Second Heart Valve Replacement Returns Patient to Active Life

In a perfect world, Randy Okun would be out surfing, on the golf course or somewhere hitting the slopes for an afternoon of skiing. Unfortunately, Mr. Okun was born with a defective aortic valve ― and while it went undiscovered until a doctor visit for an unrelated health problem, it eventually made doing what he loved impossible. He needed an aortic valve transplant. He was 37.

For nearly 20 years following surgery, the Boca Raton resident again enjoyed the outdoors and his favorite sports, but he was always aware that at some point the replacement valve would outlive its usefulness. “I had started feeling a little sluggish, very lethargic. One night I couldn’t breathe. I was sweating, I had a headache. I was just in a total panic. I went into cardiac failure,” he recalled.

Fortunately, Mr. Okun’s wife brought him quickly to Christine E. Lynn Heart & Vascular Institute at Boca Raton Regional Hospital, part of Baptist Health. The Institute offers a wide range of diagnostic testing and care for cardiovascular problems and participates in and leads clinical trials to advance cardiac care.

(Watch video: Hear from patient Randy Okun and Baptist Health cardiothoracic surgeon Marc Gibber, M.D. Video by Alcyene de Almeida Rodrigues.)

“Once patients start to have symptoms from heart failure, that is considered severe,” explained Baptist Health cardiothoracic surgeon Marc Gibber, M.D. “It’s important to intervene. If we didn’t, his heart could have stopped, and he would not have survived.” Doctors advise calling 9-1-1 at any sign of a heart attack or other cardiac problem.

Mr. Okun’s condition was due to a bicuspid aortic valve, a birth defect that causes the valve to have two flaps rather than the normal three. The flaps help control the blood flow from the aorta to the rest of the body. It is the most common congenital heart condition, affecting up to two in 100 people, and is twice as common in men as in women, according to the National Institutes of Health.

Many patients, like Mr. Okun, remain asymptomatic for years. Over time, the valve can weaken or narrow, causing the heart to work much harder. At this point, symptoms commonly include fatigue, shortness of breath, chest pain, fainting or lightheadedness and sometimes a heart murmur.

“Randy had a replacement of his aortic valve previously. At the time, he was told that these valves typically last between 15 and 20 years and he was lucky that his lasted about 20 years,” Dr. Gibber said. “We had to go in and do a redo operation, take out his previous valve and put in a new valve because his wasn’t working and was leaking. This causes a lot of strain on the heart.”

To replace Mr. Okun’s valve, Dr. Gibber performed traditional open-heart surgery, involving a long incision in the center of the chest and being placed on cardiopulmonary bypass which allows the heart to remain still during the procedure. Mr. Okun was not a candidate for a less invasive technique called transcatheter aortic valve replacement, or TAVR, in which a catheter is used to reach the damaged valve and position a new valve inside the old one.

He spent about a week in the hospital. “I started walking in the hospital hallways, and before I left I actually walked up a flight of stairs,” Mr. Okun said. “Inside, I felt like I was in my teens. Dr. Gibber saved my life. He is an extraordinary man.”

To build his stamina, Mr. Okun participated in cardiac rehab, and five weeks after surgery, he said, “I can literally go out there and take a jog down the street.”

At 57, Mr. Okun knows he could need another valve replacement later in life and he also understands the importance of paying attention to any signs that the current valve is weakening.

“He should live a long, healthy, normal life,” Dr. Gibber said.

For now, Mr. Okun is happy to return to his near-perfect world, spending time with his wife, son and granddaughter and getting back to his outdoor pursuits.

For more information on Baptist Health Heart & Vascular Care services throughout South Florida, click here. To learn more about services in Palm Beach County at Lynn Cardiac & Vascular Institute, click here.