Patient of the Month

September, 1999

Geraldine Marchese

Geraldine Marchese has quite an amazing story to tell. As a result of childhood rheumatic fever, she developed mitral valve stenosis, a condition which interferes with the normal flow of blood into the heart and leads to congestive heart failure. Ten years ago in 1988 she underwent mitral valve replacement using a porcine (pig) tissue valve to correct the problem.

In March 1998 she saw Dr. Pond for evaluation of fatigue and shortness of breath. An ultrasound study and subsequent cardiac catheterization study revealed that her porcine valve had seriously deteriorated and she had congestive heart failure again. In addition she had pulmonary hypertension and a large clot in her left atrium, adjacent to the defective valve.

She underwent a second open heart operation, her defective valve was replaced and the clot was removed from the atrium. Her surgical risk was very high because of her debility and marginal lung function, but the operation was felt to be her only chance for survival.

The operation was successful, but her hospital course was difficult. She required a ventilator to assist her breathing. She developed obstruction of her airway and required a tracheostomy. She had a number of heart arrhythmias. Her nutritional status was poor and she needed intravenous nutritional support. She went through cardiac rehabilitation, stopped smoking, and has been diligent about her diet and medications.

One year now after her operation, her recovery is complete. She and her husband are looking forward to their return to friends and family in Alabama, and Geraldine has a new outlook on life. Her sense of determination has been an inspiration to all of us. We therefore have selected Geraldine as out "patient of the month" for September.

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