John's half-century of heart valve surgery

John Fitzsimmins

John Fitzsimmins has had open heart surgery three times spanning more than 50 years. He tells Sarah Brealey about the medical improvements he’s witnessed.

As a child my life was similar to other kids’,” recalls John Fitzsimmins. “I ran about, played football, jumped, swam and got up to all the mischief of my peers.” But a serious bout of rheumatic fever at the age of ten left him with lasting heart damage, which shaped the rest of his childhood. In the years since, he’s had open heart surgery three times and has witnessed advances in medical science spanning 50 years.

Now 74 and living in Newtownards, near Belfast, John still remembers falling ill with rheumatic fever. He says: “It was a traumatic experience. I was running a temperature of about 105°F [41°C] and it was a very dangerous situation.”

Lasting effects

After receiving injections of penicillin, John eventually returned to school, but all was not well. He says: “I was trying to take part in sports and I was blacking out.” John’s GP referred him to the Royal Victoria Hospital in Belfast, where he was told he had a faulty mitral valve.

One of four valves in the heart, the mitral valve regulates the flow of blood between the left atrium, where blood comes into the heart from the lungs, and the left ventricle, which is the main pumping chamber sending blood around the body. The heart valves make sure that blood flows in the right direction, but if they do not open or close properly, this can obstruct the flow of blood or allow it to leak backwards, putting a strain on the heart.

John Fitzsimmins out walking As the valve worsened through his teenage years, John became increasingly breathless and restricted in what he could do. At the age of 20, he had his first open heart surgery, to correct his mitral valve. It was 1959 and just three years after the first open heart surgery to correct a mitral valve had been performed.

“It was a major operation,” he says. “Access to the heart is now achieved by incising the breastbone but back in the 1950s, the incision was through the back and was a much bigger procedure. To this day, I have a big scar from the back of my neck, right down my back and across the left side.”

John had a valvotomy, a procedure still occasionally carried out today, where a small cut is made into a valve to allow it to open better. These days, replacing the valve is usually a more effective treatment when it is seriously damaged. When it came to recovery, things were very different back then, and John spent several weeks in hospital.

In my experience, things are very different today; the progress has been dramatic

“At first I was in an oxygen tent, which was quite a claustrophobic experience,” he recalls. “These days you just have a small tube going into your nose or a face mask. I also had a big tube in my back to drain fluid from my chest. One of the worst things was when they took it out, they just pulled it out without any anaesthetic.

"Those memories have left a lasting impression. In my experience, things are very different today; the progress has been dramatic.”

Life as normal

On leaving hospital, John says the senior registrar told him: “Take things quietly for a few months, and then get out and live as normal a life as possible.” So he did. A year later he started his own fresh food business, and in 1962 he married Winifred, a nurse, and the couple went on to have two sons and a daughter. John and his wife were on holiday in South Africa in 1987 when it became clear that his health was starting to deteriorate. “I had some fluid retention, breathlessness and fatigue. When I got home from that holiday, they told me the valve was starting to narrow again.”

John Fitzsimmins with his wife WinifredSix years later, John had his second open heart surgery, and had the valve replaced with a mechanical one. This time, John’s heart surgery was through the front of his chest, and his breastbone was wired back together again. He recalls it being much less traumatic and painful. John’s mitral valve replacement is still “going strong”, as he puts it, 20 years later.

Further shock

John had taken all of this in his stride, so it was a shock to discover during a routine check-up that he had a narrowed aortic valve. “I thought having two heart operations was enough,” he says.

The aortic valve controls the flow of blood leaving the left ventricle into the aorta, and is subject to the greatest pressure of all the heart valves. By 2012, the valve had deteriorated to the point that that John felt permanently tired and breathless. So John had his third episode of open heart surgery, this time to replace the aortic valve.

He recalls the procedure as similar to that carried out in 1993 – the surgeons cut along the same scar in his chest. But compared with 1959, he says: “The differences are dramatic. The surgery, the style of nursing, everything is very different. The first operation was definitely the worst – things are so much better now.”

The best advice I can give is to try to live a life that is as normal as possible

He is full of praise for the hospital teams “whose skill and commitment know no bounds”, as well as all the staff at his GP surgery. He has also relied on the love and care of his wife, Winifred.

John has recovered well from his valve operations but he has heart failure, which means he often feels tired, but he makes an effort to keep active through gardening and walking two miles every day. “I find the great outdoors is good for general wellbeing – not just physically but also the mental benefits of just being out, to listen to the birds sing, and to enjoy the countryside.” He is keen to encourage others who are facing heart surgery.

He says: “I have enjoyed a full working life. The best advice I can give is to try to live a life that is as normal as possible, to go out and do things.”

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