On March 28, 2023, Cardiologist Eiran Gorodeski MD, MPH. (@EiranGorodeski), my wife, and I reviewed my options now that CAMZYOS® (mavacamten) was shown to not be a successful treatment for my hypertrophic cardiomyopathy (HCM). Please read my previous HCM blog post about the months of learning about HCM, trying a new medication (which did not work out), and ending with my third echocardiogram showing that as the CAMZYOS™ wore off, my gradient was getting worse again:
(It is interesting to think that if CAMZYOS® had been successful, there would have only been a "Part One" HCM blog post. Now, there also a third HCM blog post entitled: My Hypertrophic Cardiomyopathy Part Three: Hospital & Home)
Before the meeting, I identified and researched what I thought were my five options going forward after the CAMZYOS® failed to work for me. I put together a spreadsheet with columns laying out the pros and cons of all five options, along with my questions for the two most likely options. I brought my laptop with the spreadsheet to my appointment with the results of my research.
Here are my five ideas with comments relating to the outcome of the meeting:
Continue current dose of CAMZYOS®
My gradient had significantly improved while taking CAMZYOS®, maybe the side effects would go away like magic?? (sarcasm!!) -- continuing CAMZYOS® is unfortunately not a viable option!
Try lower dose of CAMZYOS®
Dr. Gorodeski said that with the side effects I was having from CAMZYOS®, even a lower dose would not be a viable option.
Do nothing and just deal with chest pain and shortness of breath for the rest of my life!
Not a viable option!
Septal ablation -- a procedure to destroy with alcohol the thickened part of my heart muscle that was causing the obstruction.
Viable option one!
Septal myectomy -- surgeon removes a small amount of my thickened septal wall to widen the path the blood takes (outflow tract) from my left ventricle to my aorta.
Viable option two!
In reality, I already knew before the appointment that I was down to just two valid options, but I was glad that I prepared for the appointment so that my choices were based on research and not just emotion.
The March 28, 2023, cardiologist appointment ended with Dr. Gorodeski (@EiranGorodeski) making a referral for one appointment (on April 7, 2023) with both Interventional Cardiologist Anene Ukaigwe, MD (@ACUkaigweMD), and Cardiac Surgeon Yasir Abu-Omar, MD, to get their opinion on if I was a good candidate for alcohol septal ablation and/or septal myectomy.
April 5, 2023 - Dreaming More!
Waking up during sleep impacts whether a dream is remembered – and some people remember them while others don’t. . . . let’s say they’ve been a slug all day. They’ve been laying around. They haven’t done anything. Maybe they took a nap. They’re going to have longer extended wake ups throughout the night that happened right after they’ve been dreaming. Therefore, they wake up and they’re like, oh my goodness. I was dreaming.
When I was thinking about writing the first HCM blog post -- My Hypertrophic Cardiomyopathy Part One: Diagnosis & Medication -- and this blog post, I thought to myself that I should include something about my dreams being noticeably different starting in 2023. At first, I decided against mentioning the huge change in my dreams, since I could not explain to others (or even myself) how my hypertrophic cardiomyopathy (HCM) symptoms caused this!!!
Then, on April 5, 2023, I saw the following @UHhospitals tweet, and it all made sense!!
We lose 90% of our dream content almost immediately. But there are reasons why some people remember them and others don't. Dr. Carolyn Ievers-Landis has the answers and also examines our ability to control our dreams. https://t.co/9j3tsKJkXV— University Hospitals (@UHhospitals) April 5, 2023
Historically, I don't remember my dreams, but starting in early 2023, I started remembering dreams most nights. To quote the University Hospitals article, the answer is that I was now "a slug all day," just lying around and not able to do anything, maybe taking a nap. (My hypertrophic cardiomyopathy is truly debilitating.) Thus, I had more "longer extended wake ups throughout the night that happened right after [I'd] been dreaming," and therefore remember my dreams. It would be interesting to see if, after my hypertrophic cardiomyopathy symptoms are resolved through medical intervention, I remember fewer of my dreams. I look forward to being busy again during the day and not remembering so many dreams.
