Aortic Root Replacement

[Pharaoh]

I'm 47 yrs old with a good health through my life, I got a high blood pressure for the last 9 years and under a medication since then. early this year, my GP advised to go through a routine heart check-up which was a surprise to discover a dilated aortic valve roots (52mm dia). specialist recommended to go for a valve replacement operation. Options givin was Mechanical, Tissue or using my own valve and replace roots only!
Is any one there had a similar operation or know more information about it?

 

[Agian]

You haven't mentioned what they told you about the actual aortic valve. I will need a similar operation, but my valve is beyond repair (I'm thinking of using it as a paper-weight). I'm a newbie as well. There's heaps of information on this forum.

 

[Pharaoh]

My aortic valve in a very good shape, The sino-tubular junction is 4.5cm and at the level of RPA the aorta is 4.3cm. The arch is 2.7cm and the descending aorta 2.6cm. There is no coarctation or patent ductus arteriosus.

 

[Heart Of The Sunrise]

Pharaoh: I had my aortic valve and root replaced I am doing fine. Click on the video link in my signature and you can learn much more. My surgeon discusses the entire procedure. I had this entire procedure the only difference is that I choose a mechanical valve. Good luck!

 

[Pharaoh]

Thanks Heart of The Sunrise.

 

[Agian]

Pharaoh, given that your valve is in good nick, if it was me, I'd want to know if I could keep it without needing another operation later on to replace it. If replacing it now will save you from another definite OHS in the future, then I would seriously give replacement some thought. Your surgeon needs to give you the information that will allow you to make an informed decision. What does your cardio think?

 

[Pharaoh]

Agian: I'm going for Valve sparing Aortic root replacement where they will use my own valve in September (mostly 20/09/2013). This will get me out of a second replacemnt in 15yrs time if I choose a tissue valve or to be on a wolferen if I choose a mechanical valve.
This operation is is only 5 years in Australia but more longer done Oversease.

 

[Agian]

That's good news.

PS A Dacron repair will last you a lifetime.

 

[jhc1]

Pharaoh- on June 10th, I had similar surgery. my surgeon replaced my aortic root, valve and repaired an aneurysm similar to yours with a dacron graft. I'm ~7 weeks post op and am resuming normal activity-riding my bike to build endurance, and racing small sailboats. Best advice-find a surgeon who does the procedure frequently, and a hospital that does frequent open heart surgery. As traumatic as this is for us, for the professionals involved, this is major, but routine surgery. Best wishes for a great outcome

Joe

 

[pellicle]

Hi
Which side of Brisbane? Mine was done at HSN Chermside.

I don't want to be the sole voice of devils advocate but its also good to be prepared for the what if of them getting in there and deciding to replace the valve anyway. I would ask your doctor what are the chances of that.

As a backup consider then if you'd go tissue or mechanical. I went in for a dialated aorta and we decided prw surgery to replace the valve with an ATS mechanical. The logic being that as this was my 3rd surgery it would be very tricky to undertake a 4th at a later date to replace a tissue at end of life.

I was quite anxious about warfarin at that point and were it not for the obvious risks of the inevitable 4th surgery would probably have opted for the tissue. However I can say that I have learned a lot since then and realise that the angst I had about warfarin was totally unfounded.

Hope all goes well for you.

Agian: I'm going for Valve sparing Aortic root replacement where they will use my own valve in September (mostly 20/09/2013). This will get me out of a second replacemnt in 15yrs time if I choose a tissue valve or to be on a wolferen if I choose a mechanical valve.
This operation is is only 5 years in Australia but more longer done Oversease.

PS I was 48 going into the surgery which was 2012

 

[Rachel]

Pharaoh,

If your doctors can save your native valve - I think that is the very best option (IMHO) - like Pellicle mentioned above though...it's a VERY good idea to have a back-up plan just in case - many times surgeons go in and find "little" surprises that could not be detected through the pre-tests.

