This summer, Marianne Wilder, a 25-year-oldÊfourth-grade teacher
and 50-mile-per-week runner, visited her doctor for a routine
physical. Doctors heard a faint heart murmur and diagnosed an
atrial defect; she had a hole in her heart. She got her diagnosis
just as she was preparing for another 10K race, and she had never
before had a serious health problem.
She was told that she would need open heart surgery to repair
the defect. The prospect of breaking open her breastbone, recovery
that would take many months, and life with a 10-inch scar in
the middle of her chest was devastating.
Marianne learned about a new approach for heart surgery that
had been used on only a limited number of patients. She chose
that procedure and five days later she was walking and driving
her car. She had her first run one month after surgery and was
up to six miles a day a couple of weeks after that, on her way
back to her pre-diagnosis mileage.
When a runner, cyclist or other endurance athlete needs open
heart surgery, it typically means that training must stop for
many weeks or months. It is often several more months or even
years before athletes feel back to normal. Now a new approach
to heart surgery is helping some athletes to get back to training
within only weeks of surgery.
Using this new technique, specially trained surgeons operate
on the heart through a small hole or “port” in the
torso, without having to break through or even move any bones.
The procedure is known as "Port Access" and enables
doctorsÊto reach the heart using surgical instruments that can
be inserted between the ribs. The incision can be smaller because
the larger clamps and tubes necessary for surgery can now reach
the heart through veins in the neck or groin.ÊDr. Douglas Murphy
of St. Joseph's Hospital in Atlanta pioneered one new instrument,
a “steerable” catheter, travels to the heart from a
vein in the neck within minutes, reducing the time necessary
to prepare a patient for surgery by up to an hour. Doctors use
tiny cameras to guide the surgical instruments and monitor progress.
Because this new technique is less invasive and does not affect
bone, recovery can take a matter of days rather than weeks or
months. (Heart muscle repairs quickly after surgery; the trauma
to bone is what typically causes the lengthy and painful recovery
associated with cardiac surgery.) Scarring is often minimal.
Patients typically spend less time under anesthesia. Physical
trauma is often dramatically reduced, as is emotional distress
during recuperation. For runners and any other athletes, they
can return to training weeks or even months earlier than patients
treated with traditional open-chest surgery. Yet many athletes
who face this type of surgery do not know about this new option.
Another advantage is that surgeons operate on the heart from
the right side of the chest. From this position they can now
repair many valve defects that formerly required more invasive
valve replacement procedures.
Endoscopic cardiac surgery using this technique is available
from only a handful of surgeons at this point. Dr. Douglas Murphy,
who operated on Marianne, is one of the nation’s most experienced
cardiac surgeons using this procedure. He has completed about
100 endoscopic cardiac surgeries and now trains other surgeons
in this technique.
Today Marianne's only reminder of her heart surgery is a two-inch
scar under her right breast.