Contrast: April 7, 2023 vs April 7, 2022
After reading about backpacking on the Continental Divide Trail for many years, I finally stepped foot on this wilderness trail on Thursday, April 7[, 2022.] . . . Despite these years of backpacking, the desert of New Mexico was totally different than anything that I had ever experienced -- this adventure can't be explained in words. I had a great time, and I feel incredibly fortunate to have had this opportunity. . . . Hiking the Continental Divide is not just following one trail. It is a "choose your own adventure" trip, . . .
April 7th is an important date in my personal history as a backpacker.
April 7th is both the anniversary date of the start of my Appalachian Trail Thru-Hike (from Georgia to Maine), and the start date of my northbound Appalachian Trail section hiking 10 years ago on April 7, 2013. (In the past nine years of section hikes, I have completed 10 of the 14 states from Georgia to southern Massachusetts. My original plan for April 2023 was to backpack another section of the A.T.) Last year, on April 7, 2022, I was starting a once-in-a-lifetime adventure -- a 22-day backpacking trip on the Continental Divide Trail (New Mexico desert section), starting at the Mexico border.
April 7, 2023:
One year ago, I was on my way to the Mexico border to start my Continent Divide Trail section hike!— Stuart O. Smith, Jr. - sosAssociates.com (@sos_jr) April 7, 2023
This morning I'm thinking about all the great backpackers & trail angels I met last year on the ,trail.
Thank you @CDNST1 volunteers & staff for making my adventure possible!! https://t.co/U5WuRWSvEO pic.twitter.com/7QI4dJV7mF
@CDNST1, on this Friday before Easter Sunday 2023, the one-year anniversary of the start of my CDT section hike, I am mailing a thank-you note to some trail angels who helped me.— Stuart O. Smith, Jr. - sosAssociates.com (@sos_jr) April 7, 2023
Sent to two horseback riders on the CDT who invited me to join their family for Easter dinner 2022 pic.twitter.com/0YgR6wiegx
Thanks for making us a part of your journey!— Continental Divide Trail Coalition (@CDNST1) April 7, 2023
April 7, 2022 (one year ago):
#ThoreauQuote: “I went to the woods because I wished to live deliberately, to front only the essential facts of life,...and not, when I came to die, discover that I had not lived”— Stuart O. Smith, Jr. - sosAssociates.com (@sos_jr) April 7, 2022
I’m #backpacking a section of @CDNST1 #ContinentalDivideTrail! #BraveTheCDT#EmbraceTheBrutality pic.twitter.com/wqeA8bUHtj
April 7, 2020, Continental Divide Trail trip canceled due to COVID-19. The trip ended up being delayed until April 7, 2022. The Continental Divide Trail shirt in the photo is what I wore to my April 7, 2023, doctor's appointment.
April 7th, I want to thank @CDNST1 for both their March letter confirming my Continental Divide Trail shuttle (which is now canceled) & the shirt I purchased— Stuart O. Smith, Jr. - sosAssociates.com (@sos_jr) April 7, 2020
From being excited https://t.co/b2r376BRsn
To disappointed https://t.co/OsSbol5SIt
I’m now looking forward to 2021! pic.twitter.com/CbJ16asRG4
Tweets from the days before and after April 7, 2013 (10 years ago). Click on links to see photos from 2013 on Foursquare.
.@AT_Conservancy answer is never enough of the Appalachian Trail. I can always go back to do more, even if only a week here and there.— Stuart O. Smith, Jr. - sosAssociates.com (@sos_jr) March 29, 2013
2100+ miles to Maine via Appalachian Trail from here. (@ Appalachian Trail) [pic]: http://t.co/ofBujkW4B4— Stuart O. Smith, Jr. - sosAssociates.com (@sos_jr) April 4, 2013
Great to be visiting Mountain Crossings @MOUNTAINCROSSIN at Neels Gap, GA. (@ Mountain Crossings - Walasi-Yi) [pic]: http://t.co/mH7Smdkqx9— Stuart O. Smith, Jr. - sosAssociates.com (@sos_jr) April 4, 2013
I'm at Amicalola Falls State Park (Dawsonville, GA) [pic]: http://t.co/ilvDzhkHSp— Stuart O. Smith, Jr. - sosAssociates.com (@sos_jr) April 4, 2013
I'm at Top of Amicalola Falls (Dawsonville, GA) [pic]: http://t.co/hQlEtuTksR— Stuart O. Smith, Jr. - sosAssociates.com (@sos_jr) April 5, 2013
Glorious!! Nearing the end of the 1st half of my adventure. (@ Blood Mountain - The Summit) [pic]: http://t.co/lXMQ0XZfy2— Stuart O. Smith, Jr. - sosAssociates.com (@sos_jr) April 10, 2013
Have retuned to #Cleveland from my glorious trip backpacking on Appalachian Trail followed by car camping while helping thru-hikers, but...— Stuart O. Smith, Jr. - sosAssociates.com (@sos_jr) April 16, 2013
I have been too busy planning my next backpacking trip to be on Twitter.— Stuart O. Smith, Jr. - sosAssociates.com (@sos_jr) April 16, 2013
.@AT_Conservancy think video was taken week after I was there. I think I met one of the ppl featured in video when I was on Clingmans Dome.— Stuart O. Smith, Jr. - sosAssociates.com (@sos_jr) May 2, 2013
This year, April 7th is a very significant date for me in an entirely different arena.
