Aortic & Triscupid Repair/Replacement

[Michaelena]

Hi,
This site is great! I am so happy to have seen the link on Web MD. Sometimes you feel so alone.
I am facing an aortic replacement & triscupid repair or replacement in the very near future. I already have my mitral valve replaced 20 years ago.
Has anyone out there had a similar operation? Any advice?
Many thanks.

 

[kizzy]

welcome to waiting and learning

welcome to waiting and learning

Welcome!! I am also new to site and I am learning a lot! I have a list of questions for my doc that will anoy the hell out of him!
Best to you Mic!
Kizzy

Hi,
This site is great! I am so happy to have seen the link on Web MD. Sometimes you feel so alone.
I am facing an aortic replacement & triscupid repair or replacement in the very near future. I already have my mitral valve replaced 20 years ago.
Has anyone out there had a similar operation? Any advice?
Many thanks.

 

[geebee]

Michaelina,

Welcome.

We have a few members who have had both mitral & aortic replacements (not sure about tricuspid). I am sure you will hear from them.

Happy to hear your mitral valve is still going strong after 20 years. What type do you have?

I wish you well for your upcoming surgery. You have certainly come to the right place for assistance.

 

[Michaelena]

Aortic & Triscupid Repair/Replacement

Michaelina,

Welcome.

We have a few members who have had both mitral & aortic replacements (not sure about tricuspid). I am sure you will hear from them.

Happy to hear your mitral valve is still going strong after 20 years. What type do you have?

I wish you well for your upcoming surgery. You have certainly come to the right place for assistance.

I have a St. Jude valve. However, I am very interested in learning more about the scar tissue, because my cardiologist had mentioned this to me when I had my last echo and in his report to my pcp. From what my doctor has told me about triscupid valves, rarely do they repair or replacement them, mine however is non existant, so I am not sure if they will sew the valve together or put in another one. My guess is that they will decide when they can get a first hand look, during surgery.

I have seen other doctors, getting different opinions. Only one in PA that I know is an "expert" in valve replacement is V. Paul Addonizio. Anyone know of others?

Thanks again for your good wishes, your input is helpful, unless you have experienced something like this it is difficult for people to understand some of the little frustrations.

Many thanks

 

[geebee]

I think you are right, they will probably make the valve decision once they are in there. Since you are already on coumadin they can go mechanical or tissue depending on what works best in that position.

Scar tissue is always an issue when dealing with repeat surgeries. The scar tissue surgery I had in 1982 was a bit unusual tho. I had a Bjork-Shiley single leaflet valve that seemed to be "sticking". Echos indicated the possibility of a clot but definitely showed inadequate functioning.

When the surgeon went in, he found I had grown excessive scar tissue over the leaflet which was causing it to malfunction. He cleaned out the scar tissue and that was that. After surgery I went on a quest to try and determine what caused the scar tissue buildup since everyone said it was the first time they had seen this problem.

Come to find out I had "anti-heart" antibodies which seemed to be attacking my heart tissue. Became part of a study that used long-term (1 year) prednisone to treat. Solved my problem and, when my valve was replaced in 1994, there was very little sign of scar tissue and every indication that it was old scar tissue probably from the time after surgery and before the prednisone. Just in case, it was replaced with the St. Jude bileaflet in the hopes that if scar tissue is still an issue having 2 leaflets might allow better functioning. However I have had no problems with the St. Jude valve.

Did this answer your question or way more than you wanted?

 

[lucky400]

I am from the Philadelphia area and have heard of Addonizio. I, too, have aortic stenosis and tricuspid regurgitation. I am not ready for surgery yet and am in the so called "waiting room". However, I have been looking around for possible surgeons and I prefer the surgeons affiliated with University of Pa hospital. Addonizio used to be at Penn and left to go to Temple where he became the "head honcho" there. I understand he is very good and is especially known for the Ross Procedure. Even knowing all that I personally prefer going to Penn. You need to meet with your possible choices for surgery, see who does the most of your procedure, and determine who you have the most faith in and are comfortable with. It really is a very personal choice.

I hope this helped.

Barb

 

[Michaelena]

Scar tissue

Scar tissue

Yes, thanks for your clarification, everything seems so jumbled these days, the doctors seem to think out loud, maybe I did not hear right in reference to the scar tissue, I will be seeing my cardiologist soon before surgery and that will be one of the many questions I have for him.

