic aneurysm and valve replacement operation.

This patient is 64-years old who was found to have a large aneurysm near the heart.  We often refer to these proximal ascending aortic aneurysms as "root aneurysms" meaning that they occur at the very beginning of the aorta.

In this instance I did not feel the patient's aortic valve could be saved and therefore I replaced the valve and root using a Medtronic Freestyle Porcine (Pig) Valve Conduit.

Turn on your speakers and listen as a describe the procedure as you watch the video!

 



We are all the same on the inside!

One of the great ironies of human diversity is that fact that for the most part, humans are less diverse as a species than most other animals on the planet.  In fact, if we compare ourselves to the other 8 million species that live on the land or beneath the seas, Homo sapiens –Latin for “wise men”—have among the least amount of genetic variation.

For example, a 2012 Oxford University study showed that groups of chimpanzees living in a relatively small area of central Africa have more genetic diversity than human beings living on different continents.  Needless to say, man’s best friend –the dog, or the cat for that matter—have a tremendous greater amount of genetic diversity than humans.  Penguins have twice the genetic diversity as humans. Fruit flies have 10 times as much, and so on.

Sure, we humans look remarkably different on the outside. Some are tall, some short. Some have blue eyes, some brown.  But these different traits are minor from a genetic standpoint and, more importantly, they are discordant, meaning they don’t match up.  You cannot tell a person’s eye color from their height and you cannot tell a person’s blood type by their skin color.  Perhaps most importantly, you cannot tell a person’s IQ, athletic abilities, or future leadership potential from any external physical characteristic because in fact beneath the skin, we are all genetically similar.

As a heart surgeon, I have had the privilege of knowing firsthand what lies beneath the skin.  After 21 years in practice and nearly 6,000 operations, I can assure you that we are all the same on the inside.  Your heart, your lungs, and your bones are all indistinguishable from race to race, person to person, man or woman.

And yet, wars continue to be fought, fences continue to be built, and children continue to die unnecessarily in the name of race, creed, ethnicity, nationality, religion, and even sexual orientation.  How can this continue to happen?  How is it that we continue to see only our superficial differences and not our human similarities?  These visual differences that we see on the surface of our bodies tell us nothing about what lies beneath the skin, nor what lies within our hearts or in our souls.

I am in awe every time I step into the operating room.  To literally hold a heart in your hand is an experience that is like no other.  No matter how many operations I perform, I will never cease to marvel at both the complexity and the efficiency of the human heart.  And, of course, even beyond the splendor of its anatomy, the heart has always represented the very essence of our thoughts –love and hate, strength and fear, passion and calm.  These metaphors are perfect. Just as our hearts are genetically similar, so are our human needs.  We all just want to survive, love our families, and live in peace.

Mother Teresa once said, “If we have no peace, it is because we have forgotten that we belong to each other.” It is undeniable that we belong to each other, not only from a philosophical or spiritual standpoint, but also because of our very DNA.

I often wonder how different things would be if everyone in the world could see into each other’s hearts as I do each day in my profession.  Imagine if we no longer saw each other as different races or countries or religions… just people, all the same on the inside.  If we all begin to see each other as one and the same, perhaps someday we can all finally live together in peace.

“You may say I’m a dreamer, but I’m not the only one. I hope someday you will join us.  And the world will live as one.” –John Lennon

 

PBS Channel 39 Tempo In-Depth on Heart Disease

This week, WLVT PBS 39 dedicated their Tempo In-Depth show to heart disease.  Below is a video of the show.  The show features a number of heart health issues such as women's health, the new trans-catheter heart valve replacement technology, and the new implantable left ventricular assist devices (LVAD) --all available at Lehigh Valley Health Network.

 

 

 

HeartMate II LVAD Implantation at LVHN --First In Region

Lehigh Valley Hospital's collaborative team of heart failure cardiologists and heart surgeons implanted the first Thoratec HeartMate II Ventricular Assist Device in our region. Our Mechanical Heart Assist Device Program is affiliated with the Hospital of the University of Pennsylvania Heart Failure and Transplantation Team. We are pleased to provide this advanced technology to our region and we are honored to be affiliated with Penn's nationally recognized transplant center.

