• Venice Regional Bayfront Health - New Lease On Life

    Former paratrooper’s heart gets new lease on life with mitral valve repair
    By Heidi Smith
    While serving as a U.S. Army paratrooper as a young man, Eric Kepley became focused on physical fitness. Later in life, working as a banker and real estate investor, his fitness began to slide, but Kepley fought back, shaving off 50 pounds during his early 60s.
    In 2019, Kepley moved to Venice from Ohio and joined a gym where he worked out several times a week. One day, during a “boot camp” class, he nearly fell over in a faint. “I had to lean against a wall to stay upright,” he said. “I thought, ‘is this what it’s like to get old?’”
    According to Kepley, doctors had advised that abnormalities with his heart’s mitral valve were causing the shortness of breath Kepley experienced during exertion. They told him the valve needed to be replaced, he says.
    “I didn’t want a valve replacement, because the doctors said the artificial valve would probably have to be replaced later in life and I would have to be on blood thinners my entire life,” said Kepley, now 64 years old.
    Fate, in the form of COVID-19, took a hand.
    As Kepley waited for surgery to be scheduled, the pandemic arrived, delaying what was considered a non-emergency procedure. But then in March of 2020, Kepley and his wife, a respiratory therapist, decided his symptoms were becoming so frequent and serious the couple sought help at the Emergency Department at Venice Regional Bayfront Health.
    “I was concerned about COVID-19 risk (in a health care environment), but I didn’t have a choice at that point,” Kepley said. “I needed help. As it turned out, I felt completely safe at with the protocols they had in place.”
    After an extensive workup to rule out other cardiac issues, doctors determined that Kepley’s mitral valve might be repaired, rather than replaced. It would still be major, open heart surgery, but if his native valve could be repaired, he could avoid a second valve-replacement surgery later in life and probably wouldn’t need blood thinners except for a brief period after the repair.
    “We never know for sure until we actually see the damage with our own eyes, but we would much rather preserve the native tissue because nothing is better than what God gave you,” said Michael Bolanos, M.D., a cardiothoracic surgeon with Venice Regional’s heart team. Dr. Bolanos specializes in surgical treatment options for atrial fibrillation, coronary artery disease, and valvular heart disease. He is employed by Gulf Coast Medical Group, which is affiliated with Venice Regional Bayfront Health.
    Preserving the tissue and restoring the geometry of both ventricle and valve has been shown to provide excellent long-term results,” Dr. Bolanos said. “In a 64-year-old, you want to do a repair that should hopefully last the rest of his life.”
    In the operating room, Dr. Bolanos saw that a segment of Kepley’s mitral valve was prolapsing, or bulging, leading to a severe leakage of the valve. This leakage can cause abnormal heartbeats (arrhythmias) that may eventually become life-threatening, including leading to heart attack and stroke. To repair the valve, the surgeon removed the prolapsing segment and brought surrounding tissue back together. He placed an artificial ring around the mitral valve to provide additional support and stability.
    The surgeons even preserved Kepley’s 82nd Airborne tattoo on his chest.
    “We keep the incision as small as possible, and it goes down the middle of the chest,” Dr. Bolanos explained. “We perform a plastic surgery type closure, so the incision typically heals really well. Many patients after a year only see a faint line.”
    Kepley remained in the hospital four days after the procedure, but could stand on his own the day after surgery. He credits the skilled attention from heart team doctors and nurses for providing diligent care during his hospital stay and educating him on how to achieve a quick recovery.
    “Mr. Kepley’s experience demonstrates how our heart team works together with a highly individualized, ‘concierge’ style focus on each patient,” said John Galat, M.D., a cardiothoracic surgeon who participated in Kepley’s surgery. Dr. Galat founded and directs Venice Regional’s heart program and is employed in the same practice as Dr. Bolanos.
    A key difference in our practice is that many of our team members are solely dedicated to heart surgery patients,” Dr. Galat explained. “The anesthesiologist only works with our surgical team and then provides critical care management for our patients after surgery. Our patients and their families also benefit from having nurses who are dedicated to the heart team before, during and after surgery. This continuity of care is a key reason for our patients’ positive outcomes.”
    Following discharge from the hospital, Kepley recovered at home with his wife’s help. Because of his prior fitness, physical and occupational therapists weren’t needed, Kepley said.
    I would walk through fire for Dr. Bolanos and Dr. Galat,” said Kepley, who has returned to working out at the gym at least every other day. “I had never had surgery before and was scared to death, but the doctors and nurses explained everything to me. It was a gift from God that they did that surgery. Give me another couple of months of training, and I can pass the Army’s new physical fitness test.”
    People interested in learning more about their own heart health can take a free heart risk assessment online at https://www.yourheartsage.com/bayfront/. To learn more about Venice Regional’s heart program, visit veniceregional.com or call 941-486-6770.


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