Mondesir has Surgery--May 2015

Mondesir--April 2015 (Photo by Lucy Buck)

Mondesir arrived in the States on Monday of last week and had heart surgery on Friday (two days ago).

I posted about Mondesir’s precarious situation here and here.

When Mondesir was 24 years old he had heart surgery at OSF-SFMC in Peoria where he underwent the Ross Procedure. (His sick aortic valve was replaced with his healthy pulmonic valve and his pulmonic valve was replaced with a pulmonic valve homograft.) However, over the past 15 years after surgery he developed wide open aortic insufficiency (leaky aortic valve) as well as a large 5.5 centimeter aneurysm of his ascending aorta. His main pumping chamber, the left ventricle, was failing and Mondesir was in heart failure and struggling to breathe.

On Friday the heart surgeon performed a Bentall procedure. He placed Mondesir on bypass and removed Mondesir’s diseased aortic valve, aortic root, and aortic arch and replaced all of it. His aortic valve is no longer leaky and his aortic aneurysm is gone. The entire procedure took about five hours.

This heart surgeon and medical center are the only ones in the United States that accepted Mondesir to give him this second chance. Without them Mondesir had no chance at much life expectancy. Medical centers as a rule do not want people like Mondesir because they have already been operated and they worry about complications and the cost involved.

During the last several months in Haiti I discussed with Mondesir and his family the seriousness of the situation. I told him that he is high risk for surgical repair but even higher risk if we do no surgery. We also discussed putting in a mechanical valve in the aortic position versus the Bentall Procedure (which would not entail long term anticoagulation with warfarin.) Mondesir chose the Bentall and now he will not have to take and monitor warfarin for the rest of his life.

We also talked about Mondesir’s two young sons and wife and where I would bury Mondesir if he did not survive surgery. All of this has to be talked about BEFORE huge heart surgery no matter how uncomfortable it is to discuss.

Once again, I am impressed with the courage of the Haitian. Mondesir looked at all of these choices objectively, chose surgery, and never blinked.

Mondesir was up and walking in CardioVascular ICU yesterday. His surgeon is very happy how he is progressing. Mondesir has has a long ways to go but he is over a big step.

Thank you to his wonderful host family and to all of you for your support of Mondesir.

John A. Carroll, MD
www.haitianhearts.org