On April 7, 2023, I had an appointment to choose one of two life-changing procedures to regain the life I had before I started having hypertrophic cardiomyopathy related symptoms approximately four months ago. (I wore my Continental Divide Trail t-shirt to the appointment to remind me of the appointment's significance.) During my appointment with Interventional Cardiologist Anene Ukaigwe, MD, and Cardiac Surgeon Yasir Abu-Omar, MD, they reviewed the current statistics regarding the success and risks for alcohol septal ablation and septal myectomy. In the end, they let me know that I was a good candidate for either procedure -- the decision was mine!!
I read some articles and watched a couple of YouTube videos about alcohol septal ablation and septal myectomy before the appointment, so I would be prepared for the meeting with the two doctors. Of all the YouTube videos I watched, the following are two videos that I shared with family members, since I thought they did a good job of explaining the two procedures:
Alcohol Septal Ablation: Surgical Procedure for Hypertrophic Cardiomyopathy (HCM)
Tufts Medical Center
. . . Jun 21, 2016
. . .Alcohol septal ablation is a minimally-invasive, catheter-based treatment performed to reduce the thickening of the heart muscle, specifically the ventricular septum, for patients with hypertrophic cardiomyopathy (HCM).
During this procedure, the femoral artery is accessed and a catheter is advanced from the leg until it reaches the coronary artery supplying blood to the thickened septum. Once the catheter is properly positioned in the septal artery, a tiny balloon at the tip of the catheter is inflated, blocking blood flow.
One to two CCs of absolute alcohol is then injected through the catheter and into the septal artery. The alcohol directly damages the heart muscle, which, over the course of several weeks to months, will reduce the thickness of the septum.
By thinning this area, the mitral valve will not move toward the septum, eliminating obstruction to blood flow. This restores the pressures in the heart to normal, resulting in a significant improvement or elimination of heart failure symptoms.
It can take several weeks to months for the septum to completely thin and the full benefits of the procedure to be felt.
Hypertrophic Cardiomyopathy: What is it and how is it treated?
. . . Apr 16, 2019
Learn why people have hypertrophic cardiomyopathy, symptoms and how heart surgeons at Cleveland Clinic tailor care to each and every patient.
Based on what I had read/watched and what the doctors told me, I made my decision. I chose the surgical option -- the septal myectomy!
It was good that my situation allowed me to make my own choice of the two options. Actually, I had pretty much already made the decision before the appointment, but hearing from the two doctors confirmed my decision. It offered the opportunity for my wife, Julie, to ask questions, and for both of us to hear from the two doctors the current information about the options. It is my hope that the surgery decision I made this April 7th will allow me to go back to having the type of adventures I used to have on April 7th in years past.
I also learned at this appointment that for either of the two options, I would have to first have a cardiac catheterization (heart cath). My next step would be to contact Dr. Ukaigwe's office to set a date for her to perform my cardiac catheterization.
Before my appointment where I had to decide between alcohol septal ablation and septal myectomy, I watched a good video which helped me learn more directly from a man's real-life experience with septal myectomy surgery.
My Septal Myectomy Open Heart Surgery Experience
. . . Nov 5, 2021 TUFTS MEDICAL CENTER
In this video, I'm sharing my Septal Myectomy Open Heart Surgery experience. I had the surgery on March 4th and it was a very intense experience. I'll give you a brief overview of what happened, as well as my thoughts and feelings after the surgery.
