5 years in and time for 2nd OPH....

[roundsgirl]

Hey gang, some of u may remember may and a lot not. My name is Lisa, I had my first OHS in Jan. 08 and now they tell me it's time to do it again. Scheduled to go into hospital on the 4th of March to start the testing before the surgery, heart catch etc. This has been the worse roller coaster of my life. I never felt good after my first surgery. They told me it was do to Patient Body Mismatch, so they suggested I have gastric bypass to lose weight as my heart has so much pressure on it they want me to take it easy. Even went to Charleston for a second opinion before I did proceed with the surery, it was a sucess, I have lost 127 lbs. Here is the puzzling thing once I lost the weight my echo's started going crazy, gradient pressure went up in six month the peak was 62 and rose to 85. Mean was in 30's rose to 50's. The opening to my valve went for 1.47 to 0.70. Nobody can tell me why. My surgeon will be Dr. Puskas at Emory University. If anyone is familar with him or what has happened with my valve I'd appreciate some input. Thanks.

 

[DebbyA]

Lisa,
I do remember you--maybe because we had surgery about the same time. Sorry I have no insights for you, but I do wish you well the second time. Like yours, my valve won't make it 10-15 years. The cardiologist says within a few years, but so far I have no symptoms. Her insight is "it just happens that way for some people".
I wish you well with the upcoming surgery. Please come back to keep us updated.

 

[kfay]

Lisa, I remember you as well. I remember you having problems almost from the start and I'm sorry that you are going to have to go through this again, but I'm so glad you've lost so much weight. I can only imagine that you have to feel better from that, even though your valve isn't cooperating. I hope this time around they can get a better result for you and that it lasts longer and you feel better right off the bat. Please keep us posted.

 

[nngbwh]

I am sorry to hear. Wishing you the best !

 

[pellicle]

Sorry but I can't shed any light on the issue either. Sometimes all this stuff just doesn't go according to what the experts expect. Which is very disturbing. All I can suggest is to try to cast around for other medical opinions. Perhaps someone else can suggest something which makes sence to you.

Do you have any other information?

 

[ramjet]

I was told that the likely mechanism of failure of the tissue prosthetic aortic valve is a gradual and often observable stenosis or narrowing of the valve. I guess its not so important to know exactly why your valve failure has been accelerated, but your valve haemodynamics have been monitored, and, unfortunately, its time to replace the valve. Now is the time to look foarward, not back, focus on what is ahead and not what has been, the surgery is coming in a few weeks, so focus on getting ready for that, try and avoid getting the flu or getting sick else that will postpone your surgery. Make sure you are taking exactly only those medicines that the doctor knows all about, includng any suppliemnts or vitamins or fish oil etc, (as they may have to be stopped as soon as possible if the doctor/surgeon wants you to), and stay positive, trust the experts, the cardiac echo has spoken, your heart valve has spoken, and now is the time to fix it ....again. Take care and let us know how it all goes.

 

[pellicle]

as an engineer I am often seeking the why. It can help sometimes to know in unexpected ways.

Other than that I reckon Roger Ramjet is spot on with the above analysis

 

[tom in MO]

Per some other discussions, there is not a lot of data on how quick stenosis sets in for younger valvers. From another thread, for people <60, ~30% need a replacement for their tissue valve in 10 years...so for you at 39 yo, 5 years may not be "normal" but not too much of an "outlier."

Often, the younger you are, the replacement tissue valve gets stenosis quicker, for a variety of reasons as of yet not fully explained. I would suggest you discuss with your doctor what type of replacement is best for you.

I had diverticulitus as well and have chronic bleeding issues due to my resultant hemrhoids. I was really concerned about warfarin since at 54, I wanted no more operations and a mechanical valve. I specifically saw my colorectal surgeon for this issue (a young guy...thus up-to-date). He said that my hemrhoids will not be a problem with warfarin...he was right. They go away with Calmol 4 suppositories like pre-warfarin days.

 

[ottagal]

Lisa,
Sorry to hear that you have to go through this a second time around. I was only a year behind you with my surgery and recall your early issues. Congrats to you on the weight loss.
Thinking of you...please keep us posted!
Just an afterthought...have you had either a TEE or other test (angiogram) to confirm the readings from your echo? I would want that confirmation esp. with it being second time around and knowing echos can sometimes be inconsistent.
Sending you positive thoughts!

 

[Rachel]

Lisa,

I'm too "young" (on this forum anyway) to remember you, but it sounds like you've been through a lot! So sorry that you're looking at another surgery so soon since your last one, I'll be thinking of you! Glad to hear that you were successful in losing weight though, that's quite an accomplishment!

Rachel