and will address the issues discussed when I meet the cardiologist at Cleveland Clinic in early December.
Not far away, that's great!!
To me this is a ghastly failure of duty of care to you. I mean its serious enough to require someone at 69 to require a surgery but that this was your second surgery in such a short time should have sent alarm bells clanging.
I hope you get resolutions and if I was you I'd be firmly advocating for myself on this. So to summarise the above (please correct me where I'm wrong):
- the quite reasonable choice was made for a bioprosthesis for your first surgery when you were 64 years old
- this lasted 5 years before some sort of issue caused it to presumably calcify and become stenotic.
- that should have been a shock to your cardiologist and your team (it apparently wasn't, so they're not the sharpest scalpels on the table)
- they proposed another bio and after 7 years that failed ... this slight increase in duration actually isn't inconsistent as due materials variations in bio's and to age (and slightly decreased metabolism associated with increased age)
- now at 76 you are contemplating another surgery
So going forward you need to get that Lp(a) test done and I've got a strong feeling that it will return a number that's high ... very high. Armed with that you can make better decisions on what you should choose and what the risk analysis profile is for whatever valves are chosen.
Also, if you don't already have any arrhythmia then the chances of that being a gift from this 3rd surgery (either presenting in recovery from surgery or in the following years) is very high. I would also ask pointedly what is the chance of requiring a pacemaker as a result of surgery #3 due to damage to SV and or AV nodes on your heart.
Google's Ai summary is pretty reaonable:
The sinoatrial (SA) node and the atrioventricular (AV) node are both groups of cells in the heart that control electrical pulses and are part of the heart's conduction system:
- SA node
Also known as the heart's natural pacemaker, the SA node generates electrical signals that cause the atria to contract. The SA node is located in the right upper chamber of the heart. In a normal adult heart, the SA node causes the atria to contract about 60 to 100 times per minute.
- AV node
The AV node acts as a bridge between the atria and ventricles, passing electrical signals from the atria to the ventricles. The AV node is located in the posteroinferior portion of the interatrial septum.
https://www.hopkinsmedicine.org/hea...-and-function-of-the-hearts-electrical-system
I would sack your cardiologist immediately, they are clearly a dope. I mean really, what kind of twaddle is "you body doesn't like foreign objects in it" ... for gods sake this is obvious to everyone who's even had a splinter!! Now I don't know what was said at that time, but if a mechanical was not proposed then I'd be shocked even more than I am.
Of course there is so much I don't know about all this process so its hard for me to be sure.
Your third OHS will be risky because its your third and because your older so I understand why TAVR is being mooted. But those valves are made of the same stuff as a bioprosthesis (just without the frame and delivered as an origami). So I would demand to know what makes them think that this would last you even another 5 years?
Its a very tough situation and I feel a lot of sympathy for you. I've had a life time of 3 OHS's but had about 20 years between each, so that's a fair return on investment each time.
Best Wishes