If you're considering having a septal myectomy then this video is for you! I'll share everything you need to know about the surgery, including the risks and benefits. After watching this video, you'll have a better understanding of what to expect before, during and after the surgery!
If you found the video useful, please share it by retweeting the following:
Here is video I watched about a man's real experience with septal myectomy before I decided to get the surgery.— Stuart O. Smith, Jr. - sosAssociates.com (@sos_jr) April 25, 2023
"My Septal Myectomy Open Heart Surgery Experience" https://t.co/ANsCgDEuxX via Getting Epic
". . . considering having a septal myectomy then this video is for you!" pic.twitter.com/ERwB3CiLig
I also watched this "The Two Minute Article" before deciding on septal myectomy:
Survival Following Alcohol Septal Ablation or Septal Myectomy for Patients with Obstructive HCM
. . . Dec 19, 2022 The Two Minute Article Cardiovascular Surgery Series, Reviewing the Latest Research
In this thirtieth video of the Mayo Clinic Cardiovascular Surgery Two Minute Article weekly series, Juan Crestanello, MD discusses survival following alcohol septal ablation or septal myectomy for patients with obstructive hypertrophic cardiomyopathy.
April 10-12, 2023 - Binging Cardiac Surgery YouTube Videos!!
With my septal myectomy surgery decision made on April 7th, I spent a couple of days binge watching YouTube videos related to my surgery. I wanted to learn more about what was going to happen to me, and how to be prepared. Here are a few of the videos that I found most useful:
Preparing for Heart Surgery
I love how this former Boy Scout is following the Scout motto to "Be Prepared" for his septal myectomy open heart surgery:
Septal Myectomy for Hypertrophic Cardiomyopathy (HCM)
The following two videos have a YouTube warning stating: "Age-restricted video (based on Community Guidelines)." I would not recommend some people watch these videos, since they show actual surgeries, and you might find them disturbing. I, on the other hand, wanted to be knowledgeable about all the gory details.
Septal Myectomy for HOCM
Jun 11, 2021 -- This video shows the operative technique of extended left ventricular septal myectomy in an adult with hypertrophic cardiomyopathy.
Extended Septal Myectomy (Graphic)
Mar 1, 2021 -- Warning: This video contains actual surgical footage which may not be suitable for all viewers.
Open Heart Surgery
If you really want to see what the opening and closing of the chest for open heart surgery looks like, watch the next two videos together. I want to warn that many people getting the surgery and their family members might find these two graphic videos disturbing.
How Chest is opened by Cardiac Surgeons for Open Heart Surgery / Mid Sternotomy Incision
Explore Learn & Share
Notice: Age-restricted video (requested by uploader)
How is Chest closed after Bypass / Open Heart Surgery
Explore Learn & Share
Notice: Age-restricted video (requested by uploader)
Heart Lung Machine
Very cool tech in a heart lung machine!!!
Heart Lung Machine | How does it work in (2022)
"I am sharing some scenes from a recent heart operation where we used the heart lung machine. I am using this opportunity to share how the heart lung machine works and how it is connected to the patient. This video is for educational purposes only. Viewer discretion is advised, as some heart scenes may be disturbing for the viewers. Age-restricted video (based on Community Guidelines)"
A Heart Lung Machine is very cool tech!!— Stuart O. Smith, Jr. - sosAssociates.com (@sos_jr) April 25, 2023
I watched four very interesting videos how this amazing machine keeps a patient alive while both the heart and lungs are stopped! https://t.co/mYmWx2WFqphttps://t.co/h0hVZEvonFhttps://t.co/yBcvAKIApxhttps://t.co/PCJLb6c1eG pic.twitter.com/tz5SYp1lLm
As I was looking at all these YouTube videos about heart procedures, the lyrics "soon turned out had a heart of glass" jumped into my head, so of course I had to listen to:
Official Music Video for Heart Of Glass performed by Blondie.— Stuart O. Smith, Jr. - sosAssociates.com (@sos_jr) April 25, 2023
🎶 "Blondie - Heart Of Glass" 🎶 https://t.co/7hmWBoMmZX via @BlondieOfficial.
"Soon turned out had a heart of glass" pic.twitter.com/nAXvSNMmD2
April 12, 2023 - Preparing for Surgery with SeamlessMD Patient Engagement Platform and Emmi® Programs
With my selection of septal myectomy, University Hospitals started the pre-surgery education process using website and app resources:
Education for Patients on Conditions and Procedures
Emmi® is a series of free, animated online programs that walks patients through important information about a health topic, condition or procedure.
