Dr. Sheldon Kardener discusses his experience as the first patient to undergo the procedure (July 2018) of inserting Abbott’s next-generation version of the company’s leading MitraClip® heart valve repair device in the U.S. This minimally invasive option, allowed him to return home a mere two days after his procedure and let him get back to his daily activities, like teaching and exercising, more quickly.
Dr. Kardener graduated engineering college and practiced for four years before going back to medical school. He completed his psychiatric residency at UCLA and joined the full time faculty, subsequently becoming part of the clinical faculty upon entering private practice. While having just retired from that practice, he continues teaching as a clinical professor of psychiatry at UCLA.
Neal Howard: Welcome to Health Professional Radio. I’m your host Neal Howard, thank you for
joining us once again. Our guest is Dr. Sheldon Kardener, he’s a UCLA Professor of Psychiatry. He’s a patient who received the very first procedure inserting Abbott’s next-generation version of the MitraClip® heart valve repair device here in the United States and he’s joining us here today to talk about his experience with this groundbreaking device. Welcome to the program Dr. Kardener.
Dr. Sheldon Kardener: Thank you very much.
Neal: Well as I said, you are a UCLA Professor of Psychiatry and the first patient to receive this MitraClip® heart valve. How and when were you diagnosed with mitral regurgitation and did you understand what it was when you were diagnosed?
Dr. Kardener: Certainly I understood because I am a physician although it’s not my area of expertise but I was diagnosed with having a mitral valve murmur. I can’t quite recall, it must be 20 maybe 30 years ago and that murmur has simply always been part of the physical finding when I have physical exams. But it has generally went from “Yes, we can detect it” to “Wow, that’s pretty severe!” And it’s gone over, as I said, it’s progressed slowly but definitely so it’s hard to date the onset but I would guess it could be 30 years or more, yeah.
Neal: Going from “We can detect that” to “Wow, that’s pretty major!” – were there any symptoms looking back that you experienced that maybe you missed or could have paid closer attention to?
Dr. Kardener: Well there’s no question that fatigue was setting in and gradually again and I thought perhaps it was related to work schedule, etc but also Dyspnea that was the major symptom that was disconcerting and I often would walk to my office to get some exercise and found that my breathing pattern was more consistent with having jogged then walked so I could do it but again was kind of panting as if I had jogged. And so the tiredness and the Dyspnea were the major symptoms that were increasing.
Neal: How did you hear about this MitraClip® procedure?
Dr. Kardener: Well because of the Dyspnea, a reasonable question was is it pulmonary or is it cardiac? Well I suspected it was primarily cardiac, it was for other reasons I have had a middle lobe infection a couple of years ago and so it was reasonable follow up and see what the status of to make sure was all healed and well. So I consulted with a pulmonologist and he heard me with my shortness of breath and speaking and he said “Your lungs are clear, they’re fine. You really ought to see Dr. Kar.” And I said “What for?” And he said because of repair of the mitral valve and I wrestled with that for a while but I hate to have my chest cracked. I just was not looking forward to that and he said “No, Dr. Kar does a procedure through the femoral vein and feeds into the heart.” And so I was intrigued and then spoke with my cardiologist and independently thinking about it and we had discussed the possibilities before but again my hesitancy was the major surgery that would be involved and he said “Well you oughta get evaluated and why don’t you see Dr. Kar?” So it’s ideal when you get two personal physicians triangulate a referral independently and they did indeed with Dr. Kar so I saw him and he felt very enthusiastic about the likelihood of a good outcome and that the procedure would be this process through the femoral artery rather than cracking the chest.
Neal: It allowed you to return home a lot earlier than you expected or did you expect the short recovery time? Tell me about the procedure and your personal recovery.
Dr. Kardener: Well the procedure was on an early morning and by that afternoon, I was feeling a bit fine. They of course for safety reasons and wanted a monitor overnight otherwise planned to discharge me on the next morning and I felt perfectly fine. I felt some improvement in speech without the shortness of breath and generally felt very good. There were no problems in terms of the post procedure recovery at all. The only aspect that sort of came at us unexpectedly was during the night, I got very little sleep. Now that, people might ask well nobody expects to get a good night sleep in the hospital overnight but the reason I didn’t aside from it being a hospital was that the monitor was going off all night and in fact when they came in the next morning they said “Doctor you need a pacemaker.” And that afternoon they put in a pacemaker so I went home the next day. But the procedure itself, I was ready to go right afterwards. Of course wisdom prevailed in terms of them asking that I certainly stay overnight and it turned out to be fortuitous because the monitor again indicated a secondary issue and that got taken care of at the same time. So it was a two days stay compared to what would happen otherwise.
Neal: So as far as managing since the procedure, has your recovery gotten progressively better? Are you feeling progressively better? Have there been any setbacks or anything like that? Any other side effects? I mean you had two two surgeries, two devices implanted in the same 24-hour period it seems. So how are things since then?
Dr. Kardener: Exactly, very well. I did have a one-month follow-up, the echo cardiogram and it demonstrated that the valve is absolutely competent. There is almost no leakage whatever and certainly my physical symptoms clearly with that early absence of physical symptoms I have steadily felt greater, strength and I’m anxious to get back to exercising. The heat wave we’re currently experiencing in this area has made it important to consider getting out and doing much out in the heat so as soon as it cools off some, I’m going to be out doing what I’d like to do and that’s going for a good walk as exercise. But certainly feeling far more rested and comfortable and alert and energized as well as not having that shortness of breath.
Neal: Going from not being able to walk to your office as you previously could to considering exercise especially when it cools down, on your doctor’s recommendation – do you feel even more confident to get out there and maybe do a little bit more than you were doing before the procedure?
Dr. Kardener: Good brisk walking is something I’m looking forward to resuming and that I could do a while ago as I said this slowly increasing symptomatology because the valve was getting worse and one of the most exciting things I’ve always if I saw a new physician or if I had a physician who might not seen in a while check with the stethoscope, there was a very classic profound mitral valve murmur and it was a kick to have my cardiologist listen and say “There’s no murmur.” And indeed the murmur’s gone and all that was associated with the symptoms of that regurgitation was gone.
Neal: Would you say being a prime candidate for this type of procedure, what would you say to someone else who’s dealing with a mitral regurgitation such as yourself about considering the MitraClip® system?
Dr. Kardener: Well I think it certainly work profoundly well and I think there is a perfect marriage, if you would, between advanced technology and the equipment associated with that coupled with clinical skill. I think clinical skill without the technology or technology without the clinical skill leaves a less than satisfied situation. So I have a perfect combination of good current best available technology and the clip and superb clinical skill in Dr. Kar.
Neal: We’re wishing you continued recovery and great success Dr. Kardener.
Dr. Kardener: Thank you so much.
Neal: You’ve been listening to Health Professional Radio, I’m your host Neal Howard. Transcripts and audio of the show are available at hpr.fm and healthprofessionalradio.com.au. Subscribe to the podcast on iTunes, listen in and download at SoundCloud and be sure and visit our Affiliate Page at hpr.fm