In 2017 at a routine wellness visit, Diane Shimanowitz’s primary care provider discovered a sudden heart murmur, a sound heard via a stethoscope when blood flows abnormally. At the time, the Metuchen native was being routinely monitored for an unknown autoimmune disease, getting bloodwork every four months.
“I didn’t have any history of heart disease or a murmur. I stretched out getting bloodwork for nine months because I was feeling great, exercising, and my inflammatory markers had been within range,” said the 59-year-old. “So, I was quite shocked to find out I developed a loud murmur that my primary physician had never heard before.”
She then began to see a local cardiologist to be monitored for her heart murmur, and eventually, in November 2022, when a significant blood pressure change was found, was recommended for additional testing for the murmur.
In February of 2023, after additional testing, an aortic aneurysm was identified.
An aortic aneurysm is a bulging of the aorta, the largest artery in our body, which carries blood from the heart to the rest of the body. The condition does not present with symptoms and is often identified incidentally when patients are having imaging tests, such as chest X-rays or computed tomography (CT) scans, for other reasons. If left untreated, an aortic aneurysm could rupture and be fatal.
“I met with many surgeons trying to find the right surgeon and type of surgery that was best for me. Some mentioned doing a David procedure, which is a valve-sparing aortic root replacement; others an aortic root replacement using a bioprosthetic valve; and others a minimally invasive procedure with a bioprosthetic value,” said Diane. “I was eventually recommended for a consult with Valley.”
Diane met with Juan B. Grau, MD, Director of Cardiothoracic Surgery at The Valley Hospital, and Habib Jabagi, MD, a cardiovascular surgeon. They were the first to mention the Ross procedure.
“The Ross procedure is an advanced surgical technique for aortic valve replacement,” said Dr. Jabagi. “The procedure replaces a damaged aortic valve with the patient’s own pulmonary valve. A healthy donor pulmonic valve is then used to replace the patient’s pulmonic valve.
The aortic and pulmonary valves are quite similar in their structures, making the pulmonary valve an excellent aortic valve substitute. The Ross procedure can offer some benefits over other aortic valve substitutes, such as mechanical and bioprosthetic valves, by using the patient’s natural tissue as a durable replacement. As the only living valve substitute for aortic valve replacement, the pulmonary valve can adapt to its new physiologic environment and help restore life expectancy.
“The beauty of going to Valley was they didn’t just offer the Ross procedure,” said Diane. “They offered the Ross procedure and additional surgical interventions, to treat the entirety of my condition. When I left Valley after initially meeting with the doctors, I cried and said to my husband, ‘I finally found my surgeons!’”
On September 19, 2023, Diane underwent the Ross procedure at The Valley Hospital. She had an aortic root replacement, pulmonary valve and main pulmonary artery replacement, ascending aortic replacement, and left atrial appendage ligation.
“I went home with no pain medications,” said Diane. “In the beginning, it took me time to see progress, it was slow. After seeing Dr. Jabagi five weeks later, I was cleared to drive and within twelve weeks, I started physical therapy. Within a few months, I felt more myself and back to normal.”
Diane now sees a Valley cardiologist and will have follow-up appointments every year. “Dr. Jabagi recommended that Dr. Rahim perform my pre-surgery cardiac catheterization procedure – a procedure to evaluate how well the heart is working. I was so impressed with Dr. Rahim’s care that I decided he would be my new cardiologist. Having both my cardiologist and surgeon communicate so well together has made my surgery, post-surgery, and now lifetime of heart health monitoring less complicated,” said Diane.
“I am very grateful for the collaborative cardiac healthcare I am receiving. Thank you for offering me and your patients several treatment options to choose from rather than a one-size-fits-all treatment,” continued Diane. “The best thing we can do as patients is advocate for ourselves to find the right surgeons like you who offer what is in our best interest. I am so thankful I advocated for myself. It allowed me to find my team at Valley, where I am in great hands!”
To learn more about the Ross procedure at Valley, please visit ValleyHealth.com/RossProcedure.