Aortic valve replacement....AGAIN.....

[OLDLADY]

I had my aortic valve replaced in October of 2011 by Dr. Petterson at Cleveland Clinic. I used this forum for reassurance, guidance,and information and went into the surgery with great confidence at knowing what to expect. Now I find I need that reassurance again. My valve has recalcified and I need another valve replacement. I got a tissue valve the first time because I had a history of nosebleeds. Well, after a very short episode of afib/flutter, I have been on coumadin ever since, maybe 3yrs. So at a routine protime I asked the nurse to check my pulse as it seemed off. The dr ran an EKG which revealed AFIB, controlled the DR said with rate under 100. Of course an echo followed which showed severe aortic stenosis. Previous echos had shown some stenosis but apparently it has reached a point of needing another replacement. I have sent my nfo to cleveland clinic and got a call today that DR Petterson is reviewing the info and I should receive a call by the end of the week. I am so much more nervous this time. I was intubated while awake the first time and it still makes me cry to think of it. I also had an issue of coming off the vent due to unknown sleep apnea. Anyways, I need ifo from anyone having a second surgery or any reassurance from any and everyone. I just need to be prepared the best I can and I know you folks on here have firsthand experience. I thank you for taking time to read this.

 

[jwinter]

I just had my second AVR this last November. I was on life support going into surgery the first time and had a mosaic porcine valve. I had shortness of breath last May and tests showed my valve was severely stenosed also.

I had an On-X mechanical valve put in by Dr. Daly at Mayo in Rochester, MN.(second surgery)

I, like you, was very anxious this time as I was not awake for a week before my initial surgery. I did what I see as protocol. I read a lot on here and asked the doctors all kinds of questions. After that I had to hand it over to my higher power as it was all too much for me to handle. I also stayed as busy as I possibly could and read a book on meditation and practiced it.

I was not as nervous as I thought I would be and on the day of surgery spoke at length with the OR nurse even.

Think positive and my best wishes to you. I have said it here before but will say again....I am not an extremely religious person but am spiritual.....do what you can and then put it in His hands to guide the surgeon.

Oh and my husband told me so many times how brave he thought I was.....You have to be strong when the only choice you have is to be strong! Let us know how it goes.

I had that vent tube in and out twice before first surgery and only remember it coming out. Both times were non issue for me. The drain tubes were my concern and came out no problem second surgery (they have really come a long way on this)

 

[pellicle]

Hi there OldLady

firstly I'd like to say that redo-operations are far more manageable than they have been in the past. The biggest issue being scar tissue hiding what the surgeon needs to see (not to cut, like nerves) but higher res imaging and more precision in surgery is helping along that.

As such todays redo-surgeries do not present as significant risks as they once did. So I think you'll recover quite similarly to how you recovered last time (from a physical feelings point of view). Myself over my life I've had 3 Open Heart Surgeries.

This is not to say that one should take lightly the prospect of this redo requiring a redo for as I understand it the risks rise significantly after operation #3 and operation #4 brings with it many risks that come from such things as the bone scar tissue (yes, bone forms scar tissue when healing) and other compounding effects.

I had my aortic valve replaced in October of 2011... My valve has recalcified and I need another valve replacement. I got a tissue valve the first time because I had a history of nosebleeds. Well, after a very short episode of afib/flutter, I have been on coumadin ever since, maybe 3yrs. .... Anyways, I need ifo from anyone having a second surgery or any reassurance from any and everyone. I just need to be prepared the best I can and I know you folks on here have firsthand experience.

given your above statement I'll assume that you are picking a mechanical valve this time to avoid the calcification (which you have now direct experience with does indeed occur) and you must be at least comfortable with the routine of coumadin as you've had it for 3 years.

If you do go this route and you wish help / assistance in managing your INR yourself (or at least understanding it better please don't hesitate to ask. Self Testing liberates you to be free to do as you wish, go where you wish and do the testing on your own timetable. Further is usually brings with it better outcomes because 1) the frequency of testing is higher thus you are in range more 2) greater awareness of self and what dose and does not matter.

Please feel free to PM me if you feel like a chat.

