Below are patient testimonials from AF patients treated by Washington University Physicians at Barnes-Jewish Hospital.
It gave me a new life…Susan Meyer
Susan Meyer gets her life back
Susan Meyer enjoys her classroom work once again. She raised three children and worked as a first-grade teacher, so she thought it was normal to always be so tired. But her fatigue was due to worsening atrial fibrillation compounded by mitral valve stenosis. Diagnosed in May 2005, she underwent what she calls her “replacement, repair and remodel” heart operation.
She had a mitral valve replacement, a tricuspid valve repair and the Cox-Maze procedure to cure her atrial fibrillation. “Now I feel wonderful,” she says. “It gave me a new life.” On a recent vacation to the mountains, she outhiked her husband. “I’m lucky to have had such capable, caring people to fix me,” she says of her Washington University physicians at Barnes-Jewish Hospital.
Jeff Strickland looks forward to life without symptoms of atrial fibrillation
Jeff Strickland is a former U.S. Marine devoted to running and exercise. In 1990, he was diagnosed with atrial fibrillation (AF). Over time, his AF worsened until it became difficult to run and even life’s daily routines frequently left him exhausted.
Strickland turned to the Washington University Center for Atrial Fibrillation after many years of medical treatment and undergoing catheter ablations for atrial flutter and pulmonary vein isolation (PVI) ablations. Eight months after his Cox-Maze procedure, he was free from AF. He also had run three miles on one occasion and planned to start swimming as part of his exercise program.
Marian Gregor resumes horsemanship after Cox-Maze IV procedure
A busy Realtor in Ann Arbor, Mich., Marian Gregor was very concerned about her irregular heartbeat and had expressed her concerns to her doctor, but had not received any treatment. One Sunday morning, her apprehension proved to be justified. As she was taking two of her large horses out of their stable, she had a stroke.
After undergoing four catheter ablations to destroy the heart tissue causing the AF, which did not help significantly, she was resigned to a compromised lifestyle. Then a real estate client told her about the Cox-Maze procedure, and an Internet search led her to cardiac surgeon Ralph Damiano Jr., MD. After having the surgery, she has resumed a busy lifestyle including horseback riding and gardening.
Keeping up with work and family had become difficult for Susan Meyer, a first-grade teacher who was looking forward to her son’s upcoming wedding.
Meyer, 55, had lived with mitral valve stenosis for 15 years and was accustomed to not feeling 100 percent. But, as the wedding date approached, her symptoms worsened. “I was tired all the time,” she says. “My heartbeat had always been very irregular, but it was wearing me out more than usual.”
Meyer finally sought treatment in the emergency room when her symptoms became even more severe. Diagnotic tests determined she had atrial fibrillation (AF) — the most common type of irregular heart rhythm — and she was referred to Ralph Damiano Jr., MD, chief of Cardiothoracic Surgery at Washington University School of Medicine and Barnes-Jewish Hospital (BJH).
Damiano performed a successful surgery, giving Susan a new mechanical mitral valve, repairing another valve and performing a Cox-Maze procedure to correct the AF. All the procedures were done at once through a minimally invasive incision under the breast and, thus, Meyer avoided the dramatic scarring and longer recovery of a cracked-sternum procedure.
Meyer also benefited from the long-term experience of Washington University cardiac surgeons in treating AF. James Cox, MD, pioneered the Cox-Maze procedure — considered the gold standard of surgical AF treatment — at BJH in 1987. Since then, BJH has seen patients from around the globe with AF, and its published success rates are the best worldwide.
The Cox-Maze procedure, when it was first developed, was a series of incisions that were placed around the left and right atrium to prevent the fibrillation from being able to sustain itself, explains Damiano. The operation is designed to block the conduction pathways needed to maintain AF.
In recent years, Damiano and his colleagues have modified the technically challenging “cut and sew” procedure using radiofrequency energy to heat heart tissue. Instead of making incisions, the surgical team creates lines of ablation, or scar tissue, on the heart muscle. The ablation lines redirect the abnormal electrical currents responsible for AF.
The new technique makes the procedure easier to perform, reduces OR time and improves patients’ recovery. “Our success rates in almost 200 patients are equal to those of the ‘cut and sew’ procedure,” says Damiano.
Since undergoing the modified Cox-Maze procedure and heart valve surgery, Meyer once again has energy for family and work. “I feel I have my life back,” she says.
Running is a very important part of Jeff Strickland’s life. But, for 17 years, his training and participation in the sport often were interrupted by a serious medical condition.
Strickland is a veteran of the U.S. Marine Corps (USMC) and a substance abuse counselor at the Federal Bureau of Prisons in Jesup, GA. In 1990, he was diagnosed with atrial fibrillation (AF), the most common form of irregular heart rhythm. Over time, his AF worsened until it became difficult to run and life’s daily routines frequently left him exhausted.
Like many with AF, Strickland went through many years of medical treatment before turning to surgery to cure the heart arrhythmia.
“The way I discovered it was through running,” says Strickland. “Back then, I normally ran six to eight miles, but there were some days I couldn’t run a mile. I said, ‘What in the world is going on?’”
For a long time, medications worked well enough to keep Strickland’s AF mostly in check. Then, several years ago, his symptoms worsened. He sought out a cardiologist at St. Vincent’s Medical Center in Jacksonville, FL, who performed two catheter ablations for atrial flutter.
“After the ablations, I continued to take medications,” says Strickland. “I was able to muddle through it, but I was never completely cured. I’d have episodes and couldn’t stand it anymore, so I’d go back to the doctor and we’d try another medication.”
