Beating a silent killer

Sharon Smelser of Sidney, Mont., chose Sanford Health and Dr. Sean Russell when she developed heart problems.

Sharon Smelser first attributed her constant fatigue and shortness of breath from climbing stairs as “old woman complaints.” The retired Sidney, Mont., woman had been diagnosed two years earlier with an aortic valve problem before the “old woman complaints” prompted her to seek additional medical attention in January 2009. Her family nurse practitioner in Sydney began treating her for anemia and recommended Smelser see a cardiologist. The decision to travel to Bismarck to see Dr. Sean Russell, cardiovascular surgeon with Sanford Clinic, was simple for the Hazelton native. “I knew the quality of care Dr. Russell provided my brother-inlaw and my now 94-year-old father,” Smelser, 71, said. “That’s why I had so much confidence in him. Even though I had never met him, he was my first choice.”

“When Sharon’s heart relaxed, blood would leak back into the heart,” Dr. Russell said. “People with aortic valve problems typically have symptoms of being tired or out of breath.”

What proved to be a more critical issue was an abnormality that had caused no symptoms.

The aneurysm, a weakened bulging area, was located near the aortic valve at the top of her heart. “The more striking condition was the aneurysm,” Dr. Russell said. “If that were to rupture, it could cause life-threatening bleeding.” Aneurysms typically cause no symptoms until they rupture, underscoring the importance of having an echocardiogram to diagnose aortic aneurysms and an abdominal ultrasound to detect aneurysms in the abdomen. While the possibility the aneurysm would rupture stayed in the back of her mind, Smelser lived as normally as possible. “I didn’t have all the energy I wanted, but I am 71 and taking a nap in the middle of the day is good,” she said.

Dr. Sean Russell Cardiovascular surgery

“Mrs. Smelser continued to have a severely leaking valve, and in combination with the aneurysm, it was felt surgery was needed sooner rather than continued monitoring,” he said.

Aortic valve replacement is a common heart procedure in the older population and is performed for leaky valves, as in Smelser’s case, or, more commonly, for stenotic valves where the valve narrows, restricting blood flow.

Artificial valves are made of metal or tissue. Tissue valves do not require patients to be on the blood thinner Coumadin, making it the preferred choice for Smelser because she has a history of anemia and bleeding ulcers.

A tissue valve is made of cow pericardium, the sack around the heart. The pericardium tissue is placed on a valve-like scaffold and sewn into place.

“Growing up on a dairy farm with beef cows, I told Dr. Russell it had to be either a Holstein or a Black Angus valve, but he said there was no guarantee,” Smelser said with a smile.

Dr. Russell also removed the damaged area of her aorta and replaced it with an artificial artery made of Dacron, a synthetic material used to replace human tissue.

“Sharon’s case was more complicated because we were doing two operations at the same time, but we are experienced in performing these procedures and have excellent outcomes,” Dr. Russell said.

Smelser underwent open heart surgery March 23 and returned to Sidney six days later.

“My recovery hasn’t been bad at all,” she said. “People comment they can’t believe I’ve had surgery. They tell me I have more color in my face now because I had been very pale.”

She continues hour-long cardiac rehab sessions three times a week in Sidney and has progressed to walking a mile on the treadmill.

At her two-month check-up, Dr. Russell described her progress as “awesome,” and noted she will continue to see gradual improvement.

“When I met Dr. Russell, I immediately felt he would care for me very well,” Smelser said.

Dr. Russell advises anyone experiencing fatigue and shortness of breath to check with his or her family doctor and ask questions about the heart. “Heart disease is the leading cause of death,” Dr. Russell said. “Your family doctor can conduct a stress test or echocardiogram to determine if you have any potential issues with your heart.”

Click here for more information about Sanford Health cardiology or call 701.323.5202.