In my case I didn't worry about what type of valve I should have....I was much more interested in just having the surgery done soon (my ascending aorta was also 5.2cm) - I did choose a tissue valve and happy so far with that decision. I also think a mechanical valve is an excellent choice...and if mine fails early then obviously I'll go mechanical - as long as it works!

Good luck to you!

 

[AZ Don]

Hi Pharaoh,
I had a valve sparing aortic root and ascending aneurysm repair done in May. I have a Bicuspid Aortic valve but it is well functioning, so it was a tough choice. The surgeon seemed to prefer a mechanical valve, because he thinks there is a 50% chance my valve will fail in 15 years, because it is bicuspid. The Cardiologist seemed to prefer to spare the valve because it is well functioning, and the literature I could find seems to side with him. The advantage of sparing the valve when it is well functioning are that it is better than any replacement valve, at least for now. The only reason to replace a valve is if there is something wrong, or expected to go wrong with it. If your valve is well functioning then even if it is bicuspid generally the recommendation is to spare the valve. If it is not bicuspid then I don't know why it would be suggested to replace it.

As mentioned earlier, it is important to have a very experienced surgeon. Also, as mentioned earlier, if the valve is not as expected, or if there are problems with the aortic root repair, your surgeon should discuss with you what to replace it with. My backup choice was the On-X mechanical valve.

 

[Pharaoh]

Thank you Joe, this reduces my worries.

Pharaoh- on June 10th, I had similar surgery. my surgeon replaced my aortic root, valve and repaired an aneurysm similar to yours with a dacron graft. I'm ~7 weeks post op and am resuming normal activity-riding my bike to build endurance, and racing small sailboats. Best advice-find a surgeon who does the procedure frequently, and a hospital that does frequent open heart surgery. As traumatic as this is for us, for the professionals involved, this is major, but routine surgery. Best wishes for a great outcome

Joe

 

[Pharaoh]

Pellicle, I'm in southern Brisbane, I will have my operation done in Greenslopes Private Hospital, my doctor said "it's straight forward operation" as I don't have any other issues than dilated valve roots. as a back-up I will choose Mechanical valve. Thank you for the good wishes.

Hi
Which side of Brisbane? Mine was done at HSN Chermside.

I don't want to be the sole voice of devils advocate but its also good to be prepared for the what if of them getting in there and deciding to replace the valve anyway. I would ask your doctor what are the chances of that.

As a backup consider then if you'd go tissue or mechanical. I went in for a dialated aorta and we decided prw surgery to replace the valve with an ATS mechanical. The logic being that as this was my 3rd surgery it would be very tricky to undertake a 4th at a later date to replace a tissue at end of life.

I was quite anxious about warfarin at that point and were it not for the obvious risks of the inevitable 4th surgery would probably have opted for the tissue. However I can say that I have learned a lot since then and realise that the angst I had about warfarin was totally unfounded.

Hope all goes well for you.




PS I was 48 going into the surgery which was 2012

 

[Pharaoh]

Rachel: Thank you for the advice and I will choose mechanical valve as a back-up.

 

[Pharaoh]

AZ Don: Thank you for your post, yes my surgeon advised to do valve sparing (use my own valve) as it's not defected. at the same time, I will choose mechanical valve as my backup.

 

[pellicle]

Wow, individual replies very polite

Best wishes for a good recovery mate!

 

[Pharaoh]

Thank you Pellicle.

 

[OldManEmu]

Pharaoh

This operation is only 5 years in Australia but more longer done Overseas.

Valve sparing has been available in Australia for more than 5 years. This would have been an option for me back in 2004 if my valve hadn't been destroyed by endocarditis; the surgeon said the valve damage had ruled this option out when dealing with the aneurysm.

 

[Pharaoh]

Thank you OldManEmu for the information, that what my surgeon told me but it's good to know that is more longer than 5 years. This gets me more less fear

Pharaoh
Valve sparing has been available in Australia for more than 5 years. This would have been an option for me back in 2004.