The Emmi® video is a good review of what will happen before, during, and after surgery. It also contains some warnings of what could happen if things go wrong -- including death!!!
University Hospitals Harrington Heart & Vascular Institute has launched SeamlessMD, a HIPAA-compliant platform for patient engagement, remote monitoring, and virtual care. It is now using the platform for patients undergoing open-heart surgery at University Hospitals Cleveland Medical Center, to keep patients safe, on-track and connected . . .
UH’s Harrington Heart & Vascular Institute is a leader in cardiovascular care and was looking to further drive innovation to elevate its open heart surgery program. To achieve a standardized, higher-quality consumer experience, while also improving clinical outcomes, UH looked for a Digital Patient Engagement platform to keep cardiac patients safe and connected to their care team while at home.
UH rolled out SeamlessMD to engage and monitor patients more effectively before and after Open Heart surgery.
15-day countdown with SeamlessMD Patient Engagement Platform!
SeamlessMD was the main communication technology used for preparing for surgery. There is access via both website and app. I found the iPhone app most useful, and did comunicate with the SeamlessMD tech support efficiently when I had questions.
@UHhospitals, FYI, I just now received by mail the information for my 4/19/23 (yesterday) appointment. https://t.co/BY9TrIolni— Stuart O. Smith, Jr. - sosAssociates.com (@sos_jr) April 20, 2023
Fortunately, I had already received all the info I needed from the UH @SeamlessMD & UH MyChart appshttps://t.co/2wIkflXazJhttps://t.co/zhZSQyKkQA pic.twitter.com/wCtstObzk0
So glad @SeamlessMD was helpful in your care journey!— Joshua Liu (@joshuapliu) April 23, 2023
.@joshuapliu, yes, thank you.https://t.co/6u4mRxeFVP— Stuart O. Smith, Jr. - sosAssociates.com (@sos_jr) April 23, 2023
FYI, I have emailed your support staff a few times regarding app settings.https://t.co/nOpufuySJ2https://t.co/lffAxrGbVZ
I appreciate that your @SeamlessMD support staff have been most helpfulhttps://t.co/Z5L6E8UM0z pic.twitter.com/IoygYGy3rG
Amazing - glad to hear our support team was helpful!! thank you for sharing your feedback— Joshua Liu (@joshuapliu) April 23, 2023
@SeamlessMD tweets about @UHhospitals:
ICYMI - Here are the results of our partnership with @UHhospitals - leveraging #RemoteMonitoring technology to dec #Readmissions, #EDVisits, Phone Calls, & Discharge to SNF for patients undergoing #openheartsurgery patients. Read the full case study here: https://t.co/5dcBTGi9kB pic.twitter.com/0YI3dLd75y— SeamlessMD (@SeamlessMD) February 20, 2022
Exciting new partnership w/ @UHhospitals – helping Cardiac patients stay safe & connected during #COVID19. UH using @SeamlessMD to guide patients pre and post-surgery, delivering #ERAS education & #RemotePatientMonitoring to improve outcomes! Read more: https://t.co/5fbtdK7HZ6 pic.twitter.com/kllLsp9uaZ— SeamlessMD (@SeamlessMD) February 4, 2021
Check out the results of our partnership with @UHhospitals - a leading healthcare system that implemented #digitalcarejourneys in order to achieve:— SeamlessMD (@SeamlessMD) November 5, 2022
↓ 49% Readmissions
↓ 68% ED Visits
↓ 59% Phone Calls
↓ 52% Discharge to SNF
Learn more here: https://t.co/VSGe5Si5eY pic.twitter.com/oG355RMWEN
April 14, 2023 - Publicly Sharing on Social Media
Once I let all my family members know that I had chosen septal myectomy, I decided to publicly announce it on Twitter and Facebook. I greatly appreciated the people I connect with on social media wishing me well with my upcoming surgery.
One week ago, after I met with an Interventional Cardiologist & a Cardiac Surgeon, I took this photo of a @UHhospitals banner— Stuart O. Smith, Jr. - sosAssociates.com (@sos_jr) April 14, 2023
Now my heart cath & heart surgery are scheduled over the next 2 weeks.
