The following program
presents principles designed
00:00:01.36\00:00:02.76
to promote good
health and is not intended
00:00:02.80\00:00:04.83
to take the
place of personalized
00:00:04.87\00:00:06.50
professional care.
00:00:06.53\00:00:07.87
The opinions and ideas expressed
00:00:07.90\00:00:09.30
are those of the speaker.
00:00:09.34\00:00:10.71
Viewers are encouraged to
draw their own conclusions
00:00:10.74\00:00:13.07
about the information presented.
00:00:13.11\00:00:15.18
The heart is a complex
organ with many moving parts.
00:00:15.21\00:00:18.25
On today's program,
00:00:18.28\00:00:19.61
we'll take a look at
the valves of the heart
00:00:19.65\00:00:21.05
and discover what can be done
00:00:21.08\00:00:22.65
when there's a
problem with a heart valve.
00:00:22.68\00:00:24.65
Thanks for joining us today
00:00:24.69\00:00:26.02
right here on the
Ultimate Prescription.
00:00:26.05\00:00:27.69
Welcome to the
Ultimate Prescription.
00:00:48.74\00:00:50.41
I'm your host Nick Evenson
here with Dr. James Marcum,
00:00:50.45\00:00:53.62
practicing Cardiologist
00:00:53.65\00:00:54.98
with the
Chattanooga Heart Institute.
00:00:55.02\00:00:56.55
Welcome, Dr. Marcum.
It's nice to be here, Nick.
00:00:56.58\00:00:59.02
And I was thinking,
you know, I've been doing
00:00:59.05\00:01:01.49
television
programs for a few years,
00:01:01.52\00:01:03.49
but I really
enjoy meeting patients
00:01:03.53\00:01:06.19
every day, and talking to them
00:01:06.23\00:01:08.46
about their different problems
00:01:08.50\00:01:09.83
and sort of
coming up with a plan.
00:01:09.86\00:01:11.43
And, of course, I
mainly work with hearts,
00:01:11.47\00:01:13.64
but, you know,
time goes by, quickly,
00:01:13.67\00:01:17.77
you know, and I
think there's an advantage
00:01:17.81\00:01:19.74
of being able to
look at things over time.
00:01:19.77\00:01:23.45
And you see what
things don't work
00:01:23.48\00:01:25.21
and I have to relearn everything
00:01:25.25\00:01:27.58
in medicine
about every 10 years.
00:01:27.62\00:01:29.92
How about that in your field?
00:01:29.95\00:01:31.35
Yeah, technology
is always changing,
00:01:31.39\00:01:33.46
and it got to keep up
with it year-over-year,
00:01:33.49\00:01:35.79
otherwise,
you're gonna fall behind
00:01:35.82\00:01:37.16
and five years down the road,
00:01:37.19\00:01:38.53
I might not be
able to do my job.
00:01:38.56\00:01:39.89
You know, now a lot of
people, you know, they see you,
00:01:39.93\00:01:42.36
and they think you're a host,
00:01:42.40\00:01:43.73
but in reality, you
know, you have your own company
00:01:43.77\00:01:47.44
that does video
and that kind of stuff.
00:01:47.47\00:01:50.07
And, you know, you've
worked with Heartwise Ministries
00:01:50.11\00:01:52.74
doing just about everything.
00:01:52.77\00:01:54.78
And you can agree
with me that your field
00:01:54.81\00:01:56.95
is constantly changing.
00:01:56.98\00:01:58.41
Yeah, yeah.
00:01:58.45\00:01:59.78
In video production,
obviously, we've got television,
00:01:59.81\00:02:02.42
but we've also
got digital media,
00:02:02.45\00:02:03.79
and then there's YouTube
00:02:03.82\00:02:05.15
and all kinds of
outlets for video now.
00:02:05.19\00:02:06.52
And so it's a really, you know,
00:02:06.55\00:02:07.89
the landscape has
changed over the last 10 years,
00:02:07.92\00:02:09.99
even
significantly, in the way that
00:02:10.03\00:02:11.76
we format videos
and write videos,
00:02:11.79\00:02:13.90
it can all change and vary.
00:02:13.93\00:02:15.50
And it's amazing how
the world is changing.
