Deborah Rothstein

Deborah Rothstein knew from a young age that she would face a lifetime of challenges with heart disease. What she didn't know was that she'd find treatment so close to her Cold Spring, Minn., home when she needed it most.

Rothstein, 36, was diagnosed as a child with sitosterolemia — a genetic disorder causing a hyper-absorption of plant fats that leads to an early onset of heart disease. At age 12, she had her first open heart surgery, undergoing an aortic valve replacement at Mayo Clinic.

The surgery was a success and Rothstein's life returned to normal — she went on to college, studied in Japan, married and landed a finance position with a top Wall Street firm. It was while living in New York City that she first visited medical experts to make sure she was well before conceiving a child.

Given clearance by her cardiologist in New York, the Rothsteins tried, without success, to have a baby. Years passed as she tried to regulate her menstrual cycle, a process complicated by the blood thinner she was required to take for her heart valve.

With heavy bleeding lasting as long as six weeks and an episode of internal bleeding caused by a burst cyst, Rothstein was left anemic and in need of multiple blood transfusions. She decided to seek another opinion regarding her health.

This time, she did so at Mayo Clinic. It was in December 1999 while visiting family for the holidays that the Rothsteins saw Heidi Connolly, M.D., a Mayo cardiologist who gave the couple startling news.

Dr. Connolly detected a host of problems with Rothstein's heart — her mechanical valve was severely narrowed by the in-growth of tissue into the opening, she had developed an aneurysm of the great artery (the aorta) exiting the heart and her coronary arteries were severely narrowed — and recommended she undergo open heart surgery.

"There was no question an operation was required," Dr. Connolly says. "Given her past history of cardiac surgery, another operation did carry an increased risk, but we felt there was no choice."

Rothstein describes the visit as shocking. Already under the care of a cardiologist in New York, the Rothsteins were merely seeking alternative options for safely conceiving a child. It was only through a thorough exam required by Mayo that Rothstein's heart problems were discovered.

And although having surgery meant a temporary setback for conceiving a child, Rothstein's potential for having a family looked as if it would be improved after her operation.

"Our whole visit was such an eye-opening experience," Rothstein says. "We were shocked and angry at first, because we really made an effort in New York to see my cardiologist and any specialist recommended to us. We knew we had to keep an eye on my heart valve."

Rothstein was a complex redo case, recalls Kenton Zehr, M.D., her Mayo Clinic surgeon. He replaced her mechanical heart valve and aortic aneurysm with a Human allograft valved conduit (Homograft), which alleviated her need for blood thinner post-surgery. Dr. Zehr also opened her narrowed arteries and sent Rothstein home with a restored heart.

Rothstein said going to Mayo was the best choice she'd made regarding her health. And returning to Minnesota for her surgery gave her added comfort.

"Being back in Minnesota near family and at Mayo where everyone went out of their way to make us feel comfortable really put us at ease," she says. "We felt so blessed to have found this path."

Dr. Connolly says making patients feel comfortable about their treatment is a top priority at Mayo. Doctors have time in their schedules for lengthy consultations with patients and surgeons meet with patients and their families before surgery to answer questions.

"It's critically important that patients understand the available treatment options," Dr. Connolly says. "A treatment decision is made by the patient, after consultation with the cardiologist and surgeon, individualizing management for each case. It's the way Mayo works. We're set up to accommodate patients."

No longer required to take the blood thinner Coumadin after her surgery, Rothstein could again try to conceive a child, this time without danger. She and husband Mathew relocated to Boulder, Col., to seek a new lifestyle. Six months after her January 2002 surgery, Dr. Connolly gave Rothstein the go-ahead to try and have a baby.

Rothstein says she no longer felt the urgency to get pregnant, and anxious to test out her improved heart, she used her new surroundings to get into the best physical shape of her life. Eventually, she began ovulating with normal cycles for the first time in her life.

Now mother to 5-month-old Sydney, Rothstein says she feels better than ever. She hikes, skis, swims and runs without worrying that her heart is at risk, a fear she struggled to overcome before her open heart surgery four years ago.

The one-time finance industry career-woman stays home with her daughter and hopes to have a second child. She plans to return to Mayo for her third open heart surgery, should her Homograft require replacement as expected.

"I am looking forward to running with my daughter Sydney one day," Rothstein says. "I feel really fortunate that although I've had these problems, it's motivated me to take care of myself. I'm at the healthiest point in my life right now."