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OHSU Performs Unique Heart Valve Replacement

   Portland, Ore.

First time its been performed on West Coast and one of only about 10 performed in the United States

Twenty-two-year-old Emily Johnson can't wait to get home to Alaska to be with her husband and 21-month-old son because she finally has the energy to play with them. "I have never felt this good in my whole life," said Emily.

For the last year her failing heart required her to take three naps a day and sleep 10 hours a night leaving little time or energy to play with her son, Jeremiah. She didn't even have the strength to walk to the bathroom. Emily's body wasn't getting the oxygen it needed because the valve between the left chambers of her heart, called the mitral valve, leaked due to a birth defect.

On June 16, 2003, OHSU Hospital cardiac surgeon Ross Ungerlieder, M.D., and his surgical team performed a surgery on Emily called a Ross mitral valve replacement. This is thought to be the first time this procedure has been performed on the West Coast and one of only about 10 performed in the United States. Ungerlieder removed Emily's leaking mitral valve and replaced it with one of the big valves attached to the top of her heart, called a pulmonary valve. Then he placed a cadaver valve in the pulmonary position. Within a week she was able to go home to her mom's in Portland.

Mitral valves usually are replaced with mechanical valves that are so loud patients can hear them open and close. These valves also require patients to take blood thinners for the rest of their lives, which can restrict physical activity due to the risk of uncontrollable bleeding from injuries and may cause birth defects when taken during pregnancy. The other option is using a pig heart valve, which can require additional surgery five to eight years later, when it begins to deteriorate. Neither option was a good match for the life Emily wanted to live.

"This new procedure opens up a lot of opportunities for young people who need mitral valve replacements," said Ungerleider, chief of pediatric cardiac surgery at Doernbecher Children's Hospital. "Emily should be able to gain the active life she wants to have."

It was Ungerlieder's extensive track record with a more commonly performed surgery, called a Ross procedure, that gave him the experience to perform this unique mitral valve replacement. In the Ross procedure, the aortic valve is replaced with the patient's own pulmonary valve while a cadaver valve replaces the pulmonary valve. Patients who receive the Ross procedure usually go home within days. He has performed close to 150 during his career, more than any other surgeon in the Pacific Northwest, with a zero death rate related to the surgery -- one of the best success rates in the country.

The Ross mitral valve replacement not only provides a better quality of life for patients, but is also more cost effective because the surgery utilizes the patient's own tissue. Ungerlieder estimates that about six to 12 OHSU patients a year will benefit from this new procedure.

Emily said she's proud to be the first on the West Coast to get this new surgery. Her mom is excited that her daughter got the opportunity, but says now she can't keep up with her daughter because she has too much energy. Emily will fly home to Alaska on Tuesday, July 22.


FULL TITLE: Ross Ungerleider, M.D., pediatric cardiac surgeon; professor of surgery in the OHSU School of Medicine; interim chief of the Division of Cardiothoracic Surgery at OHSU Hospital; and chief of pediatric cardiac surgery at Doernbecher Children's Hospital.


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