00:02:15.53\00:02:18.53
And one constant
that we do have is change.
00:02:18.57\00:02:22.20
And I've been
amazed at watching back
00:02:22.24\00:02:24.64
over my career in
cardiology, you know,
00:02:24.67\00:02:27.98
when my kids were little
Jake and Kelly, you know,
00:02:28.01\00:02:30.51
I was doing
things much differently,
00:02:30.55\00:02:32.01
and now that they're grown.
00:02:32.05\00:02:33.38
Now you have a couple
little kids too, right?
00:02:33.42\00:02:34.75
I do.
00:02:34.78\00:02:36.12
I've got a
wonderful wife Leslie,
00:02:36.15\00:02:37.62
and we got two little
boys, Hayden and Corbin.
00:02:37.65\00:02:39.72
They're four and five.
00:02:39.75\00:02:41.09
And they are full of
energy and they keep us hopping.
00:02:41.12\00:02:43.93
So we do our best to keep up.
00:02:43.96\00:02:45.29
I remember those days, Nick,
00:02:45.33\00:02:47.23
and all those
out there with kids.
00:02:47.26\00:02:48.80
You know, we're
empty nesters now,
00:02:48.83\00:02:50.67
and that's a whole
different stage of life, too.
00:02:50.70\00:02:52.73
Yeah.
00:02:52.77\00:02:54.10
You know, despite all
the change that happens,
00:02:54.14\00:02:57.24
I'm reminded that
God's Word is constant.
00:02:57.27\00:03:00.18
And I really appreciate
the Biblical Prescriptions app
00:03:00.21\00:03:02.91
that we've developed.
00:03:02.94\00:03:04.28
Now if we could talk
about that for a minute,
00:03:04.31\00:03:06.15
it's available for
Android and iOS devices.
00:03:06.18\00:03:08.88
And it's a free download.
00:03:08.92\00:03:10.25
You can have it on
your phone or your tablet.
00:03:10.29\00:03:11.92
And it's designed to
just remind you every day
00:03:11.95\00:03:14.62
to spend 10 minutes.
00:03:14.66\00:03:15.99
And, Dr. Marcum,
00:03:16.02\00:03:17.36
you've done a
specific worship routine
00:03:17.39\00:03:19.29
that's in the app.
00:03:19.33\00:03:20.66
Yeah. It takes about 10 minutes.
00:03:20.70\00:03:22.03
And it really helps
people retain that scripture
00:03:22.06\00:03:24.20
and apply the
biblical prescription
00:03:24.23\00:03:25.67
in their lives.
00:03:25.70\00:03:27.04
Can you just
describe that for us?
00:03:27.07\00:03:28.40
Yeah.
00:03:28.44\00:03:29.77
And the reason we use 10 minutes
00:03:29.80\00:03:31.14
is because the studies
on how our brain changes,
00:03:31.17\00:03:33.84
our physiology
changes have studied
00:03:33.88\00:03:36.28
just 10 minutes
of biblical worship.
00:03:36.31\00:03:38.95
We know that the
part of the brain
00:03:38.98\00:03:40.45
called the anterior
cingulate cortex gets bigger.
00:03:40.48\00:03:43.82
The stress chemistry comes down
just from studying 10 minutes.
00:03:43.85\00:03:47.92
And in this app, you
know, you warm-up to exercise,
00:03:47.96\00:03:50.36
we have some things
00:03:50.39\00:03:51.73
that we do to
warm-up to worship.
00:03:51.76\00:03:53.19
Okay, hold on.
00:03:53.23\00:03:54.56
We're talking about
some physical activities
00:03:54.60\00:03:56.50
to warm-up that help your brain
00:03:56.53\00:03:58.43
get some better
blood flow maybe.
00:03:58.47\00:03:59.80
Well, when we worship,
00:03:59.83\00:04:01.17
we don't wanna be stressed out,
00:04:01.20\00:04:02.54
we wanna be focused
on that relationship.
00:04:02.57\00:04:04.67
And there are some things
that we can do to breathing,
00:04:04.71\00:04:07.01
stretching, moving
different parts of our body
00:04:07.04\00:04:09.48
that can turn on the
upper part of the brain
00:04:09.51\00:04:11.88
and sort of turn down
the stress part of the brain
00:04:11.91\00:04:14.82
and get us
focused on worshiping God.