Surgery will deal w/ recently diagnosed genetic heart disease & improve my life pic.twitter.com/xnmD2lynOz
Good luck!— Mimi Plevin-Foust (@MimiPlevinFoust) April 19, 2023
Best wishes Stuart for the surgery.— Meenakshi Sharma (@MStrategy216) April 14, 2023
Praying for you Stuart!— Dan Hanson (@DanHanson) April 15, 2023
Good luck!— Phil Kalina @firstname.lastname@example.org (@pkalina) April 14, 2023
Yay and— (((clevecarole))) (@Clevecarole) April 14, 2023
Godspeed, Stuart!— Erin O'Brien (@erin__obrien) April 14, 2023
You will do just fine. I pick up a lot of people who have this. You will be stronger and healthier after this.— Jim (@jimmyb44140) April 21, 2023
wishing you a speedy recovery!— Laura McShane, MLIS, MLA (@LauraMcShaneCLE) April 25, 2023
April 19, 2023 - HCM Hiker Near PCT!!
Living With HCM: Know Your Choices | CardioSmart
American College of Cardiology
. . . Feb 24, 2022 #HCM #CardioSmart #PatientVoices
Living With HCM: Megan was diagnosed with hypertrophic cardiomyopathy, or HCM, at birth. HCM happens when part of the heart muscle becomes too thick. After learning about her choices – including alcohol ablation or open-heart surgery (myectomy) – she picked the right treatment for her. It has made all the difference in helping her feel better and live her life.
Learn more at https://www.CardioSmart.org/HCM.
After learning about her choices – including alcohol septal ablation or open-heart surgery (myectomy) – she picked the right treatment for her. It has made all the difference in helping her feel better and live her life.
I saw it as a good omen that the first American College of Cardiology patient story video I watched was about a woman who was able to go hiking after having septal myectomy surgery. I got chills when I listened to her story about being able to walk up a hill and not get winded (she started crying). I realize that her story might be my story -- being able to hike again after my septal myectomy surgery.
I got even more excited when I used a photo in the video to figure out her location. She was VERY close to where I hope to backpack on the Pacific Crest Trail someday:
Please retweet the following two tweets so that more people learn about Megan's HCM story:
The 1st American College of Cardiology @ACCinTouch video I watch is about a woman with hypertrophic cardiomyopathy, who after open-heart surgery, is able to hike https://t.co/XFROyoJqIZ— Stuart O. Smith, Jr. - sosAssociates.com (@sos_jr) April 19, 2023
She hikes near where I hope to hike someday on Pacific Crest Trail!https://t.co/BWcn58o9Xf pic.twitter.com/rI5HYUxyYh
More of this story on American College of Cardiology @ACCinTouch website:— Stuart O. Smith, Jr. - sosAssociates.com (@sos_jr) April 26, 2023
"Patient Voices: Listening to Your Body is Part of Managing HCM" https://t.co/rOB1q1SSp3
"Know Your Choices for Treating HCM" https://t.co/OBQ1R2h24u
Open-heart surgery helped her feel better! pic.twitter.com/cFS90zlCc6
Please learn more by reading Megan's two HCM stories:
- Patient Voices: Know Your Choices for Treating HCM
April 19, 2023 - Pre-Admission Testing
Today, I successfully completed my pre-admission testing (also called PAT) at @UHhospitals for my heart surgery. https://t.co/BY9TrIolni— Stuart O. Smith, Jr. - sosAssociates.com (@sos_jr) April 19, 2023
The hospital staff took a few of my fluids and gave me an x-ray. pic.twitter.com/QcR8SdscIt
A COVID-19 test was also required:
This morning I took my pre-surgery self-swab COVID-19 test.— Stuart O. Smith, Jr. - sosAssociates.com (@sos_jr) April 26, 2023
I just received my results via the @UHhospitals new MyChart App. https://t.co/zhZSQyKkQA
Everything looks good!
Normal value: Not Detected” pic.twitter.com/FRJXbCl0XQ
April 21, 2023 - Cardiac Catheterization
Anene Ukaigwe, MD
Dr. Ukaigwe has special interests in hypertrophic cardiomyopathy, transcatheter therapies for aortic, mitral and tricuspid valve diseases as well as left atrial appendage occlusion for stroke prevention in patients with atrial fibrillation. She has authored numerous publications and given presentations on these topics at local and national professional meetings.
