Stenosis vs. regurgitation - any difference post-op?

First of all I should thank you all again for the wonderful support I've been receiving in this forum, as I move along my valve replacement journey, so to speak. One thing I've noticed (and it's just a perception, I haven't tried to do any number crunching on that) is that most people posting here who went through aortic valve replacement had valve stenosis by the time of surgery. Since I have aortic regurgitation, which hasn't had yet a clear impact on my daily life (maybe because my EF is still 64%, I guess), I wonder if the recovery will be in any way different as well.

I also ask that because, while talking to the surgeon yesterday, he mentioned the healing of the sternum as the major challenge post-op, while he said that the heart would immediately benefit from the non-leaking valve. I fell that it's not what I've read here - I had previously understood that the heart does need time to adjust to the new valve, even it being more efficient. On the other hand, I wonder if the facts of: 1. me having no stenosis; 2. being still relatively asymptomatic and 3. having a good cardiac performance despite the leaky valve (VO2 max in the high fifties) should point to a faster recovery. Curious if anyone who had only regurgitation before surgery can chime in...

Finally, on a side note, the surgeon does not think I'll need rehab. I can certainly start walking and increase the effort level by myself, but I wonder if I'll be missing on other types of exercises (breathing, physio, etc.). Any thoughts on that?

Hi

I can't personally speak to your first part (as discuss next) however on this:

JoeWanderer said:

Finally, on a side note, the surgeon does not think I'll need rehab. I can certainly start walking and increase the effort level by myself, but I wonder if I'll be missing on other types of exercises (breathing, physio, etc.). Any thoughts on that?

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When I had my first surgery in 1974 there was no such thing, I was quite young and significantly less active than other 10yo's but about equivalent to the other nerds and geeks (such words didn't exist then either). I'd say that after surgery it took me about 4 or 5 years to gradually lift my fitness by myself.

Equally at surgery #2 again, no such thing but by then I'd developed an interest/regular involvement in some sports and was keen on bushwalking / hiking as well as cycling and motorcycling. My fitness improved before the surgery, but fell off in the year approaching it. Again there was only me and my desire to get stronger and better at work here.

At surgery #3 I think I recall someone mentioning it, but as I had my surgery in Brisbane (Capital city of Qld) and lived in Southport (about 70km) nobody mentioned to me about enrolling in anything.

So back then it was "fix it up for you, then its up to you" to make the most of it or not".

I'm not a "spoon fed" sort of guy and so I always made the most of it.

The thing I learned was to listen to my body and learn the difference between (metaphor follows) "stretching a muscle sort of discomfort VS damage to a joint sort of discomfort" ... my personal approach to this was to always push, but not "over push".

Combined with later technical developments I was able to improve my fitness by using tools to monitor my HR on bicycle rides (think starting at 4km and gradually over a year or two getting up to 27km) and charting (in a book, with graph paper and a pencil) my average and max HR's as well as time in zone and notes on how I felt.

Some people need spoon feeding and for them I believe Cardiac Rehab is a good thing, others are more self driven and data detail oriented and may no benefit from (I don't think at least) cardiac rehab.

If its there and convenient, take it, if not then just do it right.

Best Wishes

JoeWanderer said:

alking to the surgeon yesterday, he mentioned the healing of the sternum as the major challenge post-op, while he said that the heart would immediately benefit from the non-leaking valve.

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I agree with your surgeon. I had aortic regurgitation before I had a mechanical On-X aortic valve installed. I was told that the heart repairs itself in a few months because the tissue grows fast. I also had a full sternotomy, which took 3 months before I could even begin to lift heavy objects, because bone heals slowly.

JoeWanderer said:

the surgeon does not think I'll need rehab.

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I've been very active all my life, so I know how to exercise. I still found cardiac rehab worthwhile. For example, they had me using a 6 lead EKG monitor during exercise, which showed an afib incident that I thought was just fatigue. My cardiac rehab included some classes where I learned some new exercise ideas, and I learned how to eat better.

Joke: The downside of cardiac rehab is that I now read labels in the store, see what is in some foods, and then I stop eating those items!