00:04:14.85\00:04:17.25
And there's some
prayers that help bring us
00:04:17.29\00:04:19.19
into God's
presence that cleanses us,
00:04:19.22\00:04:21.82
just as a good 10-minute study
for people to stay on track
00:04:21.86\00:04:25.96
in that relationship with Jesus.
00:04:25.99\00:04:27.43
Yeah, you know, I
think it's a great approach.
00:04:27.46\00:04:28.96
I've discovered in my own life,
00:04:29.00\00:04:30.33
that I have some
of my most creative
00:04:30.37\00:04:32.67
and best thinking
moments when I'm exercising.
00:04:32.70\00:04:34.74
Yeah.
00:04:34.77\00:04:36.10
And so doing a
little exercise to warm-up
00:04:36.14\00:04:37.47
before we study something
as important as God's Word,
00:04:37.51\00:04:39.41
it's a great strategy.
00:04:39.44\00:04:40.78
And physiologically
what that does, Nick,
00:04:40.81\00:04:42.44
as you make a chemical
00:04:42.48\00:04:43.81
when you
exercise called endorphin.
00:04:43.85\00:04:46.21
Endorphin turns
down stress chemistry.
00:04:46.25\00:04:48.92
So this gets more of your brain
00:04:48.95\00:04:50.55
working up in
the prefrontal cortex
00:04:50.59\00:04:52.82
where you communicate with God.
00:04:52.85\00:04:54.56
So there's real physiology
behind some of these things.
00:04:54.59\00:04:57.46
And it's just fascinating that
00:04:57.49\00:04:58.83
now we have the
technology to prove God's Word
00:04:58.86\00:05:01.56
once again is true.
00:05:01.60\00:05:03.16
That's right.
00:05:03.20\00:05:04.53
Now so when we
talked about change,
00:05:04.57\00:05:08.07
and in medicine,
it's changed so much
00:05:08.10\00:05:10.81
just how we handle
every part of the heart,
00:05:10.84\00:05:12.64
bypass has improved,
00:05:12.67\00:05:14.01
we have all these technologies
for rhythms of the heart,
00:05:14.04\00:05:16.85
but today I want to
focus on some of the changes
00:05:16.88\00:05:19.15
on our heart valves.
00:05:19.18\00:05:21.18
Okay. Okay.
00:05:21.22\00:05:23.02
Describe, I was gonna say
00:05:23.05\00:05:24.39
describe for us,
the heart valves.
00:05:24.42\00:05:25.75
Yeah.
00:05:25.79\00:05:27.12
Some people may have no idea
00:05:27.16\00:05:28.49
what they do,
where they're located,
00:05:28.52\00:05:29.86
kind of give us an overview?
00:05:29.89\00:05:31.23
Well, the heart is a pump
00:05:31.26\00:05:33.06
that pumps to the
cardiovascular system,
00:05:33.09\00:05:35.06
all the blood
vessels throughout the body.
00:05:35.10\00:05:37.50
And within that
pump, we have a left side
00:05:37.53\00:05:39.97
that pumps to the
body and a right side
00:05:40.00\00:05:42.67
that smaller doesn't have to be
00:05:42.70\00:05:44.11
as strong that
pumps to the lungs.
00:05:44.14\00:05:46.07
When the blood gets...
00:05:46.11\00:05:47.44
Usually, when the blood comes,
00:05:47.48\00:05:49.44
gets to the lungs,
it's filled with oxygen.
00:05:49.48\00:05:51.95
It's filled with
oxygen and it comes back
00:05:51.98\00:05:54.32
into the top chamber
00:05:54.35\00:05:55.68
called the left
atrium with blood on it.
00:05:55.72\00:05:57.69
It goes to the left ventricle,
00:05:57.72\00:05:59.32
and then it's pumped
through the entire body,
00:05:59.35\00:06:01.89
it goes through the entire body
00:06:01.92\00:06:03.39
carrying oxygen and nutrients,
00:06:03.43\00:06:05.79
and then it's
distributed to the organs.
