Cutting-edge procedure by mends Mick Jagger’s ‘heart of stone’

Mick Jagger of the Rolling Stones performs at the Esprit arena during the Rolling Stones tour "Stones - No Filter" in Duesseldorf, western Germany. Mick Jagger is "on the mend" after a reportedly successful heart valve procedure in New York. (AFP)
Updated 08 April 2019

Cutting-edge procedure by mends Mick Jagger’s ‘heart of stone’

  • Known as transcatheter aortic valve replacement, or TAVR, the method has gradually replaced open-heart surgery
  • Since 2009, 400,000 patients in 65 countries have undergone the procedure

PARIS: When the Rolling Stone’s Mick Jagger underwent heart valve replacement surgery in New York recently, according to media reports the doctor in France who invented the technique took a modest bow.
“I am not especially a fan of the Rolling Stones but I am pleased with the outcome,” Professor Alain Cribier told AFP. “What is moving is to think about all the patients who have benefited from the procedure.”
“I’m feeling much better now and on the mend,” Jagger, 75, wrote on Twitter.
Weighing his words carefully, the soft-spoken cardiologist who pioneered the technique in 2002 doesn’t have the allure of a rock star.
But in his field, many colleagues see him that way.
Known as transcatheter aortic valve replacement, or TAVR, his method has gradually replaced open-heart surgery for repairing the valve that allows the delivery of blood through the aorta.
The most common — and serious — of valve diseases, age-related aortic stenosis occurs when the valve narrows and hardens with calcium deposits.
Valve replacement has historically been done by opening the chest surgically, stopping the heart, and placing the patient on a heart and lung blood machine — all, of course, under general anaesthesia.
More than 200,000 such procedures are performed every year worldwide, according to NewHeartValve, in Britain.
Cribier’s technique, done under local anaesthesia, is minimally invasive by comparison and has far shorter recovery times.
A surgeon or cardiologist accesses the femoral artery with an incision near the groin to insert a catheter fitted with a replacement valve inside a collapsed stent, and a balloon for inflating it.
The new heart valve, once expanded, pushes the old one out of the way and takes over the job of regulating blood flow.
“It has revolutionized patient care in this area,” Montpellier-based cardiologist Stephane Cade told AFP.
Since first performing the surgery in 2002, Cribier had trained dozens of doctors around the world. At first, TAVR was reserved for patients too weak or old to undergo open-heart surgery.
But over the last decade, its use has been expanded to those for whom the traditional approach poses an “intermediate risk.”
Since 2009, 400,000 patients in 65 countries have undergone the procedure, Cribier said.
Those numbers could now expand rapidly.
A study based on clinical trials published in The New England Journal of Medicine last month concluded that TAVR is safer and yields better results for “low-risk patients” as well.
“I must say reading the the study brought tears to my eyes,” said Cribier.
The idea first came to him in the 1980s.
“At the time, we let patients over 75 simply die — we didn’t operate,” he recalled.
After a first attempt to develop a new technique failed, finding one that worked become “an obsession,” he said.
When he finally succeeded, the approach was greeted with skepticism.
“Heart surgeons were completely opposed. ‘Who is this nutcase that’s trying to undercut our work?’,” they asked.
Today, TAVR is performed mostly by cardiologists, not surgeons. But that too could soon change.
“Surgeons are now confronted with the evidence,” Cribier said. “They will start adopting it now.”
One unknown is the lifespan of the new valves, which are made from bovine tissue.
“It has only been in use for a relatively short period — we just don’t know yet,” commented Herve Douard, a cardiologist in Bordeaux.

College golfer in hijab out to blaze trail for Muslim girls

Updated 19 April 2019

College golfer in hijab out to blaze trail for Muslim girls

  • One of the top junior golfers in Northern California coming out of high school, Ahmed was a starter in her first year at Nebraska and the No. 2 player most of this spring
  • She is believed to be the only golfer at the college level or higher who competes in a hijab

LINCOLN: Noor Ahmed outwardly lives her Muslim faith, and even growing up in a state as diverse as California she says she encountered hostility on the street, in school and on the golf course.
One of the top junior golfers in Northern California coming out of high school, Ahmed was a starter in her first year at Nebraska and the No. 2 player most of this spring. She is believed to be the only golfer at the college level or higher who competes in a hijab, the headscarf worn in adherence to the Muslim faith.
Arriving in Lincoln two years ago, Ahmed sensed hesitancy from teammates mostly from small Midwestern towns and unaccustomed to seeing a woman in a hijab. She didn’t feel embraced until an unfortunate yet unifying event roiled the campus midway through her freshman year.
A video surfaced of a student claiming to be the “most active white nationalist in the Nebraska area,” disparaging minorities and advocating violence. The student, it turned out, was in the same biology lecture class as Ahmed.
Teammates offered to walk with her across campus, and one who would become her best friend, Kate Smith, invited Ahmed to stay with her. She didn’t accept but was heartened by the gesture.
“That,” Smith said, “was when she realized how much each and every one of us care for her on the team, that it wasn’t just like, ‘Hey you’re our teammate.’ No, it’s ‘We want you to be safe, we want you to feel at home here.’“
Having grown up in the post-9/11 era, Ahmed, like many Muslims in the United States, has been a target for bullying and verbal abuse. She began wearing the hijab in middle school.
On the course, in an airport or even walking across campus she can feel the long stares and notices the glances. She said she has never been physically threatened — “that I know of” — and that most of the face-to-face insults came before she arrived at Nebraska.
Much of the venom spewed at her now comes on social media. She has been the subject of several media profiles, and each sparks another round of hateful messages. She acknowledges she reads but doesn’t respond to messages and that an athletic department sports psychologist has helped her learn how to deal with them.

Hijabi golfer Noor Ahmed. (AP)

“I’ve been called every racial slur in the book,” she said. “I’ve been told explicitly that people who look like me don’t play golf, we don’t have a right to exist in America, you should go home. It would definitely faze me a little bit, but it never deterred me. I’m really stubborn, so I’m going to prove you wrong, just wait. When people think they’re dragging me down, it kind of fuels the fire in me that I’m going to be a better golfer, I’m going to be a better student, I’m going to keep climbing up the ladder.”
The daughter of Egyptian immigrants is from a close-knit family in Folsom, California, and she steeled herself for the cultural adjustment she would have to make at Nebraska.
She dealt with loneliness and anxiety, especially her freshman year. She had difficulty finding a support network. There is a small Muslim community on campus, but she didn’t immerse herself in it. The demands on athletes are great, and they are largely segregated, eating and studying in facilities separate from those used by regular students.
Nebraska coach Robin Krapfl said she was initially concerned about how teammates would react to Ahmed. Krapfl remembered meeting with her golfers and telling them about her.
“I could tell by a couple of the looks and maybe even a comment or two that they weren’t 100 percent comfortable with that,” Krapfl said. “A lot of our girls come from small-town communities that are very limited in their ethnicity. It’s just the fear of the unknown. They had just never been exposed to being around someone from the Muslim faith.”
Krapfl said she saw a golfer or two roll their eyes, another shook her head. “I overheard, ‘Why would Coach bring someone like that on the team?’ “
“Luckily when she got here people could see her for who she was and the quality of person she was,” Krapfl said. “It took a while. It really did. You’ve got to get to know somebody, who they really are and not just what they look like.”
Smith said she sometimes cringes when she and Ahmed are in a group and the conversation turns to politics, immigration or even fashion, like when someone innocently or ignorantly tells Ahmed that she would look good in a short dress or a certain hairstyle.
“She can never wear a short dress, so why would you want to depict her as that?” Smith said. “You have to respect her beliefs and why she’s doing it. Also, I think a lot of things are connected to women’s beauty standards and how people don’t think she can look beautiful when she’s covered. I think she’s a really beautiful girl no matter how much skin she’s showing.”
For all the challenges Ahmed faced, there have been positives. Some people have complimented her for living her faith as she sees fit, a Muslim teen who golfs in a hijab and lives in the United Kingdom wrote to says she draws inspiration from her, and a player for another college team approached her at an event to tell her she recently converted to Islam and just wanted to say hi.

She started playing golf at 8. (AP)

“I remember going and crying and, wow, I’m not alone out here,” she said.
Ahmed said she’s naturally shy and a bit uncomfortable with the attention, but she hopes Muslim girls coming up behind her are watching.
“I grew up never seeing anyone like me,” she said. “Honestly, I didn’t realize how much grief I was carrying, having never seen an image of myself or someone who looked like me in popular American culture. It’s a big deal.
“Why are basketball and football so heavily African American? If I were black and I saw people who looked like me competing in that sport, that’s probably the sport I would choose. I think it’s really important when we’re talking about trying to make golf and other sports and other areas in American culture diverse, how important it is to see someone who looks like you and how it will fuel other people’s interest.”
Ahmed started playing golf at 8, and her parents encouraged her to take the sport to the highest level possible. Wearing the hijab has never interfered with her game and she has never considered not wearing it on the course.
“I think Muslim women who choose to observe it or choose not to observe it have the right to exist in any space they want to be in,” she said, “and I would feel like I would be sending a message that the hijab doesn’t exist in this place or it shouldn’t, and I don’t feel comfortable with that.”