3rd surgery and risks?

[kevin21]

I know the 97-99% stats on first surgery's but I haven't found figures on multiple surgeries. I've had the VSD closure and then a stenosis procedure, at age 6 and 10.

Do you think this plays that much of a factor in a valve replacement? I'm sure it is a little more risky but I'd imagine the only issues would be scaring inside and the state the other 2 repairs are in.

I'd also suspect that having the root redone also complicates things.

The surgeon mentioned that I have wires in my sternum and acted intrigued but never said anything and I forgot to ask him about it. I doubt that poses a huge problem, maybe it does?? Maybe he needs a wire cutting blade vs a wood blade!!

 

[Granbonny]

Let Nancy asnwer this one

Let Nancy asnwer this one

Joe's had so much done. she is an expert here. Bonnie

 

[Ross]

Every one gets more and more dangerous. Unfortunately, there is no way to predict outcomes. You could go in, get fixed, no problem or it could turn into a real nightmare like mine did.

 

[kevin21]

I'll take door number one please!!

 

[Nancy]

Well, Joe's had 3 valve surgeries, and there is definitely a different risk factor scenario for additional valve surgeries. Joe has also had 2 lung surgeries, and they also pose additional risk for any thoracic surgery. AND he was very debilitated prior to his 3rd surgery.

When we asked his surgeon about the risk factor for him for his 3rd, we were told it is approximately 10 percent, meaning 90 percent to the good.

BUT, that is just a guesstimate, and it applied to Joe.

There is scarring to contend with, adhesions, physical condition of the patient, and condition of the structures being operated on, and one other factor that nobody seems to take into account and that is the wear and tear that such serious surgeries impose on the human body. I'm not sure that is a quantifiable thing. But I know for a fact that it's there and has an affect on the body's ability to recover afterwards.

I think this is a question that you should discuss with the surgeon, and keep in mind that nothing can be a hard and fast fact.

The real question is, "What percentage do I have if I don't go ahead and do this?" And that is the question that Joe knew the answer to. He would not make it if he didn't go ahead and have things fixed up.

 

[ALCapshaw2]

Since your first two surgeries were when you were a young child, I suspect that is far different (and *probably* not as severe an addition risk) from the risk to someone who has had 3 major surgeries as an adult.

Best to discuss this with your surgeon so that he goes in FULLY INFORMED. SURPRISES are NOT GOOD when it comes to surgery.

'AL'

 

[Gail in Ca]

I was at death's door before my 2nd avr, due to a cath that went bad, chf,
blood pressure at 90/19.
My surgeon, very well known, chose to be conservative since my surgery took some time due to the buried stitches from the first avr and just the fact that it was a redo.
I was to have my leaky mitral fixed at that time, but he chose not to.
He told me that when or if I need a 3rd, he would go in thru the rib to replace it. I got the feeling that he would avoid a 3rd sternal surgery if at all possible.
I would think if the risk was really not good, he would've risked doing the fix at that time.
However, I know the risk does increase with each surgery, but many have survived 3 or more.
I hope to be in good health for the next one , if I need it in the future.
I'm sure ones health going into any surgery makes a huge difference in outcome.
Gail

 

[kevin21]

Since your first two surgeries were when you were a young child, I suspect that is far different (and *probably* not as severe an addition risk) from the risk to someone who has had 3 major surgeries as an adult.

Best to discuss this with your surgeon so that he goes in FULLY INFORMED. SURPRISES are NOT GOOD when it comes to surgery.

'AL'

I'd tend to agree with you AL. I did tell him what I had done and gave him some records to show such.

Are the wires in the sternum a problem?

 

[ALCapshaw2]

I seriously doubt that the WIRES are a concern.

One of the Major Concerns on repeat surgeries is Scar Tissue. Also, they have to be VERY CAREFUL as the heart is no longer in it's protective sack and may even be attached to the sternum so I *assume* (we all know what that means) they REALLY have to be careful making the final cut to the bone.

Your surgeon can give you a much better explanation than I.

'AL'

 

[Nancy]

I should have mentioned that Joe's third heart surgery was through the side using the HeartPort method, and avoiding another sternum surgery. It worked out very well for him using this method. Gail's post reminded me to add this.

 

[Scottie]

Hi Kevin

Hi Kevin

I have had four OH surgeries ...two as a child , one as a teen and one two years ago ...the statistics worried me too ...in fact everything worried me ...however the Drs told me that without the surgery I had in their estimation about three months left ....so I reckon the risk was worth it ....three of my cuts were front breast bone and one across the front ...I do resemble a rail road map ...however ...
the Drs did say that the last surgery took longer because of previous scar tissue ...but I seemed to suffer no ill effect because of this.
Good luck
Scottie

 

[liamty]

Over here Drs don't concider further surgery until there is no other option. I would think a repair would be better done whilst the patient was younger and not suffering dire symptoms. One would think that recovery would be quicker, but not so say our proffessionals. Further surgery, in particular, should be put off as long as possible.....the risks of any surgery get higher the more times performed. Our Dr also mentioned the wiring of the chest, it apparantly can make for longer surgery and more tricky to rewire. We've been advised future work can hopefully done by keyhole.

 

[Gail in Ca]

In my case the wires were a concern that they didn't know about going in.
My previous surgeon was proud of the fact that he had buried the wires so well so I no spiral bound notebook effect, as I was skinny.
But, as it turned out, that really was not the best way to go since he knew I would need a redo, because he put in porcine the 1st time.
My 2nd surgeon mentioned how difficult it was to remove those buried wires.
After my 2nd surgery, about 8 mos later I had all my wires removed because they were poking up and really bothering me.
Gail

 

[brendamarlene]

Gail, I will need a redo within the next year. First time was a homograft. Will probably go mechanical this time. How much more difficult was your recovery after your second surgery? Also, I know the risks are greater, too. I also have wires from the first surgery. I think I will go back to my original surgeon for the redo???

 

[Debrinha GT]

I'm having a fourth!

I'm having a fourth!

Hi Kevin, I started having heart surgeries at the age of ten due to rheumatic fever and well, going for my fourth sometime in the future. I've had three MVRs(replacements) with tisuue valves and now after just over eight years here I am again, trying my best to live with the same fear as you. Unfortunately, we don't have much choice in this case and that's why I make sure I live my life to the fullest and hope for the best. I've learned the hard way that worrying about it and becoming obssessed can only make matters worse so, although I don't feel very comfortable with my situation, I try to lead a normal life and leave the rest up to God and the doctors. Getting all the information and being here on VR has made a big difference to how I've been facing things and that's it! I hope that by the time I have to go under the knife again, I'm well prepared in all senses and everything will be just fine and I can sail through it.

Débora from Brazil

 

[ticktock]

Kevin
Hi and the best of luck to you. I have had 4 OH's... ages 6/16/23 and 44. They get more complicated with each surgery, the wires and the scarring being primary concerns. Three of mine were done through the sternum, the fourth is a thoracotomy (under the left breast, under the arm, and up to the shoulder blade). The did this to avoid going through the sternum again, as Al said above, due to scarring. The heart sometimes adheres to the bone, and is difficult to displace. HOWEVER, this is less likely in young persons, due to their activity level and movement tends to discourage adhesion.

Mine were all valves, aortic. I now have a titanium, take Coumadin and am perfectly at peace with that. Prior to surgery I was given my chances of survival without repair, and that pretty much took the decision making anxiety away. There was no decision. In a way, I'm glad there wasn't a choice, cause I don't know what I would have said. BUT, I am active, 49 years YOUNG, and my Doc says I look darned good to be so "sick".

I refused to consider the possibility that I wouldn't make it through the fourth surgery. Not consciously, I am just a Pollyanna at heart. I kept a very positive attitude, expected the best and prayed alot. You can do it. The risks are always there, as they have been always for all of us. Keep your chin up, and go forward like you know what you are doing. Sometimes, there is no other option.

The very best to you, you are in good company here on the Board.

 

[Gail in Ca]

To BrendaMarlene

To BrendaMarlene

Your ?, how was the recovery time for the redo...
I was much sicker going into the 2nd surgery, at death's door according to my surgeon, but I would have to say the recovery time wasn't worse than the 1st avr. Actually, I was released from the hospital 3 days sooner after the 2nd surgery. I was 46 vs 34 so of course that made a bit of a difference ,too. But, I was always exercising. I think the total recovery time was more, as I really felt good about 4 mos after the 2nd surgery and I think I was feeling better much sooner after the 1st, say 2 mos.
I didn't use the same surgeon because he had moved to another state.
Otherwise, I probably would've used him again. But, I was very happy with my redo surgeon, he did a great job and I liked him.
Gail

 

[brendamarlene]

to Gail in CA

to Gail in CA

Thank you for answering. I hope you don't mind ---I have a few more questions.

You said you were on "death's door" according to your surgeon, yet you also said you had been exercising. I hope it is not rude of me to ask, but how did you become so sick before having the reop? This is relevant to me because I am trying to decide how soon I should have my reoperation. My original surgeon suggests within 6 months to a year, or sooner if I develop symptoms.

Right now, I am pretty asymptomatic, except for some increasing fatigue, which may be from just "getting older." So I am thinking perhaps having the reop this spring, 2004.

The timing factor that complicates things is planning my daughter's wedding. Originally, we thought the wedding might be Labor Day 2005. But now maybe we should have the wedding December, 2004, BEFORE I have to have surgery. Then, I worry that if my symptoms may get worse, earlier surgery would conflict with a December wedding. Decisions. Decisions.

What confuses me also about the timing, is that right before the first surgery, I was playing competitive tennis, and yet it turns out my valve was critically stenotic. That's scary.

Again, thanks for advice from anyone who has had reoperations

 

[brendamarlene]

to Gail in CA

to Gail in CA

Oops, sorry, Gail, I just went back & reread where you said in a previous post that you had a cath that went bad, so that's why you were in bad shape.

Had you been exercising right up until that cath? I assume they thought you needed a reop and that's why a cath was done. Were you having symptoms?

Again, what's so scary to me is that I was pretty asymptomatic the first time (no dizzyness, no fainting, just some shortness of breath on vigorous exercise) and yet evidently after they got in there, I had really needed the surgery. And I think it's the same now---I still exercise a lot, though I no longer play competitive tennis.

 

[brendamarlene]

statistics???

statistics???

Kevin, you state you have not found any stats on reops. Has anyone? I understand that there are so many factors involved. Just wondering.

Also, I was wondering (too much wondering, I know)---is it more difficult doing a reop on an aortic homograft or an aortic mechanical or does it matter? Anyone know?

Anybody find any info written (for laymen) about reops?