University Hospitals Patient Resources:
What is cardiac catheterization?
In cardiac catheterization (or cath), your healthcare provider puts a very small, flexible, hollow tube (catheter) into a blood vessel in the groin, arm, wrist, or in rare cases the neck. Then your provider threads it through the blood vessel into the aorta and into the heart. Once the catheter is in place, several tests may be done. Your provider can place the tip of the catheter into various parts of the heart to measure the pressures in the heart chambers. Or they can take blood samples to measure oxygen levels.
On April 7, 2023, Interventional Cardiologist Anene Ukaigwe, MD (@ACUkaigweMD) let me know that I would need a cardiac catheterization before having my septal myectomy, and that she would be doing the procedure. I thought that a cardiac catheterization was always done through the groin, but I learned of a second option that she ended up using -- entering at the wrist.
Here is a good 3D animation video of the process that I watched before my April 21st appointment with Dr. Ukaigwe, except that the animation shows entering through the groin:
Cardiac Catheterization - 3D Animation
Health Decide - 3D Healthcare Education
. . . Dec 1, 2022
3D animation of Cardiac Catheterization by @healthdecide helps patients quickly visualize and understand this cardiac procedure.
What is Cardiac Catheterization?
Cardiac Catheterization is a procedure used to evaluate the coronary arteries, heart valves, and heart muscle and may determine the need for stenting, angioplasty, valve repair/replacement, or bypass surgery. It can also be used to treat certain heart conditions.
What happens in a Cardiac Catheterization?
A heart specialist inserts a small tube (catheter) through a large blood vessel (usually the wrist, groin, or neck) and then passes the catheter into the heart.
Once inside the heart, doctors use the catheter to evaluate how the heart is working by measuring pressure and oxygen levels within the heart's chambers. Doctors may inject a special contrast dye through the catheter that provides an X-ray image of the heart's internal structure and blood flow patterns. Following the procedure, the catheter and sheath will be removed, and the site will be covered and dressed to prevent infection.
What are the risks of Cardiac Catheterization?
Cardiac catheterization is generally a safe procedure and serious complications are rare. Some people experience minor issues, like bruising around the area where the catheter was inserted. Others may have an allergic reaction to the contrast dye, which can cause nausea. Other rare potential risks include a perforated blood vessel, blood clots, and an irregular heartbeat.
What are the benefits of Cardiac Catheterization?
Cardiac catheterization allows doctors to see the inside of your heart without doing surgery to open your chest. This can enable your doctor to diagnose and treat problems that may cause a heart attack or stroke, identify blockages or narrowing that could cause chest pain, assess the function of the valves and chambers of your heart, and choose the best treatment plan for your condition.
Since I had a "Cardiac Cath Left & Right Heart," I had two entry points on my right arm, and one on my left arm. An IV on the my left arm was used to give me pain medication. The one at my right wrist led to the heart via the arteries (these are blood vessels that carry oxygenated blood away from the heart to the body), and the other inside the bend of my right elbow used the veins (these are blood vessels that carry blood from the body back into the heart).
Immediately after the surgery, a clear, inflatable compression sleeve was put on my wrist to apply pressure to prevent any bleeding. Over approximately two hours, a nurse attached a syringe (see air valve in photo) to slowly let air out to decrease the pressure. I was not allowed to lift anything over five pounds for the five days after the procedure.
Except for my wrist hurting at times, I found that the procedure was straightforward. The videos at the top of this section of the blog and in the following tweet are actual views of my heart from my April 21, 2023, cardiac catheterization!!
My Friday 4/21/23 pre-surgical cardiac cath results were good! https://t.co/e3zN8PUtYQ— Stuart O. Smith, Jr. - sosAssociates.com (@sos_jr) April 22, 2023
I'm looking at the MyChart videos of my heart today.https://t.co/qe4XKmASnG
I'm all ready for my heart surgery at @UHhospitals next week. https://t.co/drppwtHt1o https://t.co/fDVS9kC0VS pic.twitter.com/U7ZoykwVH6
wishing you a speedy recovery!— Laura McShane, MLIS, MLA (@LauraMcShaneCLE) April 25, 2023
Wednesday, April 26, 2023 - CDC COVID Data Tracker
I had been sharing on Twitter the Centers for Disease Control and Prevention (CDC) COVID Data Tracker results for months. It was good for me to see that whole state of Ohio was listed as "low" risk for the first time ever the week leading up to my entering the hospital for my surgery.
