AVR surgery scheduled in 3 days. ADVICE NEEDED

[Juliemoon]

Hi everyone,

I'm so grateful to have found this group! I am a 43 yr old single mom, and and up for surgery very soon. . 3 days and counting....Safe to say I'm freaking out. Right now, I'm considering postponing surgery. My AVR is severe/ critical, and I lived with chest pain and symptoms for the past 3 years.

I chose a tissue valve, because I am worried about the coumadin,( I have always been medication sensitive) and also about the clicking noise. I hear every little sound at night, and also really small framed( 98 pounds), so I am thinking it will be even louder.

The tissue valve my surgeon uses is the St. Jude Trifecta GT. I've read here that it's not very quiet either. They also have a cage/stent? around the valve. I'm not sure how this would affect a future TAVR.

The mechanical valve he uses is the St. Jude Regent. I asked about the Medtronic ATM, as it's known to be the "quiet valve", but he doesn't use it. I also asked about the On-x and he said it was BS, or in his words "mumbo jumbo". He is the kind of doctor who is only open to what he uses, and he only uses the 2 from St. Jude. He said he will more than likely reconstruct my aortic root. ? We have done no CT scans, but it seems this is something he routinely does with his patients in order to fit a bigger valve.

I'm guessing that with a tissue valve, I would have 3 surgeries. I'm hoping that TAVR would improve in 10 years, but it's all a roll of the dice.

So my questions are these: Does reconstruction of aortic root make for a longer recovery?
Are there any small framed women out there with a mechanical valve? Has anyone gone through multiple surgeries with tissue valves? If so, would you say it's worth it not to be on the meds?
Does anyone have the Trifecta GT, and are you happy with it?
If your surgeon was only giving you 2 choices, would you see another surgeon or go with his advice?



Thank you in advance for any help with this!!!!

 

[DachsieMom]

Hi! I had surgery at 43, am very small framed female (99 lbs, 4'10"), and have a St Jude. I don't hear the ticking most of the time, but do hear it at night or when it is quiet. I find it comforting (although right after surgery, it occasionally skipped beats - not as comforting! But that regulated for me). My surgeon really trusted the St Jude, and perhaps it also may have been the one that fit me best. I have a 21mm with connected aortic conduit (Dacron, I believe). For my body size, my surgeon said that was quite large - he was pleased to get in a larger sized valve. Coumadin is not a big deal for me. My surgeon did mention that I felt more pain initially because being so small, they needed to spread me open wider to have space to work. He also said younger patients feel more pain. However, you will barely remember it later. Just make sure you ask for extra pain meds before they remove chest tubes (I had chest tubes from the pediatric unit, which were apparently still too big for me).

 

[DachsieMom]

I would also say home test if you can. I work and have young children - no time to get a blood draw! You have to wait three months after surgery for most insurances. I use coaguchek.

 

[pellicle]

This same question is posed over here:

http://www.valvereplacement.org/for...cheduled-in-3-days-any-and-all-advice-welcome

where there are more answers ... I suggest we consolidate and keep the answers in one place.