Actor Robin Williams in hospital

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Does anyone know which valve Barbara Bush had replaced. I watched the clip on former president Bush when he was crying but I didn't hear which one. I sure did feel badly for him though. It is hard on families no matter who you are. And I guess our recent former president must have had some of this on his mind also the last little while. I wonder if she was having trouble or just all of a sudden. I would think valver problems would have some symptoms.

I wish Robin Williams all the best. He is a very good actor and a fellow human being. And now just like the rest of us he needs to get through this.

aortic, it was schedualled last week, but I don't know when she first went to the doctor about the SOB. I read she was walking a couple times and is expected to move out of ICU tomorrow
 
When I first learned about Barbara Bush and Robin Williams, I thought that they should be directed to Valvereplacement.com for support. I was also thinking that having famous people in our valve replacement community would be interesting. I doubt that will happen though! Marcie
 
Probably doesn't log in with his 'real name', I wouldn't think but I agree it is possible he could be reading this very thread. :) If so, Welcome to our Community, Mr. Williams, and very best wishes to you.

I STILL want to know if he opts for tissue or mechanical. :)
 
Update: I just saw a picture of Robin Williams on the beach in Miami on tv. They said he is waiting to have his surgery and no word yet on where or when that will be.

Kim
 
I guess this just proves that rich or poor, black, white or brown, male or female, Christian, Muslim, or Buddhist, Conservative, Liberal, Libertarian, Socialist or Communist, this is an equal opportunity defect.

I am a big fan of both Robin and Barbara and wish them both the very best.

Robin - if you happened to wander in here, this is a group of great people who have been there, done that and bought the T-shirt (or in our case - the Tawdry Shirt). Read read read here, ask questions and know that valve replacement is a highly successful procedure - just go to our Active Lifestyles forum and see how this surgery will not slow you down - but give you more energy.
 
One of my coworker's father is in Methodist and right next door to Mrs. Bush. Mr. Bush has walked by his room several time and my friend says her dad just acts like a little boy when Mr. Bush waves.
 
Like we all are, Robin Williams the man not his career or talent is very important to the people in his life. I wish him a speedy recovery.

Lettitia
 
I know this is long, but it irked me that they said, well, we all know about William's cocaine-infused youth! :mad::mad: I bet his valve is bicuspid!! Idiots!!

And then toward the end... "in the early days".... so what are WE, dinosaurs???

Anyway, check this out! All I did was google Robin Williams heart surgery...

Marguerite

and from Scientific American!!
http://www.sciam.com/article.cfm?id=aortic-valve-replacement

Comedian and actor Robin Williams, 57, last week postponed a planned 80-city tour of his one-man show, "Weapons of Self-Destruction" to undergo aortic valve replacement surgery. His announcement came just days after 83-year-old former first lady Barbara Bush left a Houston hospital after undergoing the same procedure.

The aortic valve is what keeps oxygenated blood flowing from our heart into the aorta, the largest artery in our body, and prevents it from washing back into the heart with each pump cycle. But as we age, the tricuspid (three-leafed) valve tends harden and thicken, forcing the heart work harder to keep blood flowing smoothly. Open-heart surgery is typically required to replace the valve if it thickens so much that it causes aortic stenosis, an abnormal narrowing and stiffening of the valve.

Although Williams is 26 years younger than Bush, the procedure is not particularly unusual for someone in his or her late 50s. Factors such as obesity and genetics can play role in hastening the decline of the valve's function, but heart infections, typically caused by rheumatic fever or drug use, can also lead to a form of sclerosis. Williams is well-known for his cocaine-infused youth.

To find out more we spoke with Rajendra Makkar, co-director of the Cedars?Sinai Medical Center Heart Institute's Cardiovascular Intervention Center in Los Angeles.

[An edited transcript of the interview follows.]


What is the aortic valve?
The aortic valve is the valve between the left ventricle?one of the heart's four chambers?and the aorta which provides oxygenated blood to the entire body. The heart pumps blood by contracting, and if this one-way valve was not present then when the heart relaxes then most of the blood it just pumped from the ventricle would leak back in, making the heart very inefficient.