Great news!— Stuart O. Smith, Jr. - sosAssociates.com (@sos_jr) April 27, 2023
1st time I’ve tweeted where the @CDCgov #COVID19 Community Level report is low for all of #Ohio!
I think it’s week 2 for all Ohio@CuyahogaCounty https://t.co/GVHh07iEal@SummitCountyOH https://t.co/CccZbeFH9V@LakeCountyOH https://t.co/a6TsyMWq2k https://t.co/qovZayQhDK pic.twitter.com/R1ZIe3xN4u
Thursday, April 27, 2023 at 6:00 am -- THE BIG DAY!!
Septal Myectomy Surgery Day
Dr. Yasir Abu-Omar
. . . Sep 3, 2021
To schedule an appointment with Dr. Abu-Omar, click here: https://bit.ly/DrAbu-Omar
Yasir Abu-Omar, MD, DPhil, is the Surgical Director of the Advanced Heart Failure & Transplant Center, and the Russ and Connie Lincoln Chair in Cardiovascular Innovation at University Hospitals Harrington Heart & Vascular Institute. He is also a Clinical Professor of Surgery at Case Western Reserve University School of Medicine.
University Hospitals Patient Resources:
What is septal myectomy?
Septal myectomy is a type of open-heart surgery for thick heart muscle (hypertrophic cardiomyopathy). It decreases symptoms of the condition.
A muscular wall called the septum separates the left and right ventricles, the 2 lower chambers of the heart. In hypertrophic cardiomyopathy, the walls of the ventricles and septum may thicken abnormally. The septum may bulge into the left ventricle and partially block the blood flow out to the body. This causes the heart to work harder. It also contributes to many symptoms of the disease, such as fatigue and shortness of breath.
During septal myectomy, a surgeon removes excess muscle from the thickened septum. This allows the blood to empty from the ventricle more easily.
It’s showtime folks!!!— Stuart O. Smith, Jr. - sosAssociates.com (@sos_jr) April 27, 2023
I am at @UHhospitals’ Harrington Heart & Vascular Institute @HarringtonHVI. https://t.co/kqhEYQYaX7
Septal myectomy surgery will repair issue caused by HCM genetic heart disease & improve my life.https://t.co/drppwtHt1ohttps://t.co/fDVS9kC0VS pic.twitter.com/txk4YfF6E9
Good luck to you, Stuart! I know it will go great for you. Cleveland's gonna feel a little empty without you showing up at all the cool stuff. The rest of us will have to pick up the slack.— Gennifer Harding-Gosnell (@GenniferwithaG_) April 27, 2023
you got this! Speedy recovery!— Laura McShane, MLIS, MLA (@LauraMcShaneCLE) April 27, 2023
Sending prayers for a good surgery and a better recovery!— hi hello (@JasmineAGolphin) April 27, 2023
Best of luck, Stuart!— Joel Libava (@FranchiseKing) April 27, 2023
Best wishes for a speedy recovery @sos_jr— Caroline Guscott Shaw (@CarolineHerself) April 27, 2023
The night before my surgery, I finished the first very rough draft of everything in My Hypertrophic Cardiomyopathy Part One: Diagnosis & Medication, and everything up to this point in this blog post. Writing these two blog posts ended up being very therapeutic. It resulted in me being very relaxed as I entered the operating room, since I knew generally what would happen during my surgery.
As I entered the operating room, the last two things I remember before going under anesthesia is thinking that I was surprised by the large number of people there to take care of my needs, and hearing Dr. Abu-Omar go through a checklist of the surgical plan with the entire team.
My wife told me afterward that I was in surgery for approximately 3-1/2 hours. She then had to wait another three hours after surgery, while the doctors were waking me from the anesthesia and performing other post-surgery care, before she could see me in the Cardiothoracic ICU (intensive care unit).
Here is a tweet from March 2020, where Dr. Gorodeski welcomes Dr. Abu-Omar to University Hospitals cardiac team, and mentions his surgical experience.
After Septal Myectomy Open Heart Surgery
The third and final blog post of my December 2022 through spring 2023 experiences with hypertrophic cardiomyopathy (HCM) continues with: