Asst. Prof. Dr. Chartaroon, a Leading Cardiac Surgeon, and the Life-Transforming Ross Procedure for Heart Valve Surgery
The heart is an organ that never rests, a marvel that has never ceased to amaze Asst. Prof. Dr. Chartaroon Rimsukcharoenchai, ever since her medical student days. In the intricate realm of cardiac surgical conditions, the precision of a surgeon’s “pair of hands” can turn a critical crisis into a curative outcome.
In this edition of MedPark Stories, we take you into the world of a cardiothoracic surgeon whose work unfolds within the human chest cavity. For her, cardiac surgery transcends mere disease treatment; it is about restoring patients to their fullest quality of life.
Cardiothoracic Surgeon Trained at World-Renowned Institutions
Driven by a commitment to excellence in cardiothoracic surgery, Asst. Prof. Dr. Chartaroon Rimsukcharoenchai pursued advanced training with world-renowned experts at premier international institutions, including:
- AATS Graham Foundation Fellowship, University Hospital of Saarland, Germany, under the mentorship of Prof. Hans Joachim Schaefers, a globally recognized authority in aortic valve repair.
- Advanced Adult Cardiac Surgery Fellowship, The Mount Sinai Hospital, USA, under the supervision of Prof. David H. Adams, an internationally acclaimed expert in mitral valve repair.
- Assistant Professor of Cardiovascular Surgery, Icahn School of Medicine at Mount Sinai
“Working alongside world-class mentors has not only refined my surgical skills but also given me a clear sense of direction to hone my expertise, deepen my subspecialty focus, and ultimately deliver the greatest benefit to my patients.”
Through close collaboration with leading cardiac surgeons specializing in valvular heart disease, she developed a firm commitment to pursuing advanced, in-depth training in heart valve surgery.
Heart Valve Replacement vs. Repair: Meticulous Treatment Options
The treatment of valvular heart disease, whether for stenosis or regurgitation, requires individualized consideration in every instance. Like a piece of art, each heart valve has a uniquely distinct anatomy.
“Heart valve replacement is generally less complex, as it involves replacing the entire valve. Valve repair is more technically demanding, as it requires tailoring the procedure to each patient’s unique valve anatomy. However, repairing the native valve often yields superior long-term results; it tends to be more durable, avoids the need for lifelong anticoagulation, and can truly be life-changing for patients.”
“More than a decade ago, I had the opportunity to meet a world-renowned expert in aortic valve repair. At that time, it was a rarely performed procedure. I was instantly inspired and later had the privilege of training under him in Germany. He was a pioneer of novel repair techniques. During my time there, I was fortunate to become one of his close protégés.”
“Later, I had the opportunity to meet another renowned expert in mitral valve repair when he visited Chiang Mai to give a lecture. I had a chance to assist in surgery, and he subsequently invited me to pursue further training in the United States. I consider myself truly fortunate to have learned from the two exceptional mentors.”
Her experience as a cardiothoracic surgeon at The Mount Sinai Hospital provided invaluable exposure to advanced clinical systems, state-of-the-art technologies, and modern surgical instrumentation, particularly minimally invasive techniques and endoscopic-assisted procedures. However, she emphasizes that the fundamental cornerstone remains the surgeon’s technical skill, where precise, dexterous hand-eye coordination must work in perfect harmony.
Ross Procedure: A Highly Advanced “Valve Transposition” Technique Requiring Specialized Expertise
In cases where the native valve damage is beyond repair or too small, yet the patient wishes to retain a living valve, a more advanced alternative is available—the Ross procedure.
This technique involves transposing the patient’s own pulmonary valve (right-sided) to replace the diseased aortic valve (left-sided). The transposed autologous pulmonary valve, being a living valve, can endure the high pressure of the systemic circulation longer and better than bioprosthetic valves. Doctors then replace the pulmonary valve on the right side with an implanted donor valve (pulmonary homograft).
This technique is particularly beneficial for pediatric patients, as a living valve can grow in lockstep with the child, unlike prosthetic valves, which remain fixed in size and become relatively undersized as the child grows.
It is also highly advantageous for young adolescents with a long life expectancy who wish to maintain optimal functional capacity and quality of life comparable to that of healthy individuals.
In Thailand, the Thai Red Cross Society coordinates the procurement of donor valves. Significantly, Asst. Prof. Dr. Chartaroon Rimsukcharoenchai serves as an advisor on heart valve procurement and preservation at the Tissue Bank of the Organ Donation Center of the Thai Red Cross Society.
In addition to her advisory role, she has been instrumental in introducing decellularized tissue technology in Thailand, enhancing treatment outcomes and aligning local practice with international standards.
“In many countries, decellularized tissue preservation is a relatively new approach and is increasingly regarded as a global standard. Preserving tissue in a fresh state, rather than through cryopreservation, also offers greater convenience in terms of transportation and clinical use. For this reason, I coordinated efforts to introduce and implement this technology in Thailand to improve the efficiency of heart valve preservation, storage, and distribution.
Cardiac Surgery: Patient Safety is the Highest Priority
“Death following cardiac surgery should never be considered a matter of misfortune. In reality, patients should not lose their lives as a result of our intervention.”
She places paramount importance on rigorous preoperative preparation. Every patient undergoes careful screening and comprehensive risk assessment, with clear and transparent communication regarding the likelihood of success. When the anticipated risk is unacceptably high, we openly convey the message. Guided by this principle, she believes that the surgery, once decided upon, must not only preserve life but also meaningfully enhance the patient’s quality of life.
Work Hard, Play Harder
Currently, Asst. Prof. Dr. Chartaroon is a cardiac surgeon at MedPark Hospital and a visiting lecturer in the Department of Surgery at the Faculty of Medicine, Chiang Mai University, and Chulalongkorn University. In addition, she serves as an advisor on heart valve procurement and tissue banking at the Thai Red Cross Society.
Outside the operating room, the doctor unwinds by scuba diving, finding both challenge and relaxation in natural settings. She also loves traveling to experience novel discoveries, to the point where her friends often tease her that they would never guess she was a surgeon because her photos are almost entirely of her travels.
And this is another facet of this highly experienced surgeon, a pioneer of innovative techniques in cardiothoracic surgery, driven by unwavering commitment, eagerness to learn, and continuous pursuit of excellence to achieve optimal outcomes for every patient.