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Grateful Heart FTR

Healed Heart: The Innovative Surgery That Kept This Michigan Man Doing What He Loves

When you’re athletic and in your early 20s, you don’t think about being in a hospital with your chest cut open for heart surgery. But that’s where Andy Smith ended up at age 23.

In October 2005, while living in Columbus, Ohio, severe lower back pain led Smith to visit his primary care doctor. What the doctor originally thought was sciatica, which is pain along a large nerve from the lower back down the leg, ended up being a failed heart valve. Never having heart issues before, Smith learned he was born with a bicuspid valve. The heart's aorta is the main artery that pumps oxygen-rich blood to the body. The aortic valve has small flaps on it that keep blood flowing properly. Bicuspid means the valve has two, rather than three, flaps. People with this condition are prone to infections. Smith was soon sent to Cleveland Clinic for surgery, and his aortic valve was replaced. Doctors also shared that the new valve would last about 10 years.

“I remember everything after the surgery, including the immense amount of pain I felt. I was asking for more drugs to numb the pain, and they said I was already at my limit,” he says. Despite the rough recovery, Smith was playing soccer with his friends one month later. Smith, a substitute teacher, coaches two high school varsity soccer teams and lives with his wife, Amy, in Traverse City, Michigan. He plays in recreational leagues two or three times a week. “I’ve always been active in all types of sports depending on the season,” says Smith. “I’ve been playing soccer since I was 4 years old.”

As expected, Smith’s replacement valve began to wear out about seven years later. “I remember walking up stairs and getting winded. That was my first sign that I needed to check on the valve.” His treatment option was another surgery, a metal valve, weeks of recuperation and a lifetime of blood thinners – and the end of soccer. The slightest injury could lead to severe bleeding or stroke due to the blood thinners required. But a life without soccer wasn’t a life Smith wanted to consider.

Smith was determined to do whatever he had to do to avoid open-heart surgery again. In the fall of 2012 he started researching alternative procedures for valve replacement. His hometown cardiologist referred him to the work of renowned interventional cardiologist William O’Neill, M.D., at Henry Ford Hospital in Detroit. Dr. O’Neill, medical director of Henry Ford’s Center for Structural Heart Disease, performed the world’s first transcatheter aortic valve replacement procedure at Henry Ford in 2013.

The procedure is minimally invasive and replaces the aortic valve without removing the diseased valve. The “valve-in-valve” technique uses cardiac catheterization. A catheter (small tube) is guided through blood vessels in the upper leg to the heart’s failing valve. Once the catheter is positioned in the heart, a balloon on the end of the catheter is opened, expanding a new valve.Smith received a new heart valve at age 32 with this procedure in September 2015 and returned home 24 hours later. “I feel much better than I did before the procedure, and now I’m free to do what I want and live the way I want.” Smith is one of the youngest people in the U.S. to undergo this procedure to replace a valve for a second time.

“The procedure started around 11 a.m. I woke up around 1 p.m. feeling a little groggy from the anesthesia. I was not in much pain, just a little discomfort where they administered the puncture in my leg,” he says. “Once I was in my own room, I remember how great it was to be able to use the bathroom and move around. I was walking down the hallway by 7 p.m. When I had open-heart surgery, I did not want to get out of bed for three days because of how much pain I felt.”

Now Smith takes baby aspirin to help prevent clotting, stroke and heart attack. “I live a normal, healthy life. I play soccer at least once a week. I teach, coach, work construction, travel, go out with friends and try to stay busy. In the summer, I swim, play baseball, softball, beach volleyball, or any other sport that's out there. Soon, I’ll have two newborns keeping me more active!” (Smith and his wife, Amy, are expecting twins this fall.) “I’m more aware of my heart valve than most people, but I rarely feel stressed out by it and I haven’t had any issues,” he says.

Smith says everyone involved with the TAVR procedure at Henry Ford had an impact on his life. “The doctors and nurses who talked to me or comforted my family made the experience wonderful. Dr. O'Neill and his entire crew were exceptional. They treated us like we were old friends.”

A few months after the procedure, Smith attended a Henry Ford Heart and Vascular Institute fundraiser. “Dr. O'Neill and his wife took Amy and me out to lunch a couple of days later. I think that shows just how special of a doctor he is. I got to sit down with one of the busiest and most talented heart surgeons in the field and talk about Detroit, Henry Ford Hospital, and sports. I am forever grateful,” says Smith.

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