Another New Member?!!

[Jamesaz]

Hello All,

My name is James. I'm a new member to VR.com. I have a congenital bicuspid aortic heart valve (BAHV) and ascending aortic aneurysm (5.1 cm as of 11/2010). I'm 52 years old and in fairly good shape for my age (other than those two sticking points). I'm looking forward to finding out all that I can on this forum about what to expect before, during, and after surgery, which, I believe, will happen to me some time this year. I'd rather do it sooner than later, but I haven't been in my job all that long (less than a year), so I'm a little leary about doing it so soon after being hired.

I was wondering if anyone has had any valve replacement surgery done by Dr. Merick Kirshner of Cardiovascular Consultants, Ltd. of Arizona? Apparently, he is the surgeon my cardiologist recommends to perform the surgery for me (eventually).

Glad to be here. Actually, glad to be anywhere, especially with this condition.:biggrin2:

James

 

[Greg a]

Jamesaz/James , a heart felt WELCOME to our OHS family the decision you face is very personal and varies with each person .....there is a wealth of knowledge here for now and the future ..... I am sure that the surgeon you mention will find someone here with a knowledge of his expertise

I hope these will help you to prepare yourself and your home

Bob/tobagotwo has up dated a list of acronyms and short forms http://www.valvereplacement.org/forums/attachment.php?attachmentid=8494&d=1276042314

what to ask pre surgery http://www.valvereplacement.org/for...68-Pre-surgery-consultation-list-of-questions

what to take with you to the hospital http://www.valvereplacement.org/forums/showthread.php?13283-what-to-take-to-the-hospital-a-checklist

Preparing the house for post surgical patients http://www.valvereplacement.org/for...Getting-Comfortable-Around-the-House&p=218802

These are from various forum stickies and there is plenty more to read as well


And Lynw recently added this PDF on what to expect post op
http://www.sts.org/documents/pdf/whattoexpect.pdf

 

[ALCapshaw2]

Welcome aboard James !

For starters, I suggest that you browse through the Bicuspid Aortic Valve and Connective Tissue Disorder (BAV and CTD) Forum to learn more about these often related conditions.

I also suggest that you ask the surgeon(s) you interview about their experience dealing with BAV and CTD. It would be wise to select a surgeon who KNOWS how to recognize the signs of a Connective Tissue Disorder (which often results in Aortic Aneurysms, especially in congenital BAV patients) and KNOWS how to deal with it. Such surgeons are most often found at the Major Heart Centers such as UCLA, Texas Heart Institute (Houston, St. Lukes Hosp), other big centers in Texas. You need to know that surgery of the Aorta is another step up the ladder of complexity in Heart Surgery. Personally, I would not want to have aorta surgery with a surgeon who only does a few per year.

FYI, MANY Cardiologists and Surgeons use an Aortic Aneurysm diameter of 5.0 cm as their trigger for recommending surgery. Some use 5.5 cm. In my non-professional opinion, I see NO benefit in 'waiting and watching' with an Aortic Aneurysm of 5.1 cm. It will NOT heal by itself and there is a high risk of Death if it ruptures hence my belief that "Sooner is Better". First time surgeries in otherwise healthy patients is Highly Successful, even with the aorta surgery, in the hands of very experienced surgeons. It would be wise for you to start interviewing surgeons NOW.

'AL Capshaw'

 

[Duffey]

Hi, James, and welcome.

If you don't get a response to your query about the cardiothoracic surgeon, you might start a thread with his name in the title and mention your location. You might also try the search feature.

Glad you're with us.
Mary

 

[Kathy McCain]

Welcome James! You've come to a great place for support, pre-surgery, post surgery and whatever! We are all here to help, with any concerns you may have. You are NOT ALONE. We can share our own experience with AVR with you, and help to calm your fears.

 

[Jamesaz]

...It would be wise for you to start interviewing surgeons NOW.

'AL Capshaw'

Al, thank you for your welcome and advice. Obviously, this is a very important point in my life, so I want to get the best surgeon possible for my procedure. I'd like to know where to go for information on recognized cardiothoracic surgeons in Arizona that do valve/aneurysm repair procedures routinely (but more important, successfully!), but I'm kind of just starting out, so I've got a big learning curve ahead of me.

James

 

[Jamesaz]

Welcome James! You've come to a great place for support, pre-surgery, post surgery and whatever! We are all here to help, with any concerns you may have. You are NOT ALONE. We can share our own experience with AVR with you, and help to calm your fears.

Kathy, thank you for your warm welcome and your support.

James

 

[Lily]

Welcome to the site. I searched for Dr. Kirshner but yours is the only post I could find with his name on this site. Best wishes

 

[ALCapshaw2]

Al, thank you for your welcome and advice. Obviously, this is a very important point in my life, so I want to get the best surgeon possible for my procedure. I'd like to know where to go for information on recognized cardiothoracic surgeons in Arizona that do valve/aneurysm repair procedures routinely (but more important, successfully!), but I'm kind of just starting out, so I've got a big learning curve ahead of me.

James

You may want to start a New Thread, possibly in the Pre-Surgery Forum, with a subject line something like "Need BAV+Aorta Surgeon in Arizona".
We do have members from AZ but I don't recall any Aorta Specialists being mentioned.