Lastly your "nickname" instantly reminded me of the Monty Python sketch from "The Holy Grail"

[video=youtube;-8bqQ-C1PSE]https://www.youtube.com/watch?v=-8bqQ-C1PSE[/video]

so don't think of yourself as old, you may be 37 at heart ;-)

Best Wishes

 

[RobThatsMe]

Hello Ol' L,

I originally had a St Judes mechanical aortic valve put in back in March of 2000. After ten years it failed due to severe aortic stenosis. so, in Sept 2010, I had Dr. Petteresson, and Dr. Roselli perform my surgery. I had to have both surgical teams work on me due to my dissection and aneurysm which also needed some attention while they were inside. Dr. Pettersson strongly recommended installing the On-X mechanical valve at that time, as it's design helps defect and pannus growth, should it occur, away from the valve. The doctors were great, and when the made the incision, they followed the original scar, today, you cannot even see that I have had 2 surgeries. I am feeling good, and so far, no new stenosis growth around the valve.
Dr. Pettersson is an amazing surgeon, you are truly in good hands with him. Sorry to hear that you too developed stenosis after your first surgery.
What type of valve is the doctor recommending for you?

You will do fine, you have one of the best performing your surgery, have a positive mind, and be in as good health as possible for you prior to surgery.

Rob

 

[honeybunny]

From one old lady to another....you've been given some reassuring words that I hope will lessen your anxiety a bit. That said, your emotions are quite normal. I've had only one OHS but expect to have another if I outlive my tissue valve.

BTW, your experience with ACT goes to show that those of us who choose tissue ONLY because they don't want to be on warafarin should rethink their decision. That was one reason for my tissue preference but not the only one.

Sounds like you are in excellent hands. Sending positive thoughts your way~

Hugs,
Michele

 

[OLDLADY]

Thanks for the responses. I am dealing the best I can. It is another "have to" situation so I have to accept it as such. I am still waiting for a reply from Cleveland Clinic and hopefully will hear soon. My echo had shown a translucent area on my valve. The cardiologist I saw brushed it off as nothing saying it was vegetation. Yesterday my primary told me that I have infection on the valve also known as vegetation.. I would think from what I read can be very serious so now I have that on my mind. Anyone familiar with this " vegetation"?

 

[Agian]

He said it was a vegetation and brushed it off? What an idiot!!

From what I understand a vegetation could be a sign of an infection, or previous infection. But if they're going to replace your valve, it will be dealt with. If you had active endo you would probably know about it. IF it was me, I'd want answers. Get another opinion if possible.

I thought it was my experience that flavoured my opinion, but it seems there really are some doozies out there practicing cardiology.

 

[honeybunny]

OL, I have no info on vegetation but I sense your anxiety and want you to know I'm sending positive thoughts your way and am hoping that you get some answers soon.

Hugs,
Michele

 

[pellicle]

Hi

firstly I don't want to add to your distress, but I feel these questions need answers. But they are just questions

I'm a little confused ... first your post mentioned calcification (which I assumed was suggesting stenosis, now you write:

...My echo had shown a translucent area on my valve. The cardiologist I saw brushed it off as nothing saying it was vegetation. Yesterday my primary told me that I have infection on the valve also known as vegetation.. I would think from what I read can be very serious so now I have that on my mind. Anyone familiar with this " vegetation"?

so vegetation implies "something growing" and a vegetative mass is quite a concern because:

1. vegetative usually implies it is growing living (plant like) thing (as opposed to a thrombosis) and perhaps implies endocarditis has started (even if as yet asymptomatically)
2. is to me a stroke risk as they can break off

that your cario has "brushed this off" suggests either they are an idiot or you misunderstood what they said.

I'd be going back with request for answers to the question posed above.
Is this an indicator of Endo? if yes, should it not be treated with a PICC line and antibiotics ASAP
Is it a stroke risk?
and last (but not least) if its a vegetative mass should one not undergo OHS without first treating that (due to the risk of infection being spread)

I'd be asking answers for these questions

 

[OLDLADY]

I want to thank you for the answers and suggestions. I have been reading a lot and trying to prepare myself for the next surgery. I received my packet of info from Cleveland Clinic this past Monday and I am scheduled for surgery 4/6 with Dr. Petterson. I will need a CT scan of the chest to check for scar tissue etc from 1st surgery. Also EKG, Echo and Cath are scheduled. I will be there for 2 weeks if all goes as expected. I am very confident in Dr. Petterson as he did my first surgery in 2011. I suppose I have the same fears as everyone else and am trying to deal with them. I have a large family and some of them want to be with me in Cleveland so we will need lodging big enough to hold them all. I am hoping we can find a rental home for the two weeks. So if anyone out there knows of a place please let me know. Again, I appreciate everyones response and am adding all of you on this forum in my prayers. Blessings to you all.

 

[dornole]

I use VBRO for house rentals all the time for our family of 7 while traveling and have never gone wrong. If you go to vbro.com and search "Cleveland Clinic" as the location with the dates you want to book, you will see options - you can also put in the number of people, etc. This is just one example:

https://www.vrbo.com/799170

TripAdvisor is another option for home rentals that I have had good success with.

Good luck to you and hugs.