You joined the St. Jude club, I am glad to hear it is working well. I will probably have another mechanical valve, not so sure how long a tissue valve will work, and frankly I really don't want to go for three if I can help it. I am already on coumadin.

How was recovery with the second valve surgery? Was it longer, did you have any complications you might be able to share with me? Was your surgeon known for doing valve surgery? Many of our doctors in my area are bypass experts.

Many thanks again for sharing your experience.
Michaelena

I think you are right, they will probably make the valve decision once they are in there. Since you are already on coumadin they can go mechanical or tissue depending on what works best in that position.

Scar tissue is always an issue when dealing with repeat surgeries. The scar tissue surgery I had in 1982 was a bit unusual tho. I had a Bjork-Shiley single leaflet valve that seemed to be "sticking". Echos indicated the possibility of a clot but definitely showed inadequate functioning.

When the surgeon went in, he found I had grown excessive scar tissue over the leaflet which was causing it to malfunction. He cleaned out the scar tissue and that was that. After surgery I went on a quest to try and determine what caused the scar tissue buildup since everyone said it was the first time they had seen this problem.

Come to find out I had "anti-heart" antibodies which seemed to be attacking my heart tissue. Became part of a study that used long-term (1 year) prednisone to treat. Solved my problem and, when my valve was replaced in 1994, there was very little sign of scar tissue and every indication that it was old scar tissue probably from the time after surgery and before the prednisone. Just in case, it was replaced with the St. Jude bileaflet in the hopes that if scar tissue is still an issue having 2 leaflets might allow better functioning. However I have had no problems with the St. Jude valve.

Did this answer your question or way more than you wanted?

 

[Mb]

Hello!

I thought I would post a bit of a comment here, in hopes that you might have some input.
My husband had his aortic and mitral valves replaced with St. Jude's, three and a half years ago. Post surgery, he did not recover really well, and his first echo showed severe tricuspid regurgitation, which probably should have been repaired when he had the first surgery. That being said, combined with being in permanent a-fib, his activity level is somewhat compromised. His most recent echo showed an increase in his transmitral and transaortic gradients, and his cardio commented that there was probably scare tissue buildup causing a bit of stenosis. He also spoke of doing the tricuspid repair (annuloplasty) sooner, rather than later, to prevent right sided heart failure causing compromise of his other organs. So, another echo is being done in August, and discussion will take place then as to the direction to take. Does anyone know if they will try to remove the scar tissue at that time from the St. Jude valves? - Marybeth

 

[Harpoon]

If there's scar tissue that may impede heart fuction and it can be removed without "incredible" effort, it would be by a competent surgeon...



Michaelena>>WELCOME! =)

I had my tricuspid valve replaced with a St Jude's valve in 2003 at Cleveland Clinic Children's Hospital by Dr. Roger Mee.

I was born with a congenital heart defect called "transposition of the great vessels" and had surgery soon after birth. I did QUITE well for the next 28 or so years before my tricuspid valve started acting up. By the time I had surgery, the valve was almost gone.

I had a rough recovery, but I was a "special case" given that I had an underlying congenital heart defect.

If you have a good surgeon in a good hospital, it should be just fine.

Feel free to ask me anything you want. =)

 

[geebee]

My second OHS was to remove scar tissue from my mechanical mitral valve. If scar tissue is preventing the valve from working properly, it should be removed. However, if surgery is primarily for another valve, it will depend on how much time the surgeon needs for that valve as to whether he can work on the mitral also. There is a limitation as to how long someone can safely be on the heart-lung machine.

I did not find recovery from my second surgery to be more difficult than my first (the third was harder) and probably a little easier emotionally because I knew what to expect. My biggest problem was the breathing tube since I am claustrophobic. However, I made it through without going totally insane (although some people might argue that statement )

I had the same surgeon for my first 2 surgeries and he was well known for valve surgery. He had some difficulty getting in the second time due to scar tissue but managed to keep me alive so I guess that is all that counts. Keep in mind that surgeons today have so very much more experience than 25 years ago when I had my first surgery. They know how to deal with all the issues that might have been unusual then.

Let me know if I can be of more help.