Meanwhile, Strickland continued his longtime devotion to running and exercise, even competing in a mini-triathlon. “I never was really stopped in my tracks,” he says. “Some days were good and some days were bad. I just ‘kept on keepin’ on.’”
When it became evident different treatment was needed, Strickland’s cardiologist referred him to a cardiologist in Atlanta, who performed several pulmonary vein isolation (PVI) ablations. This treatment eliminated AF for several months, but the symptoms returned after Strickland was injured in a motorcycle accident.
Strickland’s Atlanta doctor had already talked to him about undergoing a Cox-Maze procedure and, at this point, referred him to Washington University Chief of Cardiothoracic Surgery Ralph Damiano Jr., MD.
The Cox-Maze procedure — pioneered by James Cox, MD, at Barnes-Jewish Hospital (BJH) in 1987 — is considered the gold standard of surgical AF treatment. Since the introduction of the procedure, Washington University cardiac surgeons at BJH have treated patients from around the globe with AF; their published success rates are the best worldwide.
In recent years, Damiano and his team have modified the technically challenging “cut and sew” procedure. Instead of making incisions, the surgical team uses radiofrequency energy to create lines of ablation, or scar tissue, on the heart muscle. The ablation lines redirect the abnormal electrical currents responsible for AF.
The new procedure — called the Cox-Maze IV procedure — is easier to perform, reduces OR time and improves patients’ recovery. Its success rates in almost 200 patients are equal to those of the ‘cut and sew’ procedure.
It took about two months to transfer and review Strickland’s medical records and set up the surgery. On May 17, 2007, Strickland underwent a successful Cox-Maze IV procedure. Shorty afterwards, he began walking in the hospital and continued to re-build his strength and endurance when he returned home.
Eight months after the operation, Strickland was free from AF and looked forward to a life without heart rate elevations, cardioversion (a procedure in which electrical shock is delivered to bring the heart into regular rhythm) and counting his heart beat. He also had run three miles on one occasion and planned to start swimming as part of his exercise program.
Although he knows medical therapy is used as initial treatment for the disease, he wishes the surgery had been available many years ago. “Dr. Damiano and his group are the greatest team of professionals I’ve observed working since leaving the USMC,” says Strickland. “Coming from a former marine, that’s a great compliment.”
A busy Realtor in Ann Arbor, Mich., Marian Gregor was very concerned about her irregular heartbeat and had expressed her concerns to her doctor, but had not received any treatment. One Sunday morning, her apprehension proved to be justified. As she was taking two of her large horses out of their stable, she became extremely light-headed. She was rushed to the emergency room, where physicians determined she had had a stroke.
Gregor, then 50 years old, recovered from the stroke and tried to get back her life, which had included horsemanship and gardening as well as her career. She started taking medication for her arrhythmia – diagnosed as atrial fibrillation (AF), the most common type of irregular heart rhythm – and had four catheter ablations to destroy the heart tissue causing the AF. But none of the treatments was effective.
“I was resigned to having a compromised lifestyle,” she says. “I couldn’t go up a flight of stairs without being exhausted, and it was really, really hard to ride my horses or deal with the animals. I was like an inactive 80-year-old person.”
Then, one Friday evening, Gregor spoke to a real estate client in St. Louis, a 50-year-old dentist, who also had AF. He and his wife had adopted two young children, and because of his AF, he was having difficulty keeping up with them. He told her he was about to undergo the Cox-Maze procedure, considered the gold standard for atrial fibrillation surgery, in which a surgical team uses radiofrequency energy to heat and create scarring on the heart muscle, which redirects the abnormal electrical currents responsible for AF.
A month later, Gregor called her client, and he was doing very well. At that point, Gregor began an intensive Internet search to find out more about the procedure and who performed it. Her search led her to Ralph Damiano Jr., MD, chief of Cardiothoracic Surgery at Washington University School of Medicine and Barnes-Jewish Hospital (BJH), who had also performed the surgery on her client. The original Cox-Maze procedure, which used surgical incisions to create scar tissue, was pioneered at Washington University and BJH by James Cox, MD. Damiano had modified the surgery with the use of radiofrequency energy and introduced a minimally invasive approach – through a small, right-sided chest incision rather cutting down the center of the breast bone.
Gregor’s insurance company initially declined her request to have the minimally invasive procedure and would only approve the traditional surgery performed by a Michigan surgeon. But the more invasive surgery was unacceptable to Gregor, and she and her husband, Matthew Kerwin, went to work to make their case to the insurance review board.
“Matthew and I were a tag team,” Gregor says. “We pointed out that research supported the radiofrequency procedure and that Dr. Damiano had been doing it for about five years. They were very interested in this.”
In December 2006, the insurance company reversed its decision, and a month later, Gregor, at the age of 53, had the procedure at BJH.
“It was rough for Marian immediately after the operation because of her basic fear of hospitals and needles,” Kerwin says. “But the procedure went well, and the staff was great. They put a cot in her room so that I could stay overnight with her.”
Gregor’s goal was to ride her Dutch Warmblood horse, Jackpot, in a four-day riding clinic in northern Michigan three months after the surgery. She achieved her goal and then some – Jackpot was a “trouper” and Gregor has maintained good health and energy since having the surgery. She is still working as a Realtor and rides Jackpot at dressage events, where horses show off their athletic ability and willingness to perform. She also resumed gardening and has an abundant flower garden to show for it.
“When I saw my heart surgeon in Michigan, he was absolutely thrilled with my progress,” Gregor says. “Things are good. I am here. I am really healthy, and it’s fabulous.”