Broncos Coach John Fox to Undergo Heart Surgery

Denver Bronco’s coach John Fox will have to undergo heart surgery this week to replace his aortic valve. The 58-year-old was diagnosed with the condition several months ago but was hoping to delay surgery until the end of the season. The Broncos are currently 7-1.

While in South Carolina this week during the Bronco’s bye week, Fox was seen by his cardiologist (heart specialist). He told him that should he have any symptoms, he should seek immediate medical care. While playing golf on Saturday, Fox began to feel dizzy, and was taken to the hospital. Contrary to earlier reports, Fox did not suffer a heart attack, but was told that surgery needed to be done this week. It is expected that Fox will be out “at least the next several weeks.”

“What does John Fox say?” (with a tip of hat to internet sensation Ylves)

I sincerely appreciate all of the support from friends, Denver Broncos fans and so many around the league today. Although I am disappointed I must take some time away from the team to attend to this pre-existing health condition, I understand that it’s the right thing to do. I have great confidence in our coaches and players, who are fully committed to our goals. I look forward to returning to coaching as soon as possible.

What is the aortic valve?

The aortic valve is one of four heart valves which help direct the flow of blood through the heart. The aortic valve lies between the muscular left ventricle (the side of the heart which pumps blood to the rest of the body) and the aorta (the body’s main artery out of the heart).

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The valve may need to be repaired or replaced for a variety of reasons, both congenital (since birth) and acquired. Valves may either too tight (stenosis) or too loose or floppy (regurgitation). Either problem can cause abnormalities in the way the blood flows through the heart.

If severe enough, valve problems cause symptoms of shortness of breath, fatigue, congestive heart failure, stroke, or even sudden death.

How is valve replacement performed?

There are two methods of aortic valve replacement: a traditional open surgical procedure, or the newer, minimally-invasive, endoscopic procedure.

For either procedure, the patient is put under general anesthesia, meaning the patient is unconscious and unable to feel pain.

For an open procedure, the surgeon makes a 10-inch-long cut down the center of the chest. The breastbone (sternum) is separated so that the heart can be seen. Most people are connected to a heart-lung bypass machine or bypass pump. The heart is stopped while connected to this machine and does the work of the heart while it is stopped.

For endoscopic procedures, the surgeon makes a 2 to 3-inch cut on the right side of the chest near the breastbone. The muscles in the area are separated to allow a view of the heart. One to four additional holes are made in the chest through which special instruments and a camera are inserted.

If the aortic valve is too damaged, a new valve will need to be placed. The surgeon will remove the diseased aortic valve and sew a new one into place. There are two main types of new valves:

valves Mechanical — made of man-made materials, such as titanium or ceramic. These valves last the longest, but the patient will need to take blood-thinning medicine, such as warfarin (Coumadin) or aspirin, for the rest of your life.
Biological — made of human or animal tissue. These valves last 10 to 12 years, but the patient may not need to take blood thinners for life.

Once the new valve is replaced and working properly, the surgeon will:

For the open procedure:

  • Close the heart and take the patient off the heart-lung machine
  • Place catheters (tubes) around the heart to drain fluids that build up.
  • Close the breastbone with stainless steel wires. It takes about 6 weeks for the bone to heal. The wires remain in the body.

The procedure takes 2 to 5 hours.

For the endoscopic procedure:

  • Close the small cut to the heart
  • Place catheters (tubes) around the heart to drain fluids that build up.
  • Close the surgical cuts in the muscles and skin

This procedure takes 3 to 6 hours.

For more information, click here to to the Resounding Health Casebook on the topic.

Michele R. Berman, M.D. was Clinical Director of The Pediatric Center, a private practice on Capitol Hill in Washington, D.C. from 1988-2000, and was named Outstanding Washington Physician by Washingtonian Magazine in 1999. She was a medical internet pioneer having established one of the first medical practice websites in 1997. Dr. Berman also authored a monthly column for Washington Parent Magazine.

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