For much of her life, Sandie Zaruca knew she had a leaky valve in her heart, but she never imagined that someday she would be helping pioneer her own treatment.
In May, the 74-year-old Sylvania resident and former office supply store owner was the first in the world to receive a new type of heart valve, implanted by Dr. Michael Moront, a cardiothoracic surgeon at ProMedica Toledo Hospital.
The bioprosthetic valve, called the Avalus Ultra, takes cow tissue and pairs it with medical-grade fabric and a special type of thermoplastic to replicate the function of a human heart valve.
Dr. Moront, who was part of the team that helped develop the Avalus Ultra, said he felt comfortable performing the procedure.
“We did a big operation for her, and she’s done very, very, well,” Dr. Moront said.
Ms. Zaruca expressed confidence in Dr. Moront. “The morning of surgery, I just looked at him, and I said, ‘He’s going to do a good job.’ Something just clicked, and I thought, ‘He’s going to get me out of this,’” she said.
Ms. Zaruca had effectively managed her heart valve disease until December, when she first realized something was off. She was in South Carolina for the holidays, walking along the bay with her daughter when she noticed she was short of breath.
“I couldn’t breathe. I couldn’t walk very far. I didn’t know how to tell her that I didn’t think I was going to make it,” Ms. Zaruca said. “That kind of told me there was an issue, that something wasn’t quite right. Thank God I got on a plane two days later.”
Shortly after flying home, Ms. Zaruca woke up in the middle of the night, struggling to breathe — a “classic sign of heart failure” called paroxysmal nocturnal dyspnea, according to Dr. Moront.
“Patients will suddenly wake up short of breath,” he said. “What happens is some of the fluid in their legs, as they lay flat, goes back into their circulatory system, and now they have all this blood volume that they can’t handle.”
Because of her difficulty breathing, Ms. Zaruca thought it was her lungs at first. But soon she learned the problem was actually with her heart. The blood wasn’t flowing properly through the valves in her heart, forcing it back up into her lungs.
“The whole thing took me by surprise. I thought I was relatively healthy,” she said.
By January, Ms. Zaruca knew she would need major heart surgery: two valve replacements in addition to a “maze procedure” that would treat her atrial fibrillation.
She soon got a call from her surgeon, Dr. Moront, and learned that she would be the first recipient of the new heart valve.
“He called me and said, ‘I want to be totally transparent with you: There’s a new valve coming out on Monday, and I want to use it on you,’” Ms. Zaruca said.
“I don’t think I even thought about it. I was so nervous about the whole procedure. You know, you watch too much Grey’s Anatomy where the person doesn’t wake back up.”
One of the valve’s biggest advantages over its predecessors, Dr. Moront said, is that it’s “easier to insert, which means it’ll go in faster.”
Dr. Moront brought up the insertion issue to the prosthetic valve’s engineers when the valve was still being developed, prompting them to make the necessary adjustments. The improved technique will also simplify any future valve replacements for the patient, if needed.
“These new valves are dropping right in,” he said.
It’s been almost two months since her surgery, and Ms. Zaruca says she’s feeling much better and was hoping to begin cardio rehab next week. But she said she’s not quite back to her old self.
That’s completely normal, according to Dr. Moront.
“It’s a big operation,” he said. “For older patients, it’s going to take two to three months to get over this surgery.”
But Ms. Zaruca said she’s happy to have her life back and can’t imagine not having gotten the new valve.
Since performing the first valve replacement for Ms. Zaruca on May 6, Dr. Moront has implanted the device 14 more times. And as of last week, eight more hospitals across the country have followed suit.
“You don’t have to go to Cleveland to get the newest, state-of-the-art valve,” Dr. Moront said. “You can get it right here in Toledo.”
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