Learning to cope.

 

First and foremost, I want to thank all the many friends and acquaintances for their messages consoling me on my loss. Your messages were really comforting.

We have just ended the seven days of mourning, the ‘Shiva’ and I am gradually returning to my daily routine. However, it won’t be the same without Roni.

At home, everywhere I turn there’s something that reminds me of her.

Roni’s dexterity was legendary. In later life it was in various handicrafts- knitting, sewing and embroidery. As a young teenager she earned the title of Ein Harod’s cotton picking queen. That was before the advent of the modern cotton harvester. One of our neighbours told us how Roni picked far more cotton than anyone else in the kibbutz.

In those days, the names of all the cotton pickers and the weight of the cotton they picked were posted on the kibbutz notice board. It was a way of ‘encouraging’ people to work harder. In effect it was what we now call ‘shaming.’ Roni was always top of the list way above everyone else.

 About eighteen months ago I wrote, “I’m back and recuperating after a brief hospitalisation with a new lease on life. I spent a few days in the Herzliya Medical Centre for the purpose of repairing a malfunctioning aortic heart valve. The procedure employed is referred to as TAVI-Transcatheter Aortic Valve implantation. This ingenious method implants a made-to-measure valve guided through one of the femoral arteries to its exact location. The hour and a half procedure was performed by a team led by Dr. Rafi Wolff and Professor Amit Segev, two of the leading cardiologists specialising in the TAVI procedure.

 A few months ago, my wife was referred to Rafi Wolff by her cardiologist. In her case the procedure was far more challenging. Diabetes along with other ailments required significant changes in the procedure. Nevertheless, Wolff and Segev were prepared to meet the challenge. The procedure was successful and Roni began recuperating well. Then suddenly, there was a turn for the worse and indications that Roni had contracted an aggressive infection somewhere. She was rushed to the hospital where Rafi Wolff personally supervised the treatment administered in the cardiology intensive care ward. All efforts to save her failed and she died surrounded by her loving family.

Roni and I at Niagara Falls (Canada) in better days.

 At this juncture I want to add a few comments about the TAVI procedure.

The Danish inventor of an aortic valve for transcatheter implantation (TAVI) finally gained recognition for his achievement by colleagues within the European Society of Cardiology

Eleven years ago, a stupid idea came home to Denmark. When first proposed it was ridiculed by many cardiologists. Nonetheless, the brilliant innovative procedure saved the life of an 86-year-old man. The idea was for a balloon-inflated aortic valve that could be implanted using a guide wire passing through the femoral artery instead of open-heart surgery. The dying man who received the valve was Jorgen Rud Andersen, the father of the inventor of transcatheter aortic valve implantation (TAVI), Henning Rud Andersen MD.

The success of that procedure, which gave back a robust life to his father, was a personal triumph that closed the circle on a journey that began for Dr Andersen in 1988 in Phoenix, Arizona. Still in training as an interventional cardiologist that year, he was inspired by a presentation of coronary artery stents. Why not make the stent larger and place a valve inside, he asked. No one was listening, so he built such a device himself, patiently bending wires to create a stent and buying pig hearts from the local butcher shop for the aortic valves. He then built a transcatheter delivery device inspired by the Cribier-Letac balloon catheter pioneered in France during the 1980s for balloon aortic valvuloplasty (BAV) by Alain Cribier MD. From conception to proof-of-concept took Andersen just 75 days.

Since its inception in 2007, more than 250,000 TAVI procedures have been performed worldwide, of which 70 000 were performed last year. By 2025, there will be 280 000 such procedures per year.

Further improvements and refinements will undoubtedly revolutionise cardiac surgery.

 

Beni,              20^th of July, 2023.

 

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