The Comfort of a Simple Crayon

 

Perhaps the single most identifiable item associated with the innocence of childhood is the Crayola crayon –and has been for over 100 years.  No doubt, this holiday season millions of children all over the world will receive a box full of crayons and a coloring book that will make them smile.

 

By chance, I was asked to speak at the Crayola Factory to their employees about heart health, only days after the unspeakable tragedy in Connecticut and only a few days before Christmas. Like so many parents, I was deeply saddened by the killing of innocent children at the Sandy Hook Elementary School. How quickly the photos of families crying in pain became seared in our minds and will not be easy to forget. It was difficult to comprehend and yet in so many ways, it was so real, and hit so close to home.

 

I was literally driving around town trying to clear my mind of this sadness so that I could think of a few positive words to tell the employees at the Crayola Factory about how to live a healthy and fulfilling life.  I was clearly not in a creative mood.  All at once it dawned on me the obvious connection between the children of Connecticut and our hometown company, the Crayola Factory.  Indeed, the connection was obvious --it was the comfort, joy, and even the smell of a simple crayon and its symbolism as part of the innocence of childhood.

 

I could not help but imagine that the children who died had Crayola crayons in their little desks, or perhaps even more tragically, in their tiny hands when that evil madman ended their lives. I imagined the many colorful drawings that likely hung in those classrooms as the horror unfolded, or the unopened Christmas presents that surely included crayons and coloring books. I began to cry.

 

Just then, I heard a CNN reporter on the radio interviewing the Sandy Hook Elementary School librarian.  The librarian told the story of how she quickly shuffled the children in her classroom into a storage closet as soon as she realized that there was a shooter in the building.  The children were all so frightened, as was the librarian.  Sure enough, the librarian saw that there were boxes of crayons and coloring books in the storage closet and instructed her students to draw happy pictures, as she reassured them that “the good guys were on their way.”

 

Later that evening, I listened to the President’s remarks to families of Connecticut. After his call for peace and hope, I realized further how thousands of children from across the country –if not the world—would draw pictures to share their thoughts and well wishes for all those saddened by this national tragedy.  No doubt, these heartfelt drawings and cards of hope would be done beautifully, yet again, with the comfort of a simple crayon.

 

When the day of my talk came, I stood in front of the employees of the Crayola Factory and thanked them. I shared with them my reflections above and simply said...

 

“To think, that the very company you work for, a company that has been synonymous with childhood, was literally present at this elementary school, both in the desks and hands of those whose lives were cut short, and in the hands of those who survived. Imagine for a moment, that in so many ways, a part of each of you were present with these kids, comforting them in their last moments, helping yet others to survive. As a father of two beautiful young daughters –who I love more than life—I want to start by thanking each and every one of you at Crayola, for your quiet, but oh so important contribution to all children.”

 

It felt so surreal that my talk at Crayola, planned months prior, would happen to fall at this time. And yet, I felt so privileged to be at Crayola, to thank them in person. We joined hands, closed our eyes for a moment of reflection and simply said together, “May God bless all the children of the world.”

An Unspeakable Horror

The tragedy that has occurred in Connecticut is an unspeakable horror --one that no parent should ever have to endure.  We live in a culture of violence that seems to be getting worse each day.

It reminds us that our daily worries should not distract from the most important things in life, our families and our health.  We must all learn to focus on what we have, not what we don't have --to take each day as a blessing and to try to always look at the glass as half-full, not half-empty.  We need to let go of our useless anxiety over what is missing in our lives and learn to enjoy and appreciate all of God's blessings.

I will be speaking at the Crayola Factory this coming Tuesday, December 18.  I do so with a heavy heart thinking of all of those children who likely had their own crayons nearby, perhaps in their hands, just as their lives were taken away by an evil madman.

All we can do is pray... and hug someone we love.

