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Top team, best outcome

Baptist Heart Specialists take patient from ‘on the way out’ to ‘on the mend.’

Article Author: Kristi Tucker

Article Date:

Ralph & Ethel Liniado
Liniado and his wife, Ethel, will celebrate their 55th wedding anniversary this year.

The day before Ralph Liniado had surgery, his thoughts were about dying. Now he is thinking about living.

Liniado has been under the care of Baptist Heart Specialists cardiologist George Le-Bert, DO, medical director of cardiology and vice chief of staff at Baptist Medical Center Nassau, for nearly 10 years. During a visit this summer, Dr. Le-Bert described his patient as having rapidly declining congestive heart failure. Liniado was having difficulty doing everyday activities, despite optimal medical therapy.

Congestive heart failure is a condition in which the heart can't pump enough oxygenated blood to meet the needs of the body's other organs. The heart keeps pumping, but not efficiently.

Liniado defined it in simpler terms, "I was in gradual deterioration where you just kind of fade away. I'd had a stent implanted. I'd had a heart attack. I was so sick I could hardly walk to my mailbox and I had to rest for hours after a shower. I just couldn't breathe."

Stopping the leaks

Dr. Le-Bert determined Liniado's newest symptoms were caused by leaking of the mitral heart valve, known as mitral regurgitation (MR), the most common type of heart valve disorder. Blood that flows between different chambers of the heart must go through a valve. The valve between the two chambers on the left side of the heart is called the mitral valve. In Liniado's case, 60% of his blood was not flowing through the proper valves, arteries and veins, which meant he wasn't getting the oxygen he needed. The leaks had to be repaired, and the answer was a MitraClip™ procedure.

MitraClip™ is a small, clip-based device that repairs MR without the need for open-heart surgery. The device is delivered to the heart through a vein in the leg and works by bringing together both leaflets of the mitral valve to reduce the backflow of blood, allowing the heart to pump blood more efficiently.

It takes a team

Dr. Le-Bert knew the best place to send Liniado was the Structural Heart Clinic at Baptist Heart Hospital and Ruby Satpathy, MD, FACC, FSCAI, interventional cardiologist and medical director of the Structural Heart Program at Baptist Jacksonville.

He told Liniado, "Hands down, Dr. Satpathy is the best. I tell patients she's the complete package – passionate about what she does and who she does it for."

"MitraClip™ is a minimally invasive way to repair mitral valves, allow patients to ambulate [walk around] within hours, and usually go home the next day. This was the perfect option for Mr. Liniado with his other comorbidities," said Dr. Satpathy. "Optimal outcome requires experienced and skilled operators, expert echocardiographers, and a team of dedicated physicians, nurses and techs. We have all three, which has helped us to be a high-volume mitral clip program with excellent outcomes."

Dr. Satpathy has been doing transcatheter mitral valve repair for more than 10 years. She is one of the few international proctors for this procedure, and teaches other new implanters about tips and tricks for success. She has also written and co-authored guidelines about management of mitral regurgitation and transcatheter mitral valve repair procedures with other national experts.

"From the moment I was introduced to Dr. Satpathy and Jenna Effron, PA-C, I knew why Dr. Le-Bert said this was the best valve clinic and team in the country," said Liniado. "The experience was so personal, thorough and professional, and the level of care was exceptional."

On the mend

"I did a lot of research on the MitraClip™. A lot of hospitals do this procedure, but if you don't have the very best team and doctor doing the procedure, your outcomes are not necessarily as good as mine. There is no doubt I have the best team," said Liniado. "It's pretty cool how I went from being on the way out to on the mend. Within hours after the surgery, I was walking around my hospital room in absolute amazement – no pain, no problems."

Dr. Le-Bert said, "The procedure was a huge success. His leaky valve went from severe to a trivial amount of leak. It's the best outcome possible."

Just a couple weeks after the procedure, Liniado said he was taking walks with his wife and doing more with his three grown sons and five grandchildren.

"I was diagnosed with heart failure and given five years to live about 14 years ago. Dr. Le-Bert is a wonderful, talented heart doctor. I'm still here, aren't I? I'm going to be 77 this year and I hope to live a lot longer. All I can say is thank you for such world-class care from Baptist Nassau, Baptist Jacksonville, Dr. Le-Bert and Dr. Satpathy. I have a completely different outlook now."  


For more information about MitraClip™, other heart valve procedures, or the Baptist Heart Valve Clinic, contact Baptist's Structural Heart scheduler at 904.202.9500 or visit baptistjax.com/valve.

Source: Operator and institutional recommendations and requirements for transcatheter mitral valve intervention.

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