My Heart Story

As I reflect upon my life, I feel the continuing need to share “My Heart Story” for those who may benefit from the Ross procedure, as I did.  In 2006, I was diagnosed with a heart murmur, not rarely found in routine physical examinations.  However, in 52 years, noone had ever diagnosed this problem for me.  I proceeded with a number of typical heart tests  (EKGs, ECHOS, etc.) and was found to have a possible bicuspid aortic valve (which I would have been born with), and an “almost closed”  Aortic valve.  At the time I was diagnosed, I was one of those people who was walking four miles per day and could have died instantly, with noone knowing why an active, hard-working 52-year-old left this world.  Following several heart tests, I was told by a local Cardiologist that I could receive a mechanical valve locally and go “from bad to less bad”.  That was NOT GOOD ENOUGH for me!  So, my husband Bill and I embarked upon a long journey of research regarding Aortic Valve Stenosis and its treatment.  What we discovered on our journey was a rare, but successful surgery, known as the Ross procedure, which we posed to our local Cardiologist during our next visit.   At that time, the Cardiologist informed me “My Dear, you don’t need a Ross procedure”.  My husband was very affirming that I was not a “My Dear” and that further research was warranted.  When the Doctor dismissed me, his patient, as a “My Dear”, we knew we were on our own.

In our research across the internet, we discovered a very accomplished surgeon, Dr. John Oswalt, from Austin, Texas, who was very knowledgeable and experienced in performing successful Ross procedures.  We also discovered that Dr. Oswalt occasionally officed and worked in San Angelo, to help people in a region served by his father in the past.  We learned that he was one of a very few surgeons internationally, who was very accomplished in the Ross procedure for Aortic valve replacement.  We met Dr. Oswalt in San Angelo and after reviewing my echo, etc., he recommended the Ross procedure for me.  Dr. Oswalt performed my open heart surgery on July 5, 2006 at Seton Hospital in Austin, Texas. 

” 1967, Dr. Donald Ross, an accomplished surgeon in England, was the first surgeon to perform an effective aortic valve replacement as an alternative to the traditional mechanical valve being used. Ten years ago, John “Chip” Oswalt, M.D., an accomplished surgeon in Austin, Texas, became the first in the state to perform this same aortic valve replacement procedure. Dr. Oswalt says, “It’s an ideal operation because it doesn’t place anything inside that obstructs flow. It’s very physiologic in that manner.”

Known as the “Ross Procedure,” this complex operation takes about three hours to perform as opposed to the two hours needed for a mechanical valve replacement. The surgeon takes the pulmonary artery artery and valve and moves them over into the aortic position for the valve replacement. A human cadaveric pulmonary valve is put in place of the patient’s pulmonary valve.

The Ross Procedure is used primarily for neonates, infants, young people who are very active and don’t want to be on medication (blood thinners) for the rest of their lives, young women in their child-bearing years (this procedure allows them to have children), and middle-aged people who are active. Patient qualifications include how long the valve will need to last (older patients could have a mechanical or pig valve) and possible use of blood thinners. It is used in young children because the living valve will grow with the child. No other valve replacement option can do this. It offers a lot of versatility because it is flexible living tissue. In theory, this procedure should last a lifetime.

Dr. Oswalt, president of Cardiothoracic and Vascular Surgeons and a partner in Heart Hospital of Austin, is the lead surgeon on this procedure and is well respected for his work. He has performed an estimated 150 procedures in Central Texas and across the United States. Cardiothoracic and Vascular Surgeons are among the top four in the nation for highest volume of the Ross Procedure. Dr. Oswalt often treats patients who live outside Texas. Dr. Oswalt added, “I get a lot of patients who decide to come here and have the surgery from around the United States because of reading about the Ross Procedure on our website.”

Because he is such a leader in the Ross Procedure, Dr. Oswalt is often invited to different hospitals across America to help surgeons perform their first Ross. He trains and participates in Teaching Symposiums as well. Dr. Oswalt comments, “I not only enjoy the opportunity to teach someone, but I really enjoy seeing other hospitals, their operating rooms, how they do things, and being around other surgeons. In addition to teaching, it allows me to learn a lot.” The symposiums often involve a live teleconference in which 100-150 surgeons view Dr. Oswalt on a monitor as he performs the Ross Procedure. They can interact verbally with Dr. Oswalt as he is operating which allows for very direct surgical teaching.

This procedure took about twenty years to catch on in the United States because American physicians wanted to see Dr. Ross’ data to verify that it was an effective valve replacement procedure. Twenty years ago, American physicians had developed a replacement procedure using pig valves, which took 15-20 years to follow-up. They realized it was failing after 10-15 years and an alternative was necessary.

The Ross Procedure carries a higher risk for patients than mechanical valve replacement because it is a double valve replacement rather than a single valve replacement procedure. The patient can expect to stay 3-4 days in the hospital. The healing process involves the bones healing rather than the heart.”  The quoted segment is from surgeon

John Oswalt’s website:  www.john-oswalt-ross-procedure-cardiac-surgeon-heart.php

Dr. Oswalt emphasized to me that he could not believe more surgeons did not recommend this procedure, because it allows young, active females to have children, as opposed to other procedures that prevent them from being able to have children in the future.  For me, an active, middle-aged female, it has made it possible for me to maintain an active life without being on Coumadin for the rest of my life.  I am so thankful for our persistance in finding Dr. O. and his knowledge and talent. 

Dr. Oswalt has also been invited internationally to present trainings on stitching procedures for heart surgery.  Once Dr. O. entered my heart, he realized I had a misplaced superior vena cava and that I was born with a hole in my heart. He told us that there was a possibility my aortic valve was not bicuspid, but that one of my three leaflets had filled in the apparent  hole in my heart, leaving the appearance of a bicuspid valve and preventing  more obvious symptoms of my problems throughout my life.  I needed his “expert stitchery” and God’s blessing to have the strong heart I have today.  He is an extremely, talented surgeon and his charm and expertise will convince you of his art.  He saved my life ; the result made it better, and I will always be  indebted to him.