Anyone who watches Ronny Turiaf play basketball can plainly see he puts his heart and soul into each game. But fans may not realize that a life-threatening heart condition nearly ended his professional career before it began. His own health scare and successful open-heart surgery inspired the New York Knicks center to become a passionate advocate for heart-health awareness.
After a stellar college career at Gonzaga University in Spokane, WA, Ronny was selected by the Los Angeles Lakers in the second round of the 2005 National Basketball Association (NBA) Draft. A routine physical examination turned up a heart abnormality, and an echocardiogram confirmed there was a bulge in his aorta right at the root, where the artery connects to the left ventricle of the heart (see box on page 7 for more information). The condition was deemed serious enough to require surgery.
Figure. Ronny and hi...Image Tools
“My surgeon gave me two choices — not play basketball again and do limited physical activities, or have surgery. It was impossible for me to stop playing basketball and not continue to help my family,” says Ronny, who had left his home on the French island of Martinique at the age of 14 to play high school basketball in France. He chose the surgery without hesitation.
Though the Lakers voided Ronny's contract, the team paid for his surgery without knowing whether he would ever be able to play as a professional. On July 26, 2005, about a week after the diagnosis, Craig Miller, M.D., Professor of Cardiovascular Surgery at Stanford University, performed the six-hour open-heart surgery procedure to replace the swollen section of the aorta with a tubular Dacron polyester graft.
That pre-season physical may not just have saved Ronny's career, but his very life. Two tests conducted a month and a half apart found that his aortic root had grown to a dangerous size. An enlarged aorta — also referred to as an aneurism when it reaches a certain size — is generally an inherited condition and, left untreated, may rupture and lead to sudden death. Tall athletes, such as basketball and volleyball players — Ronny is 6' 10” and 250 pounds — are roughly 10 times more likely to have this condition than other athletes.
“The vast majority of people are not aware of the condition. The dilated aorta is often discovered during an X-ray, CT [computed tomography] scan, or echocardiogram for other reasons,” explains Prediman Shah, M.D., Director of the Cardiology Division at Cedars-Sinai Heart Institute in Los Angeles.
A FASTBREAK TO RECOVERY
Ronny didn't tell his family about the diagnosis until two days before the surgery. “Everything happened so fast, I didn't have time to think about the magnitude of my heart condition,” he says. “I waited until the last minute so my mom, Aline, had no time to get mad.”
Aline, who travelled from Martinique to be with her son, says (through an interpreter), “I was shocked when I found out Ronny had a heart problem, and I was very scared when he had heart surgery. Ronny is a fighter and very strong. I knew he would overcome.”
Since aortic dilation has a high tendency to run in families, she said that Ronny's family has been screened. Aline, Ronny's father, Georges Louis, and his three younger sisters, Elodie, Florence and Rachelle, are all OK.
Ronny was in the intensive care unit for two days and in the hospital for about one week before heading home to Spokane. Aline went with him to help him get back on his feet. “It was a long process, but every day, things got a little bit easier, and Ronny got a little bit stronger,” she says. Ronny adds: “I had tremendous love and support from my mom, three sisters, and dad as well as the Gonzaga basketball community, who provided food and rides for my mom to go shopping.”
The post-surgery recovery included a prescription for him to walk on a flat surface for five minutes four times a day. “Thinking I'm a good athlete, I decided to push myself and walk up a hill,” he says. “I felt sick, and had a big headache for 72 hours. After that, I never did more than the doctor said I should.”
As part of his rehabilitation and to get back into playing form, he signed as a center-forward with the Continental Basketball Association's Yakama Sun Kings, and then re-signed with the Lakers on January 17, 2006, less than six months after his surgery. “Dr. Miller was not surprised at how quickly I recovered. He told me, ‘As soon as I fix you, you will be able to play basketball on a limited basis four months later,’” says Ronny.
As long as the aortic graft functions properly, Ronny does not need to restrict his activity, says Shah. “His long-term outlook is good. These grafts last 20 years or more.”
AN ASSIST FOR HEART HEALTH
Ronny was traded to the New York Knicks for the 2010–2011 season, and Knicks team physician, Lisa Callahan, M.D., oversees Ronny's care, which includes an exercise stress test and echocardiogram before and after the season. Ronny takes no medications, and he says his doctors tell him there's little likelihood he will need more surgery.
Known as one of the game's most animated and enthusiastic players, Ronny Turiaf played three seasons for the Lakers, then signed a four-year, $17-million contract with the Golden State Warriors in 2008. In August 2009 he established The Ronny Turiaf Heart-to-Heart Foundation to raise awareness about life-threatening heart conditions, and to fund prevention, detection, and treatment for those in need. “I told myself that if I was financially stable enough, I would do whatever I could to help others,” says Ronny.
Ronny has also teamed up with the American Heart Association (AHA). A shot-blocking specialist, he pledged to donate $100 to the AHA for every shot he blocked during the 2009–2010 season as a Warrior. Knee injuries limited him to only 42 games, but he made 54 blocks and rounded up his donation to the AHA at season's end to an even $6,000.