00:06:05.83\00:06:08.53
So all the organs
00:06:08.56\00:06:09.90
needed good
cardiovascular system,
00:06:09.93\00:06:12.17
then the organ say,
00:06:12.20\00:06:13.54
"Hey, I've got to
get rid of my wastes."
00:06:13.57\00:06:15.27
And it gets rid of the waste,
00:06:15.30\00:06:16.64
and the vascular
system helps get rid
00:06:16.67\00:06:18.31
of some of the waste of the body
00:06:18.34\00:06:19.71
that comes back to the heart
00:06:19.74\00:06:21.68
with less oxygen
00:06:21.71\00:06:23.04
then it got to
repeat the cycle again.
00:06:23.08\00:06:25.05
So these valves help blood
00:06:25.08\00:06:27.98
go from one
chamber to another chamber
00:06:28.02\00:06:30.09
in the heart.
00:06:30.12\00:06:31.45
Okay.
00:06:31.49\00:06:32.82
And we have four
major heart valves.
00:06:32.85\00:06:34.19
The ones we're gonna focus
on today is the aortic valve.
00:06:34.22\00:06:37.96
That's the valve that leaves
the heart and the mitral valve,
00:06:37.99\00:06:41.86
that's the valve that
separates the left atrium
00:06:41.90\00:06:44.67
from the left ventricle.
00:06:44.70\00:06:46.23
Now sometimes these
valves have problems,
00:06:46.27\00:06:49.80
okay, they don't work as good.
00:06:49.84\00:06:51.74
And different things
can cause those problems.
00:06:51.77\00:06:55.34
Sometimes it
can be an infection,
00:06:55.38\00:06:57.51
gets on the valve, we
call that endocarditis.
00:06:57.55\00:07:00.68
Years ago, they used
to have a condition called
00:07:00.72\00:07:04.09
rheumatic fever
00:07:04.12\00:07:05.45
where you were
exposed to an infection
00:07:05.49\00:07:07.02
and that damaged the heart valve
00:07:07.06\00:07:08.69
cause it to wear.
00:07:08.72\00:07:10.06
Some people,
they're born with valves
00:07:10.09\00:07:12.53
that are congenitally abnormal
00:07:12.56\00:07:15.16
and we can help
those valves out.
00:07:15.20\00:07:17.43
Sometimes the valves
just get old and wear out,
00:07:17.47\00:07:19.73
we call that
degenerative heart disease.
00:07:19.77\00:07:22.70
So there's many different things
00:07:22.74\00:07:24.11
that can cause the valves
to get older to malfunction.
00:07:24.14\00:07:27.64
Sometimes, Nick, the
heart itself gets weak,
00:07:27.68\00:07:31.88
usually from blockages in
the arteries of the heart.
00:07:31.91\00:07:34.52
When a heart gets weak,
00:07:34.55\00:07:36.15
the heart gets enlarged
00:07:36.18\00:07:38.02
so the valves
normally would close
00:07:38.05\00:07:39.79
here are spread apart.
00:07:39.82\00:07:41.92
So the door hinge leaks. Yeah.
00:07:41.96\00:07:44.13
So the valve
leaks blood backwards
00:07:44.16\00:07:45.76
instead of going forward,
00:07:45.79\00:07:47.30
the blood's going
in the wrong direction.
00:07:47.33\00:07:49.36
That's not good.
00:07:49.40\00:07:50.97
Sometimes the valves don't open
00:07:51.00\00:07:53.77
so the blood can't change
from chamber to the other.
00:07:53.80\00:07:57.41
We call that...
00:07:57.44\00:07:58.77
If a valve doesn't open,
we call that stenosis, okay?
00:07:58.81\00:08:03.14
If it leaks, we
call that regurgitation.
00:08:03.18\00:08:07.02
So for each
valve, sometimes it has,
00:08:07.05\00:08:09.18
a valve can be stenotic
or it can be regurgitant.
00:08:09.22\00:08:13.52
So once we determine that,
00:08:13.56\00:08:15.02
and there's a test that we do,
00:08:15.06\00:08:16.52
the most common one is
called an echocardiogram,
00:08:16.56\00:08:19.59
where we look at the arteries,
00:08:19.63\00:08:20.96
we can see it with sound wave,
00:08:21.00\00:08:22.63
we can actually see how
the valves open and close
00:08:22.66\00:08:25.27
and open and close.
