San Antonio Express-News (Sunday)
Matters of the heart
A novel treatment for a leaky mitral valve helped El Campo couple celebrate their 70th anniversary
When Murray Norman started having trouble breathing in the fall of 2020, he and his wife, Joyce, never expected it to be serious enough that he might need surgery for a leaky heart valve.
The problem was that Murray was not a good candidate for surgery. He was 88 years old and had been diagnosed with Alzheimer’s disease. He was also frail and experiencing pulmonary hypertension. At the time, the couple had been married for nearly 68 years, and they grew worried they may not get to celebrate their 70th wedding anniversary.
“They told us ‘Well, if you were a younger man, we could do open heart surgery on you, but we cannot at this point in your life,’” Joyce said. “And I’m thinking ‘Oh, what are you going to do?’”
Then Dr. Sachin Goel, an interventional cardiologist at Houston Methodist, suggested an alternative. Goel proposed using a device known as a MitraClip to repair Murray’s mitral valve. The minimally invasive procedure, which took place in February 2021, involved Goel accessing Murray’s heart via a vein in his leg.
The procedure helped Murray, now 91, recover so he and Joyce, 90, could celebrate their 70th anniversary on Feb. 21. Three days earlier, more than
100 family members and friends joined them for a party in El Campo.
The celebration included most of their five children, 11 grandchildren, 22 great grandchildren and one great-great grandchild. Joyce dug out her wedding dress and other mementos, including photos from Murray’s time working at NASA and the family cookbook that Joyce started.
“We are so very, very thankful for the last two years. They have just been perfect,” Joyce said. “We have enjoyed every moment of it and still do.”
Whirlwind romance
Murray grew up in Ingleside, outside Corpus Christi. He and Joyce first met as teenagers at a church camp in Oklahoma, where she grew up.
Campers were assigned seats for meals, and Murray and Joyce developed a bond while sitting together. Joyce remembers that Murray was the only camper who enjoyed eating stewed prunes at breakfast, then got sick when he ate too many.
The future couple grew closer the following summer when Murray returned to the church camp and then spent a few weeks working on Joyce’s grandfather’s farm in Oklahoma. They kept in touch for another year through letters, but the correspondence eventually
stopped.
In 1950, Murray was serving in the U.S. Navy and stationed at a base in Tennessee when he reached out to Joyce once again. Her parents told him that she was living in Tulsa, so he wrote to her and asked whether he could visit.
“I hitchhiked to her to see what she looked like again,” he said.
When he finally got to see Joyce again, he told her that he was smitten with her. She felt the same.
“We had so much in common, and we just liked each other,” she said. “It’s been a pretty stickier affair ever since.”
They married in 1953 in Oklahoma, and it’s been a “roller-coaster ride,” Joyce said. On their wedding night, they were staying in a motel in Arkansas
when they heard banging on the door. Several men with rifles burst in and looked under the bed, searching for someone named Elmo. The men quickly left, and it wasn’t until the next morning they learned a prisoner had escaped from a nearby prison.
They settled outside Corpus Christi and had the first three of their five children before Murray was transferred to a Navy base in Alameda, Calif. They stayed there until 1964, when they moved to the Houston area after Murray got a job at NASA. He worked there for more than 30 years, building parts for spacecraft.
“He made parts that
went up into space, and parts on spacecraft and some things that are on the moon,” said daughter Debbie Ehlert.
The couple moved to El Campo in 2011. It was around that time that Murray was diagnosed with Alzheimer’s disease, but medication he received as part of a study at Baylor College of Medicine helped slow its progression.
The couple remained active by going on cruises and traveling across the United States in their recreational vehicle. They’ve now been to all 50 states.
Unexpected problems
Murray started experiencing symptoms of early
heart failure about twoand-a-half years ago. He and Joyce took a walk a day, usually about a mile. One day, though, Murray told his wife that he needed to stop because he could hardly breathe.
They went to see a cardiologist who determined that Murray had mitral valve regurgitation, a type of heart valve disease that’s also known as a leaky valve. The cardiologist referred them to Houston Methodist.
The news came as a surprise to the couple. Murray had dealt with heart problems before, having a pair of stents inserted in 2014. But he and Joyce thought those issues were resolved.
“I don’t think he even realized how sick he was,” Joyce said.
The mitral valve separates the heart’s left atrium from its left ventricle. When it’s working correctly, it opens and closes to allow blood to flow from the left atrium to the left ventricle, then to the rest of the body. Mitral valve regurgitation occurs when the flaps of the mitral valve are not closing properly, allowing blood to leak backward into the left atrium.
“Instead of all the blood going out the door, half the blood is leaking back,” Goel said.
That leakage caused increased pressure in the heart and lungs. That can lead to shortness of breath and, eventually, to congestive heart failure, Goel said.
Repairing or replacing the mitral valve through surgery is the preferred method for treating a leaky valve because the procedure carries a very high chance of success, Goel said. At nearly 89 years old, though, Murray was at higher risk for complications from surgery and an arduous recovery.
Age itself isn’t a risk factor for surgery, but many older patients have other preexisting conditions. They’re also more likely to be frail, which makes recovering from surgery much harder,
Goel said.
“For patients who can have surgery safely, surgery is the way to go. But Mr. Norman was 88 years old when he presented with this problem,” Goel said. “And surgery at that age certainly carries high risk.”
Goel instead recommended treating Murray’s leaky valve with a MitraClip, a nonsurgical option that the U.S. Food and Drug Administration approved for use in 2013. The surgeon inserts a catheter into a vein in the patient’s groin or leg, then uses advanced imaging to guide the catheter to the heart.
The MitraClip is then placed on the mitral valve. The goal is to reduce severe leakage to the point where it’s mild or nonexistent, Goel said.
At first, Murray and Joyce were concerned. But when Goel explained the procedure to them, it put them at ease.
“That really made all the difference in the world,” Joyce said. “I knew he was going to be fine, and it was much easier.”
Goel ended up inserting two clips during the procedure, which took place in February 2021. Murray was able to return home within a few days.
Anniversary party
Murray and Joyce were back to taking their walks a few weeks after he was discharged from the hospital. They still go for walks every other day when the weather is nice, and Murray no longer has trouble breathing.
“I think I have done well,” he said.
Until the MitraClip was approved, there were only two options for patients with mitral regurgitation, Goel said. You either operated on a patient, or you didn’t. The MitraClip has been a game-changer for high-risk surgery patients like Murray, he said.
“This has transformed how we treat these patients,” Goel said. “A lot of these patients were not even referred to surgeons back in the day because they were old and frail, and their doctors didn’t think they would survive an operation.”
Ehlert said she’s noticed the difference the procedure has made for her parents.
“It has tremendously improved their quality of life these last two years,” she said.
Murray and Joyce were still going strong at their anniversary party, surrounded by loved ones and friends. Murray said he enjoyed the party and joked that he “didn’t sleep through it.” Joyce said she’s grateful that she and Murray could celebrate the milestone.
“I frankly thought it was perfect,” she said. “It couldn’t have been any better.”