Why would someone need a replacement?
The procedure is most commonly performed in the U.S. for a condition called aortic stenosis, where the valve fails to open properly. This is a fairly common condition in the aging population.

It begins as aortic sclerosis, a thickening of the aortic valve by calcification. About 10 to 15 percent of the population above 55 has this, and about 25 percent of the population over 65 has it. That does not produce much of a problem unless it progresses to stenosis. Over 10 years, roughly 15 percent of patients with sclerosis will progress to stenosis, and not all of those cases will be severe enough to lead to treatment.

About 2 percent of the population also has[is born with?] a bicuspid valve rather than a tricuspid valve, and this tends to wear out the heart much earlier, leading to stenosis. In the developing world, stenosis can be a consequence of rheumatic fever (caused by untreated strep infection) during childhood. Drug use can also lead to endocarditis, an infection of the heart. Anything that causes an infection of the valves can lead to stenosis.

The most common symptoms of aortic stenosis are related to the fact that the heart has to work much harder to pump blood out. These include chest pain and shortness of breath as well as fainting, known as syncope.

What does the surgery involve?
In the early days, surgeons would open up the entire sternum, put the person on a heart?lung machine, open up the aorta, and stitch in a new valve. These days the surgeons will make a smaller incision, but it is still open-heart surgery, which requires a whole team of people and lasts two to three hours.

Now, there is a technique we are testing, which involves changing the valve percutaneously (without opening the chest). We go from the femoral artery in the groin and work our way back almost 100 centimeters [40 inches] to the aortic valve. The whole procedure takes an hour and a half and is the way the whole field is going. We've done about 100 procedures as part of a clinical trial.
 
You left off the 2nd page of the article, which adds a little more information:

How do they make the replacement valves?
There are mechanical valves, and there are tissue valves. Tissue valves are the most commonly used valves, but they only have a life span of 10 to 15 years. They handcraft these valves from the covering layer of a cow or pig's heart, called the pericardium. From this, they make three leaflets and mount them in a ring. The biggest issue with tissue valves is that they get calcified over time, although companies have proprietary treatments to slow down this process.

Mechanical valves practically last forever, but the disadvantage is that patients have to take a blood thinner to prevent blood clots.

How risky is the traditional surgery?
The mortality of the procedure is about 2 percent, but it goes up in older patients with other significant medical problems. Often these patients require heart bypass surgery at the same time, which can double mortality. About half of patients with stenosis don't get treated, because they are considered too old. As we move forward, percutaneous aortic valve replacement will allow more of these patients to get treated.


I looked up Rajendra Makkar on Google, and he's a Doctor: http://www.csmc.edu/2528.html

I agree that the paragraph describing "the early days" is screwed up, but I think most of the article is fairly accurate. I think the blurb on percutaneous valve insertion is somewhat overstated, and would probably not be an appropriate treatment for Mr. Williams. However, we still have no idea whether Mr. Williams has a bicuspid valve but I agree that it is highly likely.

I did not know that tissue valves were made from the covering layer of a pig or cow heart. I thought that they were made from pig or cow heart valves.
 
Well, there you go! The pig valves are different from the cow valves. As I understood it the pig valve IS the pig valve, and the cow valve is made from the pericardium of the cow's heart or valve :confused:

But thank you for the second page. I saw it after I'd already posted this. I just don't think, in our experiences, that much of this article is very helpful. Just my 2 cents.

I had read (here?) that his brother died while having replacement surgery. Why, I wonder was his brother undergoing valve surgery? Just sounded like a family thing, so guessed at the bicuspid.
 
The Bovine PERICARDIAL Tissue Valve is made from the Pericardium of a Cow's Heart.

Porcine Tissue Valves are the complete Valve from a Pig.

Modern Procine valves are modified / treated to hopefully extend their durability. Untreated Porcine Valves often last only 8 to 12 years.

Humorist / Columnist Lewis Grizzard wrote an entertaining book about his first (Porcine) Valve Replacement Surgery entitled "They Tore Out my Heart and Stomped That Sucker Flat". He died after his third (or was it fourth?) surgery.