The most prominent Aorta Surgeons from the West that I remember being mentioned in the several years I've been reading these forums
are in California and Texas. There seem to be more in the East and Midwest (Boston, NYC, MD - Johns Hopkins), PA, Cleveland Clinic, Chicago, Mayo Clinic - MN, Atlanta, FL, etc.)

'AL Capshaw'

 

[skeptic49]

Welcome to the forum, James. combined BAVR and aortic surgery is complex, but it is being done with minimally invasive incisions by surgeons at the Cleveland Clinic and elsewhere. This is just something you might want to disuss with whatever surgeon(s) you interview, since pain, complications and recovery time can be reduced with minimally invasive techniques.

Best wishes,

Jim

 

[njean]

Welcome to VR, James! I'm sure that you will find just the right surgeon to address your situation.

Do your research, ask your questions and arm yourself with as much information as you can and then go with whom you feel more confident with.

Best of luck to you!

 

[ALCapshaw2]

Here are the links that came up for Dr. Merick Kirshner from my search on Google:

http://www.google.com/search?hl=en&...tnG=Google+Search&aq=f&aqi=&aql=&oq=&gs_rfai=

You might want to call his office and ask to speak with one of his Nurses.
Then ask about how many BAV / Aorta Surgeries he performs annually.

You could then check your Yellow Pages for CardioThoracic Surgeons and ask the same questions.

 

[malibu82]

hi there and welcome! i am 28 and was born with a bicuspid valve and developed a 4.8cm aneurysm. they were fixed on may 21st ! good luck to you!

 

[Mileena46]

Welcome James!!

 

[Sbullock]

Hi James. Welcome to the site that guided me through my surgery. I'm 57 and have a bicuspid valve and had an aortic aneurysm. When i saw my surgeon last May my aneurysm was found to have grown to 5.4 cm. He said that with a bicuspid valve he likes to operate at the 5.0 cm threshold. This is something that you might want to do sooner rather than later. When my valve was checked during my angiogram it was found to be operating normally and did not need replacing which makes the surgery much shorter. Perhaps this will be true in your case as well.
With the exception of a rating for the surgeon you've been referred to you'll find all the info you need on the surgery and recovery easy to find in these pages. The worst part about this whole event happens as you worry prior to surgery. It's been six months since my surgery and my life is pretty much back to normal. Good luck.

 

[Jamesaz]

Steve,

Thanks for sharing your experience. I think you're right about the pre-surgery worry stuff. It's probably worse than the actual procedure.

James

 

[camgough]

Hey James,
Anxiety while waiting for the surgery is the worst. I was diagnosed May 18, 2010 (at age 30) with a bicuspid aortic valve, and an ascending aortic aneurysm of 6.7cm, and had the OHS July 9. Like Steve my valve was spared, even though it is bicuspid, it was apparently working well enough the keep. The surgery I had was called valve-sparing aortic root replacement, and I believe my valve was reshaped also. Also like Steve I am almost 6 months post-op, and getting better. Day to day life is back to normal, just the more physical (running, ice hockey, etc....) is taking a long time to come back. I wish you the best, do your research, stay positive and you will be fine!

 

[jazzman]

Hi James amd welcome aboard !

I, like others, took the 'sooner rather than later' approach to my surgery.
It was about 9 weeks from discovery to being on the table for me.
Aortic aneurysm 5.0 to 5.1 (depending on whose ECHO you believed).
I do not have BAV (normal tri-leaflet aortic valve), so the David's valve sparing surgery was performed.

I used this great forum for some of my research, PM'ing several helpful folks in the process.
I went from knowing nothing at all about OHS, to deciding the type of surgery and picking a surgeon, in a short timeframe.
I'm almost 7 months out now, and things are going great.

Best of luck with everything and please feel free to PM me if you'd like.

Jazzman

 

[Jamesaz]

Well, I recently had my consultation with my surgeon, Dr. Merick Kirshner of CVC Consultants, Ltd. He explained the procedure he is going to perform on me. He said that as far as surgeries go, this is the "Grandaddy of them all." THAT was comforting. First, he said he will do a heart catheterization to assess the arteries coming off of the ascending aorta, my BAV, as well as the ascending aorta, which currently stands at 5.1 cm. He indicated that if the BAV isn't too calcified, then he would recommend leaving it, because he said that anything I can keep is better than what would be used to replace it. He also said that if the aneurysm extends into the aortic arch, then he would have to do a Deep Hypothermic Circulatory Arrest (DHCA) (i.e., a brain freeze w/heart stoppage) accompanied by CPB in order to repair the aortic arch. That's the part that frightens me the most, knowing that I could be clinically dead for about 30-40 minutes while the surgeon repairs the aortic arch. It was all a bit overwhelming, to say the least. All I could do was shake my head in disbelief. I mean, I've known for some time now that I'd need surgery, but to finally have it explained to me in such detail was hard to take. All I can hope for is that the arch is okay and I don't have to undergo DHCA.

Has anyone else undergone DHCA and lived to tell it? Did you have any neurological and/or physiological complications or side effects from the DHCA?

Thanks,
James

 

[Jamesaz]

hi there and welcome! i am 28 and was born with a bicuspid valve and developed a 4.8cm aneurysm. they were fixed on may 21st ! good luck to you!

Hi! Did the surgeon who performed your aortic arch replacement use DHCA and CPB to perform the surgery? If so, did you experience any side effects from these procedures?