{"id":2444,"date":"2015-06-25T19:21:33","date_gmt":"2015-06-25T19:21:33","guid":{"rendered":"http:\/\/[caption%20id=%20align=alignright%20width=631]"},"modified":"2018-01-22T17:29:33","modified_gmt":"2018-01-22T17:29:33","slug":"heartening-journey","status":"publish","type":"post","link":"https:\/\/magazines.uthscsa.edu\/mission\/heartening-journey\/","title":{"rendered":"Heartening journey"},"content":{"rendered":"<figure style=\"width: 631px\" class=\"wp-caption alignright\"><img decoding=\"async\" class=\"wp-image-3073\" src=\"https:\/\/magazines.uthscsa.edu\/mission\/wp-content\/uploads\/sites\/20\/2015\/06\/castillo_DSC_006.jpg\" alt=\"Andres Castillo Jr. helps his son, Andres Castillo III, with homework. \" width=\"631\" height=\"452\" \/><figcaption class=\"wp-caption-text\"><strong>Andres Castillo Jr. helps his son, Andres Castillo III, with homework.<\/strong><\/figcaption><\/figure>\n<p><span class=\"drop-caps\">A<\/span><span style=\"font-size: 18pt;\">ndres Castillo Jr. was born with a hole in his heart.<\/span><\/p>\n<p>At age 2, he underwent his first major heart surgery to repair the hole\u2014an atrial septal defect. Seven years later, his first pacemaker was implanted\u2014a box the size of an old VHS tape, visible under his shirt.<\/p>\n<p>He tried to live a normal life, though his teenage years and young adulthood were marked with repeated hospital stays and countless heart procedures.<\/p>\n<p>\u201cEvery year, my doctors wrote notes to the school saying I couldn\u2019t do anything physical,\u201d he said. \u201cI really wanted to play dodgeball and do what the other kids did. The doctors were scared my pacemaker would get hit.\u201d<\/p>\n<p>Castillo was 35 when his tricuspid valve, the door that lets blood enter the heart from the body, narrowed. It took yet another open heart surgery for the tricuspid valve to be replaced with a bovine pericardial valve: a manufactured valve made from the sack that contains a cow heart.<\/p>\n<p>It didn\u2019t last.<\/p>\n<p>By his 43rd birthday, his bovine valve was failing and creating a deadly domino effect on his other organs. With a seventh pacemaker and four decades of surgeries, his options were limited.<\/p>\n<p>UT Health San Antonio doctors, including cardiologist Marc Feldman, M.D., and A.J. Carpenter, M.D., Ph.D., the cardiothoracic surgeon who had performed his valve surgery, considered what to do next. They consulted with Steven R. Bailey, M.D., interventional cardiologist.<\/p>\n<p>They all agreed: He wouldn\u2019t survive another invasive heart valve surgery.<\/p>\n<p>\u201cWe knew we had to do something. If we didn\u2019t, he would be dead within six months,\u201d said Dr. Bailey, chief of the <a href=\"https:\/\/medicine.uthscsa.edu\/Cardiology\/index.aspx\">Janey and Dolph Briscoe Division of Cardiology<\/a> at the UT Health Science Center.<\/p>\n<p>Pacemakers had damaged Castillo\u2019s tricuspid valve, he said. When the right tricuspid valve doesn\u2019t work, the liver starts filling with blood and fluid. This condition results in cardiac cirrhosis of the liver. Once one organ shuts down, others can follow.<\/p>\n<p>Castillo\u2019s immediate future looked grim.<\/p>\n<p>\u201cHe would have endured extended stays in the hospital; he would have had no quality of life,\u201d Dr. Bailey said. \u201cThat is no way to live.\u201d<\/p>\n<p>Members of the <a href=\"https:\/\/www.universityhealthsystem.com\/cardiovascular-services\/\">Heart and Vascular Institute<\/a>, a collaboration of cardiologists and cardiothoracic surgeons from UT Medicine and the University Health System, considered a heart transplant, \u201cbut we learned that was not an option,\u201d Dr. Bailey said.<\/p>\n<p>A heart transplant is performed when there is failure of the left ventricle. Castillo\u2019s case was unique because the failure was on the right. This unusual condition required a novel remedy.<\/p>\n<p>They turned to a relatively new device called the Edwards SAPIEN XT Transcatheter Heart Valve, first introduced in the U.S. in 2011.<\/p>\n<p>The Edwards valve consists of an expandable metal mesh cage with bovine tissue within it that expands and contracts like the heart\u2019s natural valve. It is approved by the Federal Drug Administration for aortic or left valve use, but \u201cthere are so few patients with Andres\u2019 right valve problem that research has not been done on use of the Edwards valve on it,\u201d Dr. Bailey said. \u201cThis is where the art of medicine can extend the science.\u201d<\/p>\n<p>[pexyoutube pex_attr_src=&#8221;https:\/\/youtu.be\/3KcuLYBbT0E&#8221;][\/pexyoutube]<\/p>\n<p><em><span style=\"font-size: 8pt;\">Source: Edwards LifeSciences Corporation, image of Transcatheter Aortic Valve Replacement (TAVR)<\/span><\/em><\/p>\n<p>It wasn\u2019t a guaranteed fix and did include some risk. But Castillo, a single father of 11-year-old son Andres Castillo III, said he prayed about it and decided the chance to spend more time with his son was worth the risk.<\/p>\n<p>\u201cSince he was 5 years old, I have been raising him by myself,\u201d Castillo said of his son. \u201cI cherish every day I have with my son. He has made me a better father.