Fixing a Broken Heart--Minimally invasive surgery at UI hospital speeds recovery

Send yourself a valentine by taking vascular health to heart

February may be the designated month to honor our special someones — but it’s also a perfect time to honor our hearts. Heart disease is the No. 1 cause of death in the United States, and it is preventable.

UI Heart and Vascular Center is the regional leader in the diagnosis and treatment of all types of heart and vascular diseases and conditions, from routine heart care to ultra-sophisticated transplantation and minimally invasive surgery.

Did you know:

  • UI Hospitals and Clinics was the first hospital in Iowa to perform a successful adult heart transplant operation (1982), to use an Implant Advanced Heart Pump (2008), and to implant a Total Artificial Heart (2011)?
  • In an average year UI Hospitals and Clinics performs more than 6,600 adult and more than 1,140 pediatric cardiac catheterization procedures?
  • In a recent year UI Hospitals and Clinics completed 562 cardiac operations and 12 heart transplants?
  • The 2009 transplant survival rate after one year at UI Hospitals and Clinics was 100 percent? In 2011, the Heart Transplant and Heart Assist Device programs at UI Hospitals and Clinics achieved the lowest observed inpatient mortality ratio in the nation among its peers.

When he’s on the job, Damian Simcox is almost always on the go. As director of facilities for University of Iowa Athletics, he ensures that the Hawkeye sports teams have fully functioning stadiums, arenas, ballparks, and practice and training facilities.

It’s a job he loves, but one that requires handling multiple responsibilities and shifting priorities on a daily basis. So when Simcox, 44, learned in 2011 that he needed surgery to repair a leaky heart valve, “It wasn’t exactly what I wanted to hear,” he says. Weeks, or even months, spent recovering from heart surgery was a concern.

Luckily for Simcox, UI Heart and Vascular Center at University of Iowa Hospitals and Clinics has been performing minimally invasive heart valve surgery since 2008 — the only hospital in the region to consistently do so — and is the first program in the nation to receive certification for its cardiac valve repair and replacement program.

News of Simcox’s heart condition hadn’t come as a total surprise. Ten years earlier, during a routine checkup at the UI Family Care Center, Simcox learned that he had a heart murmur, an extra or unusual sound that can be detected when listening to a heartbeat.

“My little mouse-squeak,” Simcox says.

Follow-up tests showed that the murmur was due to mitral valve prolapse, which occurs when the valve between the heart’s left upper chamber (left atrium) and left lower chamber (left ventricle) doesn’t close properly. For many people, it’s a non-threatening condition; for others, including Simcox, it can allow blood to leak backward into the left atrium, which may require treatment.

Considering that he was in his 30s and his overall health was good, his UI physician recommended “keeping an eye on it,” Simcox says. He returned periodically for follow-up tests, but otherwise, “I didn’t worry too much about it,” he acknowledges.

Things changed in the spring of 2011, following new tests to check the progression of Simcox’s prolapse. His UI family physician referred him to UI Heart and Vascular Center specialists, including cardiac surgeon Robert Saeid Farivar, assistant professor of cardiothoracic surgery in the UI Carver College of Medicine. Farivar found that the mitral valve leakage had become more pronounced, enlarging the left side of Simcox’s heart. Left untreated, it could lead to congestive heart failure.

Surgery was recommended and, fortunately, Simcox was a good candidate for the minimally invasive surgery. Traditional mitral valve repair surgery involves a six- to eight-inch vertical incision along the patient’s sternum to split the breastbone and gain access to the heart. The minimally invasive procedure, by comparison, is exactly that — in this case, it required a mere two-inch incision on his right side, just under the breast. Special instruments are used through the incision to perform the mitral valve repair.

For patients, the benefits of the minimally invasive surgery are key, Farivar notes.

“With this technique, patients can expect less postoperative pain and a smaller scar, plus a shorter hospital stay and faster recovery compared to the traditional approach,” he says. “I have patients who are simply amazed at how quickly they can return to their normal routines.”

Simcox was home just three days after the surgery. Pain was “not an issue,” he says, noting that after a few days following the procedure he no longer needed prescribed pain medications. Within two weeks he returned to work, albeit with some restrictions on strenuous physical activity.

He also enrolled in an outpatient rehab and exercise program through UI Heart and Vascular Center called CHAMPS (Cardiovascular Health, Assessment, Management, and Prevention Service) that helped him regain full strength. Today, he says he feels great and the outlook is good — reassuring news for Simcox as well as his wife, Dana, and two kids, McKenna and Brady.

Choosing the minimally invasive approach for his mitral valve repair was a no-brainer, Simcox says.

“To recover so much more quickly and not be in much pain has been great,” he says, “and to get back to my normal routine so much faster — that’s the biggest plus.”

Learn more about the UI Heart and Vascular Center and minimally invasive heart surgery at or by calling 319-356-4346.

Dave Pedersen
photos courtesy Lisa Lewis of Envisage Studios (above)
and Susan McClellan (on
Spectator home page)

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© The University of Iowa 2009