Bob Kleppner: Mitral Valve Prolapse (NeoChord® Trial)

Bob Kleppner knows the importance of trusting your doctor.

“I’d trust him with my life. In fact, I did — twice!” he says.

The 51-year-old from Glenshaw has had two heart surgeries with the UPMC Heart and Vascular Institute surgical team, including a clinical trial for mitral valve prolapse.

The Problem: Heart Valve Problems

Growing up outside Washington D.C., Bob was an active kid.

“I played sports growing up, but I struggled. I was always out of breath. I tired easily. And I never slept very well,” says Bob.

An otherwise healthy guy, Bob never explored the reason causing his general fatigue. It wasn’t until well into adulthood that Bob began to get answers.

In 1986, Bob returned to his city of birth to go to the University of Pittsburgh. After college, Bob made Pittsburgh his home, started a job, and married his wife, Cheryl.

The Path to UPMC for Heart Valve Care

In 2009, Bob found himself at UPMC St. Margaret for an unrelated health issue. Bradley Heppner, MD, a cardiologist with the UPMC Heart and Vascular Institute, reviewed Bob’s medical charts and noticed something of concern.

“Dr. Heppner ran some tests on my heart valves, and found out I had a bicuspid aortic valve,” Bob says.

A healthy heart’s aortic valve has three flaps, called cusps or leaflets. These cusps open and close to allow blood to flow out of the heart but not back in, ensuring forward flow only.

With a bicuspid aortic valve, the heart valve has only two cusps and may not open and close properly. The disease can either restrict forward blood flow or cause blood to flow backward into the heart.

Only about 2 percent of people in the U.S. have bicuspid aortic valve, with it being more common in males.

Most people who have bicuspid aortic valve also form aneurysms (bulges) in the ascending aorta. The aorta is the largest blood vessel in the body. It sends blood out of the heart to the rest of the body.

People with bicuspid aortic valve, including Bob, are born with the problem. But it often doesn’t present itself until much later in life, either when symptoms occur, or a doctor detects a heart murmur.

“I went 42 years without knowing why I was always tired. Dr. Heppner reviewed my chart for two hours and found a reason,” says Bob.

The Solution: Aortic Valve Surgery and a Mitral Valve Prolapse Clinical Trial

As time went on, Dr. Heppner kept a close eye on Bob’s bicuspid aortic valve and ascending aorta.

In 2014, Bob’s ascending aorta had become severely enlarged, causing a life-threatening risk of a ruptured aneurysm or aortic dissection. And his bicuspid valve had narrowed greatly.

Dr. Heppner suggested it was time Bob think about surgery.  

Open-heart surgery and follow-up care at UPMC

Doctors performed an open-heart technique to replace both Bob's valve and his aorta. Bob spent a little less than a week in UPMC Shadyside, before going home.

After a successful surgery, Bob routinely met with Dr. Heppner.

During a follow-up echocardiogram a few years later, Dr. Heppner found Bob now had mitral valve prolapse. The mitral valve is between the heart’s upper and lower left chambers (the left atrium and left ventricle).

During mitral valve prolapse, the mitral valve weakens and leaks, with blood flowing backward from the ventricle to the atrium.

Dr. Heppner suggested that Bob once again meet with the heart valve team.

NeoChord® trial for mitral valve prolapse

The team presented Bob with a unique option — a clinical trial for people with mitral valve prolapse.

He'd be the first person to take part in the brand-new NeoChord® trial. Bob met all the necessary criteria.

Bob and his wife discussed his options, and Bob agreed to be patient #001.

“My wife and I did our research when they came to me with this option,” says Bob.

But Bob’s biggest deciding factor ended up being the faith he had in his care team.

“I think the biggest reason I was so willing to do the trial was the team at UPMC. I had complete trust in them and their skills.”

The NeoChord trial aimed at treating mitral valve prolapse without stopping the heart, compared to standard open-heart surgery.

Bob had the operation in December, where doctors repaired the mitral valve while Bob's heart was beating.

The team used a tiny keyhole incision and 3-D echocardiography to allow for real-time, image-directed placement of new artificial chords. The chords suspended the mitral valve into its proper place and got rid of the prolapse that was making Bob so sick.

After the surgery, Bob only spent about 48 hours at UPMC Shadyside before going home.

The Result: Living a Healthy Life

Now 18 months later, Bob is back to living a healthy life.

“I work out all the time now. I have more energy than ever before,” he says.

Bob and his wife enjoy going on vacation and living their lives together.

When asked about the decision he made to be part of a trial, Bob said:

“I feel that taking part in a clinical trial means you're not only helping yourself, but also helping others.”

Bob remains grateful for the trust he placed in the team at UPMC Heart and Vascular Institute and the cutting-edge research at UPMC.

Bob's treatment and results may not be representative of similar cases.

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