00:08:25.30\00:08:26.63
We can see how much
bloods going backwards.
00:08:26.67\00:08:28.57
And sometimes we can find out
00:08:28.60\00:08:30.01
what what's
causing it to malfunction.
00:08:30.04\00:08:32.11
Right.
00:08:32.14\00:08:33.48
If it's an infection, we
want to treat the infection.
00:08:33.51\00:08:36.48
If the valves worn out,
00:08:36.51\00:08:37.85
sometimes we have
to replace the valve.
00:08:37.88\00:08:40.85
So how would I know, you
know, a valve is a problem?
00:08:40.88\00:08:44.42
Yeah, what kind of symptom?
00:08:44.45\00:08:45.79
Would you feel something? Yeah.
00:08:45.82\00:08:47.16
Well usually, the first symptom
00:08:47.19\00:08:48.52
the person has is
either shortness of breath
00:08:48.56\00:08:50.43
when they do things because the,
00:08:50.46\00:08:52.06
you know, shortness of breath
00:08:52.09\00:08:53.43
because either the back pressure
00:08:53.46\00:08:54.80
of a leaky valve,
00:08:54.83\00:08:56.20
or sometimes the
blood doesn't lead the heart
00:08:56.23\00:08:59.20
from a stenotic valve,
and they can have symptoms.
00:08:59.23\00:09:02.30
It can be shortness of
breath, dizzy passing out.
00:09:02.34\00:09:05.47
Sometimes it can be pain,
00:09:05.51\00:09:07.21
sometimes it
can be palpitations.
00:09:07.24\00:09:09.14
So when a person has a symptom,
00:09:09.18\00:09:11.15
they would go to their
doctor and their doctor,
00:09:11.18\00:09:14.58
"That might be a
symptom of the heart."
00:09:14.62\00:09:16.48
It sounds like
there's a lot of symptoms
00:09:16.52\00:09:18.39
that are heart related
that could all be the same.
00:09:18.42\00:09:19.79
That's correct.
00:09:19.82\00:09:21.16
Shortness of breath,
00:09:21.19\00:09:22.52
doesn't mean
it's a valve problem.
00:09:22.56\00:09:23.89
But something with
the heart it's like...
00:09:23.93\00:09:25.26
But it could be a heart,
00:09:25.29\00:09:26.63
shortness of breath
could be a heart problem.
00:09:26.66\00:09:28.00
It could be a lung problem.
It could be anemia problem.
00:09:28.03\00:09:31.03
So lots of things
can cause the symptom.
00:09:31.07\00:09:33.23
We know the symptom
is something not right.
00:09:33.27\00:09:35.60
So you go to your doctor,
00:09:35.64\00:09:36.97
he might ask you some questions,
00:09:37.01\00:09:38.34
and they probably
have to do some testing
00:09:38.37\00:09:40.98
to see what was wrong.
00:09:41.01\00:09:42.54
So I had a patient come to
me that was about 82 years old,
00:09:42.58\00:09:46.51
and she was shortness of breath.
00:09:46.55\00:09:48.45
And she says,
00:09:48.48\00:09:49.82
"I normally didn't do this way."
00:09:49.85\00:09:51.19
So I did some testing on her.
00:09:51.22\00:09:52.89
She wasn't anemic.
I didn't think she...
00:09:52.92\00:09:55.32
I listened to her heart.
00:09:55.36\00:09:56.69
And guess what
I heard, a murmur.
00:09:56.73\00:09:58.59
Yeah. And it sound like this.
00:09:58.63\00:10:03.23
Normally, you
listen to the heart
00:10:03.26\00:10:04.93
and you can hear the
valves opening and closing,
00:10:04.97\00:10:06.84
you're not
supposed to hear that sound.
00:10:06.87\00:10:09.84
Well, that was a sound
00:10:09.87\00:10:11.21
that's
characteristic of the blood
00:10:11.24\00:10:12.57
not leaving the heart very well.
00:10:12.61\00:10:13.94
Okay.