As part of American Heart Month in February 2010, Ronny and his mother filmed a public service announcement with the Alta Bates Summit Medical Center in Berkeley, CA, to promote heart health. In the PSA, Ronny stressed the importance of education and early detection to prevent potentially life-threatening complications. He also collaborated with the AHA to launch an automated external defibrillator (AED) program at a Boys & Girls Club in Oakland, CA. Ronny donated AEDs to five Bay Area high schools and funded the necessary training for students and school administrators.
That same month, the NBA honored Ronny with the NBA Cares Community Assist Award, in part for his ongoing advocacy efforts and fundraising for heart conditions. The NBA donated $5,000 on behalf of Ronny to the AHA.
Figure. Ronny was a ...Image Tools
On May 19, 2010, Ronny participated in the AHA Lobby Day Luncheon in Sacramento, CA, joining more than 200 AHA advocates to support Assembly Bill 2705, which would increase the number of students who participate in moderate-to-vigorous physical activity during physical education classes by the start of the 2013–2014 school year. Ronny also spoke about the importance of AED machines and CPR training, and presented the AHA with a $20,000 donation.
In September 2010, Ronny served as the spokesperson for the AHA's Start! Heart Walk 2010. The Start! Heart Walk is the AHA's premiere event to raise funds for live-saving research on heart disease and stroke.
Ronny brought his community service mindset to Madison Square Garden. He is working with the AHA to screen high school athletes for heart disease and to put AEDs in schools. He has talked about raising awareness of heart-related issues with the leaders of the Garden of Dreams Foundation to brighten the lives of children facing such devastating problems as life-threatening illness, homelessness, poverty, foster care issues or tragedy. For instance, this past November, Ronny shot baskets and had lunch with a 12-year-old boy who recently had a heart transplant.
Ronny runs the basketball court with the same intensity and intelligence, says Knicks Coach Mike D'Antoni. “He's a mover, and on the defensive end he does a great job guarding the basket. He's a very smart player and is a big part of the team.”
As an athlete who was unaware that he had heart disease until a doctor told him, Ronny knows that seeing your doctor regularly is a very important component of heart health, in addition to being a non-smoker, eating a healthy diet and getting lots of physical activity. He urges everyone to “get regular check-ups to find out if you have heart disease and how to treat it.”
THE ROOT OF RONNY'S PROBLEM
The largest artery in the body, the aorta arises from the left ventricle of the heart and extends into the abdomen, where it then gives off branches to both legs. It is the largest and most important artery in the body. Each time the left ventricle contracts, oxygenated blood that has been received from the lungs is pumped into the aorta and is carried to the rest of the body through its many branches.
In Ronny Turiaf's case, the aorta was swollen at the root where the aortic valve connects the artery to the left ventricle. Normally, the aortic root is about 3 cm or less, but its size varies depending on a person's gender, weight and height. A big man like Ronny would tend to have a larger aortic root. But the size of Ronny's aortic root was abnormal and if it continued to enlarge, he could have suffered a tear in the wall of the artery (dissection) or a rupture that could cause massive internal bleeding. Both conditions are often fatal — Richard Holbrooke, the Obama administration's special envoy to Pakistan and Afghanistan, died in mid-December after an operation to repair an aortic dissection.
Aortic root enlargement is generally caused by congenital heart disease or other genetic conditions. These include: bicuspid aortic valve (one of the three flaps making up the valve is missing); Marfan syndrome (a connective tissue defect that causes weakness in the walls of the aorta); Loeys-Dietz syndrome, a connective tissue disorder; vascular type Ehlers-Danlos syndrome, which is due to a defect in collagen; and other familial syndromes for which a specific genetic defect has not been found.
The risk of dissection or rupture is related to the size of the root, as well as to how quickly the swelling increases. If your aortic root is slightly above normal size, your risk of rupture is about eight percent a year. But if the root doubles in size, your risk increases to 20 percent per year. “In some people, the aortic root grows by 0.5 to 1 cm in a year, which would be a significant risk. The more rapid the advance, the more dangerous it is,” says Prediman Shah, M.D., Director of the Cardiology Division at Cedars-Sinai Heart Institute in Los Angeles.
If you have an enlarged aortic root, your doctor will likely do imaging tests, such as an echocardiogram, CT, or magnetic resonance imaging (MRI), every 6 to 12 months. When the aortic root grows to 5-5.5 cm, doctors will recommend surgery to remove the enlarged portion of the aorta and replace it with a graft, says Shah. If an aortic valve is also damaged, that, too, is replaced. Preliminary research has suggested that the rate of growth of the aorta in some of these conditions might be decreased by medications, according to Shah. He explains that the combination of two high blood pressure drugs — a beta blocker and the angiotensin receptor blocker, losartan — may slow the rate of enlargement, but more research is needed to confirm these preliminary findings.
For more information about congenital heart defects, read “With Recent Scientific Advances, More Kids Can Live With Congenital Heart Disease” at http://tinyurl.com/HI-Congenital-Heart-Disease.
© 2011 American Heart Association, Inc.