Every difficult breath was another warning sign that something was wrong.
Rebecca Curless was waking up each night with shortness of breath. Sometimes, the episodes were so severe that the 68-year-old had to sit up and struggle to breathe normally again.
Her daughter, Mackenzie Graft, 40, thought that it was normal to be panting after walking up the stairs or to wake up with her heart pounding.
Neither had any prior medical diagnosis that their hearts were failing. But within two months of each other, both Curless and Graft had to have their heart valves repaired at Franciscan Health Indianapolis.
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The valves had been leaking blood, causing their shortness of breath even while otherwise feeling healthy. Left uncorrected, the condition could have led to heart failure.
Mother and daughter, one coming from her home in Brown County and the other flying across the country from Wyoming, sought out the expertise of Dr. Marc Gerdisch, chief of cardiovascular and thoracic surgery at Franciscan Health Indianapolis. Gerdisch is one of the country’s most skilled valve repair surgeons, specializing in a minimally invasive repair surgery that dramatically shortens recovery time and the potential for complications.
With their leaking hearts fixed, both Curless and Graft are again able to exercise, work around their homes and breathe normally.
“He gave us our lives back,” Curless said.
Knowing what they do now, a simple day of hiking near Graft’s home in Wyoming could have resulted in tragedy. During a visit recently, Curless and Graft decided to go up Heart Mountain, an intermediate hike for a Hoosier such as Curless.
Though Graft and her family were running around and making good time, Curless was having difficulty with the climb. She kept falling behind the group and didn’t think she could complete it.
“We could tell. We hiked that, and it could have been really bad,” Graft said.
Around the end of October, Curless noticed that she was having more trouble breathing than normal. The Brown County resident was wheezing at night when she went to bed, having to sit up when it became too difficult to get air.
Her suspicion was that she had an infection in her lungs, and she went to an urgent care center to get an antibiotic. The truth was that Curless’ diagnosis was much worse: She was going into heart failure.
“I couldn’t believe it. It seemed completely out of nowhere,” she said.
She was immediately referred to a cardiologist in Columbus, who tested her heart and looked at X-rays to determine that her mitral valve was leaking — a condition called mitral regurgitation. The mitral valve is located between chambers on the left side of the heart. As blood flows into the heart from the pulmonary artery, the valve opens to let it flow into the left ventricle, before it is pumped out through another valve and the aorta.
People with mitral regurgitation have a valve that leaks, allowing blood to flow two ways. The heart has to work harder to pump all of the blood the body needs. The condition can lead to a number of problems, from congestion in the chest to heart failure.
“Valve problems are fairly common. Most valve disease is sporadic; it just happens to people. But there are genetic threads to it, and familial, inheritable diseases as well,” Gerdisch said. “As can be seen here, it affects people of a broad spectrum of age.”
Curless’ cardiologist recommended seeing a surgeon in Columbus. But she had done research on heart valve repair and asked to be referred to Gerdisch.
Gerdisch specializes in innovative heart surgery, having presented around the world on unique heart valve repair techniques and participating in ongoing research in issues such as heart tissue regeneration. Over the last 21 years, Gerdisch has performed more than 5,000 innovative surgical procedures, of which 3,500 involved heart valve operations.
He is the co-director of the Heart Valve Center and Atrial Fibrillation Program at Franciscan Health Indianapolis, a senior partner with Cardiac Surgery Associates and a clinical assistant professor of thoracic and cardiovascular surgery at the Loyola University Medical Center in Chicago.
In late December, just a few days before Christmas, Curless was admitted for heart valve repair surgery.
Coincidentally, her friend, Neva Stahl, had learned that she too need her mitral valve repaired. They decided to schedule their surgeries at the same time, to have a support system to go through it together.
“We had surgeries back-to-back,” Curless said. “It was fun having someone to go through surgery with, if you have to have surgery. I’m a little competitive, so I wanted to recover faster than her.”
Gerdisch reshaped the portions of their valves that were leaking, so that it would close more fully. He and his team also replaced the failing cords that squeeze the valve open and shut with filaments so that each worked properly. An angioplasty ring was put around the valve to stabilize it, to ensure it did not get misshapen again.
The procedure was minimally invasive, with the surgical team making a small incision below the left breast, then using a technique to go between the ribs with less pain.
“We’ve come very close to mastering the elimination of the discomfort someone feels when we go between their rib cage. Our technique freezes the nerves while we work, and that has allowed people to mobilize right away after surgery and not feel limited by discomfort,” Gerdisch said.
Curless was released after four days. Since going through the surgery, neither she nor Stahl have had any complications, Gerdisch said.
“They were pleased because they had well-repaired valves through small incisions, and no pain. So they were able to go back to full activity right away,” he said. “As I’ve seen them in follow-up, they’ve been very excited that they can return to their normal lives.”
Curless’ health scare served as a wake-up call for her family. Graft kept tabs on her mother’s recovery from her home in Powell, Wyoming, where she lives on a ranch with her husband and three children.
Concerned that this valve condition could be genetic, she had her kids tested for any potential heart issues. During their checkup, Graft had doctors listen to her heart through a stethoscope.
What her doctors heard was troubling enough to warrant an echocardiogram to get imaging on her heart.
“I thought there was no way this was happening to me too. I told them I’d just get it in a few months, and they said, ‘No, you don’t understand. You need to get it right now,'” she said.
Though doctors had identified a heart murmur when she was a basketball player for Purdue University in the late 1990s, Graft had never experienced problems with exertion or shortness of breath. During her four-year career at Purdue, she could do all of the training and conditioning that other players did.
She was an avid runner, completing half-marathons and 24-hour endurance events. But in retrospect, there were warning signs that she wasn’t as healthy as she thought.
“I thought it was normal to be breathing hard when you went up stairs,” she said. “Looking back, when we were running, my friends would have a conversation and I’d be too out-of-breath to talk.”
Considering what her mother had just gone through, Curless had the results of the testing sent to Gerdisch, who told her she needed the same valve repair that Curless needed. She made arrangements for the surgery, scheduling to fly back to Indiana and have the operation done on Valentine’s Day.
“I did think about staying out there with my kids and family. But it came down to two or three weeks here in Indiana, vs. a lifetime with my kids,” she said.
Valve problems are an increasingly common condition, with more than 5 million people diagnosed every year. The issue is correctable, either through valve replacement and repair, but can lay undiagnosed for many years, Gerdisch said.
“When it is discovered can be variable. It’s important that it be found in a timely fashion. If someone has a murmur, it needs to be investigated. Even though a person feels well, the heart can have substantial changes that may not be reversible,” he said.
Graft had her final examination with Gerdisch on Feb. 28 before flying back to Wyoming. Though both she and Curless will see their doctors to keep tabs on their heart health, their hearts are both in pristine condition, Gerdisch said.
With the tumultuous past months behind them, both women are thankful for the chain of events that have led to their recovery.
“I really feel like God was looking out for us,” Graft said. “We were bad, and we didn’t know at all.”