'AL Capshaw'
 
Well, there you go! The pig valves are different from the cow valves. As I understood it the pig valve IS the pig valve, and the cow valve is made from the pericardium of the cow's heart or valve :confused:

But thank you for the second page. I saw it after I'd already posted this. I just don't think, in our experiences, that much of this article is very helpful. Just my 2 cents.

I had read (here?) that his brother died while having replacement surgery. Why, I wonder was his brother undergoing valve surgery? Just sounded like a family thing, so guessed at the bicuspid.

You're right pig valves are actually that.. pig valves. Bovine valves for the most part are made of the pericardial sac of cows, altho there is a bovine valve/conduit the contegra conduit that is actually a section of the cows jugular vein that has a valve (that if I remember right helps keep cows from tipping over) but that is just used in the pulm position.
I had read his brother Toad died following heart surgery, but didn't see what kind of surgery it was.

I don't know if the reporter wasn't very good at writing what the doctor actually said, but this article would make me nervous about going to this guy since his info isn't very good, especially since he works at Cedar, I would hope it was just bad journalism.
ps thinking about it the doctor IS a interventional cardiologist and not a surgeon, maybe they should have talked to a surgeon about different valves, but if this is the info this guy tells his patients and it is wrong, that's scarey thinking what else he thinks he knows that apparently doesn't
 
Exactly. Another "expert" talking through his hat.

The points above about the manufactured bovine pericardium valves vs. the natural pig valve are accurate.

As far as the nature of the surgery: in the "early days of 2004" I had my sternum split. Most VRs by far are still standard sternectomy (split sternum). While there are certainly a fair number of minimally evasive surgeries done, you still have to search for a surgeon who does them, or has done enough of them for you to feel secure. There are even a few DaVinci robotic surgery graduates among us.

But it's very far from "the way we do it now."

He is an interventional cardiologist (performs catheterizations. etc.), rather than a surgeon. As such, he is not actually a part of the "we" that is doing the cutting. He may have been doing the interview at the behest of a friend. (Note: Interventional Cardiology is a very technical and intense specialty of its own, and this is not at all intended to disparage that in any way.)

I'm tempted to say that the "expert" should have read more than the light reading that public media offers before opening his yap. Remember this next time you listen to a doctor who appears on your TV news show.

However, I was interviewed once in high school by a fairly large newspaper. I had a rather conservative attitude at the time. But the article turned out to be about youth in the late 1960's embracing liberal ideas. What I had said was entirely rewritten to be what the reporter wanted. I came out (quoted, mind you!) sounding somewhat left of the Gang of Four. I was furious.

So, it's possible that what he said is not exactly what was printed.

Best wishes,
 
In the developing world, stenosis can be a consequence of rheumatic fever (caused by untreated strep infection) during childhood.

This is the part that stuck out for me. I didn't realize that when I had Rheumatic Fever in 1976, America was considered a developing country! Granted it's uncommon but with the resistance to antibiotics, I think there has been a slight upswing.
 
I saw a similar report on a news network where they mentioned his cocaine use and then said that it was not likely the cause of this issue. I found it interesting that people's first thought when they found out that he had heart trouble that it must be due to his past drug use.

The problem in the article above where it mentions drug use, I believe what it means is IV drug use which can cause endocarditis, which can undermine the health of the valve. It is not drug use in general.
 
But it's very far from "the way we do it now."

He is an interventional cardiologist (performs catheterizations. etc.), rather than a surgeon. As such, he is not actually a part of the "we" that is doing the cutting. He may have been doing the interview at the behest of a friend. (Note: Interventional Cardiology is a very technical and intense specialty of its own, and this is not at all intended to disparage that in any way.)

I'm tempted to say that the "expert" should have read more than the light reading that public media offers before opening his yap. Remember this next time you listen to a doctor who appears on your TV news show.

Best wishes,


I think he is probably doing the percutaneous replacements and that is why he says we and also seems to be over stating how it is the way things are done now.
BUt I would hope someone involved in valve replacements would be better informed on the valves actually being used now.
 

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