Doctors perform rare heart surgery for first time on Del Mar patient
Del Mar resident Kimberly Trauth is the first person in San Diego County to receive a rare heart-valve replacement. The “Valve in MAC” procedure, as it’s called, had never been done before in San Diego. It is often considered a last resort, but in Trauth’s case, it was a risk worth taking. She was out of options.
Trauth was diagnosed with lymphoma at age 14. She remembers when she heard the news, she didn’t know what lymphoma was, but she had a feeling it wasn’t good. “My dad asked me a few days later what it felt like to have cancer and I flipped out! I asked my dad why no one told me I was going to die. My mom explained that the doctors wouldn’t try to fix me if they didn’t think I had a chance to live.”
At that time, there was no pediatric protocol for the disease, so doctors created a treatment plan. It included a month of intensive radiation and chemo. But the radiation damaged her aortic valve – something Trauth didn’t find out until almost two decades later. “In my 30s, I had become a substitute teacher and a pre-K teacher,” Trauth explains. “I walked the San Diego Marathon and two half marathons. Then my doctor told me I had a heart murmur and sent me to a cardiologist. I was diagnosed with aortic stenosis. By my late 30s, I had a daughter, Kailey. She was two years old when I had open heart surgery to replace my aortic valve.”
But Trauth developed complications as a result of that surgery and it became more and more challenging to care for her daughter because she felt tired all the time. Nevertheless, she put in a valiant effort. “While my health was deteriorating,” Trauth explains, “I managed to do quite a lot, including keeping up with volleyball games, participating in carpools, and I was even my daughter’s Girl Scout leader just a few short years ago. In our troop, we sold Girl Scout cookies for two or three years, we planned field trips, and had lots of fun and made lots of good memories.”
But by the age of 50, her mitral valve had deteriorated to the point that she required oxygen 24 hours a day at home. Her doctor, Dr. Curtiss Stinis, remembers her condition. “She was in and out of the hospital frequently because of worsening congestive heart failure. She was struggling to just try to finish a sentence without stopping to gasp for breath. She was literally slowly dying and there was little that we could seemingly do for her. It was truly frustrating and emotionally very difficult to witness.”
Another open-heart surgery wasn’t an option because of the previous complications. And an attempt at minimally invasive robotic surgery was unsuccessful.
“I did wonder if my time was up soon. Death happens to everyone. I didn’t lose hope but I did consider that my life could be shorter than what I thought it would be,” Trauth recalls. And she worried about leaving her daughter behind. “I love her more than anything. We’ve been bonded since the beginning, neither illness not death can change that. However, I don’t want to miss out on being in her life, so I’ve worked hard to stick around. It’s important and usually the first thing I think about. A daughter needs her mom.”
Stinis and his team kept looking for options. “I had heard of a somewhat fringe procedure called Valve in MAC,” Stinis explains, “that a few other physicians had performed, but I also knew that the reported success rates of this procedure were only about 50 percent. Despite this, I began in earnest to research the procedure and learn as much about it as I could to see if there was a way that Kim could be treated with this procedure.”
In March, Stinis and Dr. John Tyner, a cardiothoracic surgeon, and their team performed the Valve in MAC surgery on Trauth. They went through a vein in Trauth’s groin with a tiny incision, crossed the intra-atrial septum, and then implanted a catheter-based valve designed for use in the aortic position into her native mitral valve. It had to be installed upside down and anchored to her scar tissue.
“This was the first time the I had ever performed a Valve in MAC procedure,” says Stinis. “I had done over 1,500 transcatheter aortic valve replacement procedures (TAVR), but I had never performed a Valve in MAC procedure before.”
The result was absolutely perfect. Trauth began to improve immediately. Stinis and his team at Scripps are thrilled. “Kim is doing very well. The difference in her condition has been quite dramatic. She has not been hospitalized since her discharge after her Valve in MAC procedure. She is only using oxygen occasionally and is nearly completely off of it. She is now able to get out of her house. She has gone to Disneyland and is now going to her daughter’s volleyball games. She is really a changed person.”
And Trauth couldn’t agree more. “Life is so much better for me now! I’m very happy to be alive and to enjoy another day. Breathing is easier and getting better and so is my energy. I’m still recovering. Over the last few years, because moving around got harder and harder, my muscles have deteriorated and my energy has been low. Today, endurance is on the rise and still improving and my energy level is increasing. It’s going to take some time, but I’m very happy. I’m living to see another day!”
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