Rose Joubert

Rose Joubert: Heart Valve Repair for Aortic Valve Stenosis has Rose Singing and Cooking!

Rose Joubert loves to cook and sing. But aortic valve stenosis is a cruel disease to active people, sapping them of both stamina and strength. Joubert finally admitted to feeling sluggish and no longer able to sustain activity for very long, making even small dishes difficult, if not impossible. She thought her trouble might have been related to her loss of kidney function in 2004 and her subsequent three-times-a-week dialysis. “I thought, maybe this is just part of what’s going to happen to me,” Joubert explained.

Joubert also suspected the problem might have something to do with her heart because her mother had needed a triple-bypass operation when she was 87, but Joubert was only 70. “I couldn’t walk from the bedroom to the den without getting extremely tired,” Joubert said. “I’d feel like I’d been running a race, even when I was just walking to the car from the front door.” A Houston-area nurse, Linda James, suggested Joubert see Dr. Adnan Yousuf, a family medicine doctor at Houston Methodist. Joubert’s daughter, Bridgette Joubertjames, explained her mother’s problems to Dr. Yousuf. After evaluating Joubert himself, Dr. Yousuf referred her to Houston Methodist cardiovascular surgeon, Dr. Basel Ramlawi, who specializes in heart valve repair and replacement.

Joubert scheduled her first consultation and, in collaboration with interventional cardiologists, Dr. Neal Kleiman and Dr. Stephen Little, Ramlawi performed a series of tests on Joubert to examine her heart and vascular tissue. The diagnosis was aortic valve stenosis, a narrowing of the valve that sits between the heart’s left ventricle and the aorta, the body’s biggest blood vessel. This is a relatively common problem as people age, with the aortic valve narrowing (stenosis) and causing the heart to exert significantly more stress in order to pump blood to the rest of the organs. Eventually, patients develop symptoms like fatigue, shortness of breath, chest pain or fainting. If not treated in a timely manner, aortic valve stenosis can lead to heart failure and sudden death.
Joubert’s doctors explained that, due to multiple risk factors, open heart surgery to repair the valve would be too risky. While Joubert had two strikes against her – age and being on dialysis – Dr. Ramlawi suggested another approach. Houston Methodist had recently acquired a semi-synthetic valve, called the Sapien, which is put in place via a procedure called transcatheter aortic valve replacement (TAVR). Instead of relying on open-heart surgery, doctors move the valve through a small incision near the femoral artery, up through the aorta, to the problem valve. Once in place, the valve is expanded and begins working immediately. “Things were not going to get better by themselves for Rose,” Ramlawi said. “To see if this valve would be right for her, however, we needed to make sure it was safe for her.”

Joubert visited Houston Methodist several times over the next weeks to undergo tests prior to the actual valve replacement procedure, which went perfectly. After a day in intensive care, Joubert already found she had the strength to sit up. “I didn't have any pain,” Joubert said of her brief time in the ICU, “Just a little discomfort.” When Joubertjames first saw her mother after the procedure, said she found her in a chair rather than in bed. “I came back to the hospital and found her talking and laughing with the nurses,” her daughter recalls. “I was amazed.”

Nurses worked with Joubert to get her on her feet and walking, which is now standard procedure for most cardiovascular surgery patients. “I had some help,” Joubert said. “But I was able to get up and down the hallway with a walker, which is more than I’d been able to do for two or three months.” Joubert was released from the hospital just four days after the procedure (open-heart surgery patients typically remain in the hospital for five to ten days) and was already looking forward to cooking her famous creole chicken and resuming her singing.