00:10:13.98\00:10:15.31
That was a
characteristic of a valve
00:10:15.34\00:10:16.68
abnormality that people
get called aortic stenosis.
00:10:16.71\00:10:20.42
Well, I talked to her
00:10:20.45\00:10:21.78
she'd never been
exposed to an infection.
00:10:21.82\00:10:24.25
She never had problems
with other things in life.
00:10:24.29\00:10:27.49
Her genetic history
was really negative.
00:10:27.52\00:10:30.13
But, you know,
things wear out, okay?
00:10:30.16\00:10:32.89
So we did the next test, I
figured something was wrong.
00:10:32.93\00:10:35.66
The shortness of breath could be
00:10:35.70\00:10:37.03
coming from the valve.
00:10:37.07\00:10:38.40
So I ordered the echocardiogram,
00:10:38.43\00:10:40.04
and sure enough, Nick,
00:10:40.07\00:10:41.40
the valve wasn't
opening and closing very well.
00:10:41.44\00:10:44.34
We call that
aortic stenosis. Okay.
00:10:44.37\00:10:47.44
So the valve wasn't opening
and she was short of breath
00:10:47.48\00:10:50.11
because the
pressure was backing up.
00:10:50.15\00:10:51.71
She was short of breath.
00:10:51.75\00:10:53.08
She couldn't do very much
00:10:53.11\00:10:54.45
'cause the blood
wasn't flowing out
00:10:54.48\00:10:55.82
of the heart good.
00:10:55.85\00:10:57.19
It was backing up the pressure.
00:10:57.22\00:10:58.55
She was getting shorter breath.
00:10:58.59\00:10:59.92
Right. So she
said, "Well, you know."
00:10:59.95\00:11:01.46
I said, "This is
something that causes
00:11:01.49\00:11:03.12
and probably just
because of aging."
00:11:03.16\00:11:05.66
We call that, you
know, the valve is oxidizing,
00:11:05.69\00:11:08.30
it's getting
old, it's calcified,
00:11:08.33\00:11:10.50
it doesn't open good.
00:11:10.53\00:11:11.90
And we measured that by
how much pressure it took
00:11:11.93\00:11:14.34
to open the valve,
00:11:14.37\00:11:15.80
low would be 10,
high would be 50.
00:11:15.84\00:11:18.24
Hers was 60.
00:11:18.27\00:11:19.61
So a lot of
pressure to open that valve.
00:11:19.64\00:11:21.21
Right.
00:11:21.24\00:11:22.58
And we talked about
all the different options,
00:11:22.61\00:11:24.41
including open-heart surgery.
00:11:24.45\00:11:26.25
But on this lady,
we had a new procedure
00:11:26.28\00:11:29.22
that's only been
around a few years
00:11:29.25\00:11:30.89
now called trans
aortic valvular replacement.
00:11:30.92\00:11:35.22
And this is one way
that we can help people
00:11:35.26\00:11:37.93
with aortic stenosis.
00:11:37.96\00:11:39.93
All right, well,
we've got a clip here
00:11:39.96\00:11:41.30
that I'd like you to
talk us through that shows
00:11:41.33\00:11:43.70
the actual procedure.
00:11:43.73\00:11:45.07
Let's see.
00:11:45.10\00:11:46.43
So there's much that can be done
00:11:46.47\00:11:47.80
to help the valves.
00:11:47.84\00:11:49.17
And this is one
that we don't have
00:11:49.20\00:11:50.54
to cut a person open.
00:11:50.57\00:11:51.91
And what we do is the
valve doesn't open very good.
00:11:51.94\00:11:53.27
First, we squished
some of the calcium
00:11:53.31\00:11:55.34
with the balloon so we
open up and then we can
00:11:55.38\00:11:57.98
actually go in there
and put a new valve in
00:11:58.01\00:12:01.15
through the blood vessels.
00:12:01.18\00:12:02.65
And this is a
certain type of valve
00:12:02.68\00:12:04.65
called a trans aortic
valve and we expand it.
00:12:04.69\00:12:07.36
So we squish the calcium.
00:12:07.39\00:12:09.19
And now we're left
with an open valve.
00:12:09.22\00:12:11.59
Now this is the
alternative of that
00:12:11.63\00:12:13.13
and that would be
open-heart surgery.