Where have all our heroes gone? Astronaut Neil Armstrong and his generation were the “Right Stuff”

The following essay appeared in The Morning Call on-line September 4, 2012 and in-print on September 5, 2012.  I hope you enjoy reading my essay. It just seems to me that our country, indeed our world, could use a few more real heroes and true leaders like Astronaut Neil Armstrong.

http://www.mcall.com/news/local/parkland/mc-neil-armstrong-singer-yv-0905-20120904,0,2632745.story

(Neil A. Armstrong, the first man to walk on the moon, is shown at the lunar module on the moon in July 1969.

Considered an American hero, Armstrong died Aug. 25 at age 82. (NASA, AFP/Getty Images / September 4, 2012)

I could not help but see the irony in the fact that a true American hero, Neil Armstrong, died the same week that Lance Armstrong was forced to concede his fame due to allegations of cheating. I say “allegations” because in today’s world, until proven guilty by a court, our fake heroes rarely, if ever, hold themselves accountable for their words and actions.

Astronaut Neil Armstrong was, of course, a true hero, having been the first human to step on the moon.  Prior to becoming an astronaut he was a United States Naval Officer who served in the Korean War. He flew 78 missions over Korea and was shot down once, remarkably surviving after he was forced to eject from his crippled jet. From 1955-1962 he served as a test pilot at Edwards Air Force Base where he pushed the limits of jet propulsion technology with another American hero, Chuck Yeager.

In 1962 Neil Armstrong officially became a NASA astronaut, joining the Gemini and later, Apollo programs. Risk and challenges were all around him throughout his career.  In 1967, only two years prior to the lunar landing, three Apollo 1 astronauts lost their lives in a fire during a launch pad test.  Along with a vast collaborative team of scientists, engineers, astronauts and staff, the Apollo program participants continued their quest of putting a man on the moon nonetheless.   Their tireless efforts and selfless sacrifice under the visionary leadership of men like Armstrong led to the famous Apollo 11 landing on the moon on July 20, 1969.

Heroes of days gone by held themselves to a high standard.  Like so many of his generation, Neil Armstrong was all about service to country, devotion to family, and dedication to his craft.  And, after achieving what was undoubtedly the greatest human triumph of his time, he remained humble, decent, and generous. Though he received many awards, including the Presidential Medal of Freedom, he largely turned down opportunities to make money on his achievements but instead chose to teach aerospace engineering at the University of Cincinnati.

And while real heroes who possessed high ethical standards and self-reliance, like Neil Armstrong, were focused on service and the pursuit of dreams that benefitted humankind, the fake heroes of today seem “sold-out” on fame, fortune, and their own legacy - at any cost - even cheating.  Something is out of balance.   We seem to lack a collective personal integrity.  Long gone are the days when mediocrity was NOT rewarded.  Not only are relatively average professional athletes receiving millions of dollars in salaries and endorsements, many now even wear corporate logos on their uniforms that compete in size with the team emblem.

We may all be so desperate to “win the lottery” that we have forgotten as a society that true success comes from years of hard work, including trial AND error, and yes, winning AND losing.  Most of the world’s greatest inventors, statesmen, scientists, and artists, learned how to overcome failure before they experienced success.  One cannot succeed unless one accepts failure as an opportunity to work that much harder and smarter.

Sadly, we have seemingly all bought into a fantasyland where everyone deserves a trophy. I worry about our lack of true heroes today.  I can’t help but think it starts on the playgrounds where children are taught today that “everyone is a winner.”  I just don’t know.  When I lost a wrestling match in high school that I should have won, my father didn’t feel he had to pat me on the back and tell me everything was okay.  He instilled in me the meaning of hard work and how to overcome adversity on my own.  I looked up in the stands after that humiliating loss and as our eyes met, my father simply nodded gently, as if to say, “Ray, you know what you need to do, now do it.”

Neil Armstrong is being hailed as one of the great heroes of the 20^th century for his achievement as the Commander of Apollo 11.  He was a member of “The Greatest Generation” who survived the Great Depression, fought in World War II and Korea, and rebuilt our nation to become the most advanced and most powerful in the world.  The Greatest Generation knew how to serve and not just how to take. They didn’t have to cheat, look to a lottery for success; they didn’t feel everyone deserves a trophy.

Heroes like Neil Armstrong –and the countless others of his generation with similar qualities—are the “right stuff” that I believe our nation sorely needs today.