Kansas City, Kan- Key points from today’s guests:

Ann Bruer, patient

• As a child, Ann had a series of heart issues, including a lifesaving heart surgery.
• Now, as an adult, she had joined the Adult Congenital Heart Disease Clinic at The University of Kansas Health System for continued care.
• One day, she felt like she was running a marathon while just sitting and drove herself to an emergency room unaffiliated with The University of Kansas Health System.
• They told her she needed a heart transplant, but she wanted to consult with her cardiologist at The University of Kansas Health System. He determined they could help her without the need for a transplant.
• After a series of procedures, Ann had a cardiac defibrillator implanted and is now living her life being able to stay active her two teens.
• She said that Dr. Serfas and Dr. Ramirez changed the course of her life.

Dr. JD Serfas, adult congenital cardiac disease cardiologist, The University of Kansas Health System

• Our heart transplant team here is excellent. We do a very thorough, complex, detailed evaluation of every patient that we consider for heart transplant before we would ever contemplate putting someone on a transplant list.
• In Ann's case, we discovered that there were several things that we could do to help her avoid a heart transplant. And I'm glad that we did.
• Ann was born with a condition called transposition of the great arteries, where the two arteries off the top of the heart are reversed, and so the right ventricle, which usually pumps to the lungs instead is being tasked with pumping to the body, and vice versa, the left ventricle, which usually pumps to the body instead, is pumping to the lungs.
• She had a life-saving surgery as a child that we call an atrial switch procedure.
• I think the most important lesson from my perspective is teamwork. Ann’s success today wouldn’t have been possible without Dr. Ramirez and I working together, and without our multidisciplinary teams.

Dr. Rigoberto Ramirez, electrophysiologist, The University of Kansas Health System

• Atrial fibrillation and atrial flutter are two rhythms arrhythmias that start in the top chambers of the heart.
• One of them is considered to be a more regular rhythm that's called the atrial flutter. It's a little circuit that rotates somewhere in between the structures within the heart.
• The other one is a more chaotic rhythm called the atrial fibrillation. And that rhythm that really involves the top chamber of the heart just having random firing, so there's no real organization to that rhythm.
• Both of these feel the same because they're coming from the top chamber of the heart, and they both can be very rapid.
• The traditional symptoms for this is shortness of breath and a lot of fatigue.
• We found an issue with her leads when changing the batteries of her implant. It was a complicated procedure, but we were able to address it.
• Typically, a surgical process to change the batteries would only need to happen every 9-14 years.
• It’s been a real joy taking care of her. Ann is made my job easy because she is a model patient and I’m proud to be able to help her.

Friday, Nov. 8 at 8 a.m. is the next Morning Medical Update. We weigh the pros and cons of a preventative mastectomy and meet one woman who went down that path.

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