00:12:13.16\00:12:15.10
We can also
depending on the patient,
00:12:15.13\00:12:16.97
we can put a new heart valve in.
00:12:17.00\00:12:19.07
So when valves
wear out from old age,
00:12:19.10\00:12:21.37
and the aortic valve
00:12:21.40\00:12:22.74
is probably the most common one,
00:12:22.77\00:12:24.31
we can replace that valve,
00:12:24.34\00:12:25.97
either trans
aortic valve replacement,
00:12:26.01\00:12:28.28
or we can do an
open-heart surgery.
00:12:28.31\00:12:30.85
This is a place
where modern medicine
00:12:30.88\00:12:32.71
is very helpful.
00:12:32.75\00:12:34.08
If we're having a symptom,
00:12:34.12\00:12:35.68
if something parts wearing
out, we can replace that part.
00:12:35.72\00:12:39.45
Before we had this person
might die a few years younger
00:12:39.49\00:12:42.49
because the part wear out.
00:12:42.52\00:12:43.99
So my patient got a
trans aortic valve replacement.
00:12:44.03\00:12:47.20
She's not a short of breath.
00:12:47.23\00:12:48.73
We talked to her about
the risk of having it done
00:12:48.76\00:12:51.23
and the benefits of it
00:12:51.27\00:12:53.47
and she decided to
move forward with it.
00:12:53.50\00:12:55.37
Not everyone decides
that's the way they want to do,
00:12:55.40\00:12:57.71
but at 82 she has a new value.
00:12:57.74\00:13:00.28
That's working well,
she's less short of breaths
00:13:00.31\00:13:02.51
so she can play
with her grandchildren
00:13:02.54\00:13:04.48
do a lot more,
she's much more active.
00:13:04.51\00:13:07.22
So a synthetic valve,
is that a synthetic valve?
00:13:07.25\00:13:09.48
Well, this would be
considered a synthetic valve
00:13:09.52\00:13:12.65
because it's
extra cardiac tissue
00:13:12.69\00:13:14.56
that's put in the body.
00:13:14.59\00:13:16.42
It's not from a cadaver.
00:13:16.46\00:13:17.86
It's not
necessarily yes, we put it in.
00:13:17.89\00:13:20.36
And how long could you
expect one of those to last?
00:13:20.40\00:13:22.56
It depends on whether
the body wears out, okay?
00:13:22.60\00:13:26.67
Now younger
people, we would probably
00:13:26.70\00:13:28.44
put in a longer lasting
valve on the metal valve,
00:13:28.47\00:13:31.94
but now we have
newer valves that come in
00:13:31.97\00:13:34.28
that actually even
have coating on the valves
00:13:34.31\00:13:37.18
that are bioprosthetic valve
00:13:37.21\00:13:39.41
that keep it
from aging as quick.
00:13:39.45\00:13:41.52
So now we have valves
that are bioprosthetic
00:13:41.55\00:13:43.85
that lasts longer and longer.
00:13:43.89\00:13:45.25
Now these valves are never
00:13:45.29\00:13:46.62
as good as the
valves God gave us.
00:13:46.65\00:13:48.72
Right. But they are...
00:13:48.76\00:13:50.09
They do help us to slow
down this aging process.
00:13:50.13\00:13:53.66
And I've had
patients now that their valves
00:13:53.70\00:13:56.00
are now five and six years old.
00:13:56.03\00:13:57.40
Remember, they
haven't been around that long.
00:13:57.43\00:13:59.83
So we don't have
a longevity track.
00:13:59.87\00:14:01.80
But we know when the
aortic stenosis reaches
00:14:01.84\00:14:04.27
a certain place that if
we don't do something soon,
00:14:04.31\00:14:07.64
the patient's gonna
gradually get older.
00:14:07.68\00:14:09.24
All right.
00:14:09.28\00:14:10.61
Well, we've got to
stop there for just a moment
00:14:10.65\00:14:11.98
and take a break.
00:14:12.01\00:14:13.35
There's more to
come with heart valves
00:14:13.38\00:14:14.72
on the Ultimate
Prescription in just a moment.
00:14:14.75\00:14:16.25