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FAQ: Robin Williams Needs Heart Surgery

Actor-Comedian Set to Undergo Aortic Valve Replacement Surgery

How are these faulty valves detected?

A patient may report symptoms, such as sudden shortness of breath, DeAnda says. According to news reports, Williams complained of shortness of breath.

Or, a physician may detect a murmur -- an unusual or extra heart sound heard -- during a routine exam. The doctor may then refer the patient for an echocardiogram, a test that uses sound waves to create a detailed, moving picture of the heart and how it is functioning.

"Sometimes murmurs are innocent and remain innocent for years," Robertson says. "Just because you have a murmur doesn't mean you have a problem that will affect you long term." But these patients should be followed up with echocardiograms [sonogram of the heart] to monitor the condition, he says.

Are the causes of aortic valve problems genetic or due to lifestyle, or both?

"Probably genetics more than anything else," Robertson says, and DeAnda agrees. In some cases, lifestyle can be a factor, Robertson says. One example: a drug addict who injects drugs may develop a valve infection, damaging it, and making it necessary to replace it.

What is the aortic valve replaced with?

There are several options. Two of the most common approaches are to replace the damaged valve with a mechanical valve, or with a biological one, from human or animal tissue (pigs or cows).

"The younger patients are, the more likely they will have a mechanical valve," Robertson says. They last longer than the biological valves. The downside: patients with mechanical valves must be on blood thinners for the rest of their lives to reduce the risk of clots, Robertson says, although "there are [mechanical] valves being studied now that may not require ongoing blood thinners."

Patients given biological valves are typically put on blood thinners only for about three months, if at all, and then can go off the medicines. But the biological valves do not last as long as the mechanical ones.

Those with mechanical valves can sometimes hear the valve clicking, Robertson says. "When you are sitting in a room with them," he says, if it's very quiet you may hear it.

Yet another valve replacement option, called the Ross procedure, is more complicated, say DeAnda and Robertson. The aortic valve is removed and replaced by the patient's own pulmonary valve. Then the patient's pulmonary valve is replaced with a biological pulmonary valve (donor valve).

Will Williams get a mechanical or a biological valve?

"Either choice would be reasonable for him," DeAnda says.

What is the prognosis after aortic valve replacement?

"You can live a normal life," DeAnda says. "That's the whole point."

"You can return [the patient] to a normal life expectancy," Robertson says.

Typically patients are back to work in about six weeks, DeAnda says. After that, if they are doing well, DeAnda tells them they can travel, go through metal detectors without difficulty, and resume a normal sex life.

For those on blood thinners, there are some restrictions, Robertson says. "No contact sports or black diamond skiing," he says, because the risk of injury -- and potential blood loss from it -- is considered too great.


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