\u201d<\/p>\n<p>On Jan. 8, a team of 22 health care professionals at University Hospital inserted the valve into Castillo\u2019s existing bovine valve. The noninvasive procedure used a catheter to push the crimped valve into an expanded balloon.<\/p>\n<figure id=\"attachment_3084\" aria-describedby=\"caption-attachment-3084\" style=\"width: 593px\" class=\"wp-caption alignright\"><img decoding=\"async\" class=\"wp-image-3084\" src=\"https:\/\/magazines.uthscsa.edu\/mission\/wp-content\/uploads\/sites\/20\/2015\/06\/castillo_DSC_164.jpg\" alt=\"On Jan. 8, a team of 22 health care professionals\u2014including interventional cardiologists Steven R. Bailey, M.D. and Marvin H. Eng, M.D., and cardiothoracic surgeons A.J. Carpenter, M.D., Ph.D.,  and Edward Sako, M.D., Ph.D.\u2014turned to a relatively new device to extend Castillo\u2019s life.  \" width=\"593\" height=\"460\" srcset=\"https:\/\/magazines.uthscsa.edu\/mission\/wp-content\/uploads\/sites\/20\/2015\/06\/castillo_DSC_164.jpg 1000w, https:\/\/magazines.uthscsa.edu\/mission\/wp-content\/uploads\/sites\/20\/2015\/06\/castillo_DSC_164-300x233.jpg 300w\" sizes=\"(max-width: 593px) 100vw, 593px\" \/><figcaption id=\"caption-attachment-3084\" class=\"wp-caption-text\"><strong>On Jan. 8, a team of 22 health care professionals\u2014including interventional cardiologists Steven R. Bailey, M.D. and Marvin H. Eng, M.D., and cardiothoracic surgeons A.J. Carpenter, M.D., Ph.D., and Edward Sako, M.D., Ph.D.\u2014turned to a relatively new device to extend Castillo\u2019s life.<\/strong><\/figcaption><\/figure>\n<p>\u201cYou get the equivalent of a new valve without having surgery,\u201d Dr. Bailey said.<\/p>\n<p>Dr. Bailey is cautiously optimistic about Castillo\u2019s prognosis. Before the valve procedure, Castillo\u2019s liver had already begun to fail and other organs were following suit. Dr. Bailey said he is hopeful that treating the right valve will improve his overall health.<\/p>\n<p>\u201cIn all reality, we don\u2019t know. In patients who have had similar problems with their tricuspid valve, this returns them to normal status. The only thing wrong with him was that right valve,\u201d he said.<\/p>\n<p>Castillo still struggles to climb the stairs to his second-floor apartment. Coughing fits interrupt his speech. A collection of prescription pill bottles lines his tabletops. This is his daily life.<\/p>\n<p>Yet his body is getting stronger. Slowly. And his spirituality remains intact\u2014evidenced by the crosses hanging on the wall in his apartment.<\/p>\n<p>\u201cI take life day by day. I take things slow,\u201d he said.<\/p>\n<p>Dr. Carpenter has helped to save Castillo\u2019s life twice in seven years. She\u2019s seen him fight through prolonged hospital stays and multiple health crises. She is confident that with Castillo\u2019s right tricuspid valve repaired, he will be a candidate in the future for a heart transplant.<\/p>\n<p><img decoding=\"async\" class=\"alignnone wp-image-3090 size-full\" src=\"https:\/\/magazines.uthscsa.edu\/mission\/wp-content\/uploads\/sites\/20\/2015\/06\/castillo_DSC_401.jpg\" alt=\"Andres Castillo III stands behind his father, Andres Castillo Jr., who holds a prescription pill bottle.\" width=\"1500\" height=\"998\" srcset=\"https:\/\/magazines.uthscsa.edu\/mission\/wp-content\/uploads\/sites\/20\/2015\/06\/castillo_DSC_401.jpg 1500w, https:\/\/magazines.uthscsa.edu\/mission\/wp-content\/uploads\/sites\/20\/2015\/06\/castillo_DSC_401-300x200.jpg 300w, https:\/\/magazines.uthscsa.edu\/mission\/wp-content\/uploads\/sites\/20\/2015\/06\/castillo_DSC_401-1024x681.jpg 1024w\" sizes=\"(max-width: 1500px) 100vw, 1500px\" \/><\/p>\n<p>\u201cAndres told me once that his dream was to see his son graduate from high school,\u201d she said. \u201cI would like him to think bigger than that. I think we can help him be here for even more of his son\u2019s life.\u201d<\/p>\n<p>Castillo has struggled with heart failure his entire life. He knows the struggles aren\u2019t over, but neither is his journey.<\/p>\n<p>He has much to be thankful for, he said, including his family that continues to support him and his doctors who haven\u2019t given up on him.<\/p>\n<p>\u201cThanks to all of them and to God, I am doing better,\u201d he said. \u201cI believe God wants me to be here. I have been through so much, but, at a time when others may have said I had no options, these doctors worked together to help me. They saved my life.\u201d<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Andres Castillo Jr. was born with a hole in his heart. At age 2, he underwent his first major heart [&hellip;]<\/p>\n","protected":false},"author":43,"featured_media":3079,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[8,60],"tags":[126],"ppma_author":[279],"class_list":["post-2444","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-features","category-summer-2015","tag-cardiology"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.3 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Heartening journey - Mission Magazine<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/magazines.uthscsa.edu\/mission\/heartening-journey\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Heartening journey - Mission Magazine\" \/>\n<meta property=\"og:description\" content=\"Andres Castillo Jr. was born with a hole in his heart. 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