A Change of Heart
February 2026
No, not that kind of change. Still deeply in love with the man I married. I will forever adore my kids and be in awe of the people they are. I still count my blessings for the original family of 4 I was born into. I continue to love where I live, what I do, and the people around me. This is about an actual change of heart– the 47-year-old beating one that has carried me through a lifetime of activity, growth, learning, travel, adventure, careers, motherhood, hobbies, and all the highs and lows in between.
Unless I’ve told you, you wouldn’t know that I’ve functioned my whole life with a bicuspid aortic valve I was born with. Typically, this is a tricuspid valve with 3 flaps. It’s job is to open fully like a gate so blood can pass from the left ventricle to the aorta on its way out to oxygenate the whole body, and then it’s job is to close completely to keep blood from leaking back into the left ventricle. My valve has never opened or closed optimally, but I’ve never known anything different and it has done its job adequately as I’ve run marathons, hiked mountains, carried and birthed babies, and done all the things without any sort of lifestyle adjustments or intervention. The valve has worked hard (in fact, extra hard) and has served me well for almost half a century. However, my body along with my medical scans, have now indicated that this is no longer the case and it is time to retire this valve and replace it with something new.
Turns out the “something new” is a bit more complex and nuanced than I had anticipated. When my pediatric cardiologist projected that I may need a valve replacement in the future, like in my 40s or 50s, that felt so far off and distant and there was an assumption on my part and theirs that technology would be so advanced it would be a simple procedure, and I’d be good to go. Indeed, technology has advanced and interventional cardiologists can do a whole magnitude of fixes maneuvering catheters, balloons, and various tools through veins and arteries. And they can replace valves this way, too. But, if you’re looking for a solution that will get an active person more than 10 or so years, this minimally invasive procedure is off the table and you are looking at open heart surgery.
So, my “change of heart” is happening at the end of March. After enough research that may qualify me for an honorary valve replacement degree, I am going to have a Ross Procedure to replace my aortic valve. In short, this procedure is going to remove my aortic valve and root and replace it with my pulmonary valve and root (this is called an autograft, when the replacement is a part that is native to your body). The pulmonary valve and root is replaced with a cadaver pulmonary valve and root (this is called a homograft, same species–human in this case–but not native to me). Now, why can’t they just keep it simple and replace the aortic valve with a cadaver valve? The aortic valve is in a high-pressure area of the heart since it is part of the process that pumps blood to the entire body, making wear and tear higher on this valve. The pulmonary valve is in a low pressure area of the heart so a non-native valve lasts longer in this position than it would in the aortic position. The pulmonary valve adapts to the high pressure position over time (blood pressure needs to remain low for a year after a Ross Procedure) and since the valve is native to your body it adapts to working with its familiar counterparts in its new location.
The Ross Procedure is a complex operation that certainly adds an element of risk, especially for a risk-adverse person such as myself, but it has the longevity profile I was seeking without significant lifestyle changes. For background, the two other options for aortic valve replacement are 1) a bioprosthetic valve made of bovine or pig tissue that weakens over time and with activity and would will likely need to be replaced again through open heart surgery in 7-10 years or 2) a mechanical valve which has a strong longevity profile but requires a lifetime of blood thinner medications and monitoring anticoagulation levels.
I met with several surgeons all along the west coast and am confident in the skill, experience, and Ross Procedure expertise of the one I’ve selected. As an otherwise healthy person, the statistics are on my side and I’m trying to follow the words of my husband that have helped me through past challenges: Stay focused on the best possible outcome. And if that outcome is no longer available, find the next best possible outcome and focus on that.
The road to the best possible outcome is not going to be easy. It is scary. It is painful. It relies on heart, lung, and breathing machines. It is exhausting. It is quite debilitating for some time. And, it will be many things I can’t even anticipate. But, I am grateful that there are solutions for my valve and that there are incredibly skilled and accomplished surgeons who have dedicated decades and careers to getting people like me back to optimal health. And just maybe that best possible outcome is an improvement far beyond anything I’ve ever felt. After all, I’ve only known life with a compromised heart valve.
Things like this can be tricky to navigate and one may not know how to act, what to say, what to do. I’m open about what is happening and welcome outreach if you’re so inclined.