Clinical Trial: Paul Frisch
Paul Frisch was born in 1980, with a fully grown heart but was rushed into immediate open heart surgery because his pulmonary valve was sealed shut, a condition called pulmonary atresia. The cardiologist simply cut a hole in the pulmonary valve to allow the blood to flow through. This solution worked for a little while. By the time he was two and a half it was time for his second open heart surgery. Since the cardiologist only cut a hole in his sealed valve, scar tissue formed around the incision and the hole was not growing along with his heart. During the second open heart surgery the doctors cut the entire pulmonary valve out of his heart and placed a wire mesh stent in place of his valve so the blood could flow freely through the right side of the heart.
This solution worked for 22 years. At the age of 25, Mr. Frisch began experiencing back flow into his right atrium, which caused his heart to enlarge. This caused painful arrhythmias and atrial fibrillations. A valve replacement was inevitable. In his case, the cardiologist decided a pig tissue valve would be the best. He was warned that if a mechanical valve was used instead, he would have to take blood thinners to ward against clotting.
On Thursday, October 20, 2005, Paul Frisch had his third open heart surgery at Columbia Presbyterian Hospital in New York. Dr. Jan Quaegebeur inserted the pig valve, did some reconstruction on his tricuspid valve and patched a small hole in his atrium with Dacron wire; both of the other problems were caused by Mr. Frisch’s lack of a pulmonary valve. He spent the next five days in the hospital, but the recovery time would take longer.
Mr. Frisch returned to his teaching job at Fox Lane High School in Bedford, NY, as a biology teacher on December 16, 2005. His doctors told him he had no restrictions, but to do only what felt comfortable. For two years he continued to feel a sharp pain in his chest every once in awhile. Additionally, what was even harder for him, and for most cardiac surgery patients, was the mental recovery. To humans, the heart seems like the essence of our body. It is the most talked about organ in our body in everyday society and and is where emotions seem to resonate from. When this part of the body is tampered with, it is hard to not feel like something is missing or changed, more than with other surgeries.
Since the valve was a preserved pig valve, Mr. Frisch did not have to take any immunosuppressive drugs. He only takes a small dose of both aspirin and a beta-blocker for his arrhythmias. And only goes for a checkup with his cardiologist once a year. Even though the surgery was a success the valve will have to be replaced. It is expected to last 15-20 years.
When Paul Frisch was child and a teenager he never felt held back by the fact that he was missing a heart valve. He played soccer and ran around with all the other kids. But looking back on it he can feel the difference. These days he can go to the gym and run on the treadmill for 45 minutes and feel like he had a good workout but it was not too much stress on his heart. Whereas, in high school he would dread the days his soccer coach would make them run for 20 minutes because it was hard for him.
The most talked about topic in Biomedical Engineering today is stem cell research and growing spare parts. One of the major problems to overcome is growing a heart that is the proper size for the person it is meant for. The whole point of using stem cells is to grow a heart with your own cells so there will be no rejection. Mr. Frisch would have been a perfect candidate. When he was born they knew at some point in time he would need a valve replacement or heart replacement and had his stem cells right there. If they started growing it then, whenever they did the heart replacement it would be the perfect size. The question is would the grown heart have the same pulmonary atresia problem.
[Frisch, Paul. Telephone interview. 3 Mar. 2008.]