AVR + aorta replacement + CABG =??

[gpr100rs]

Ok, looking for a little encouraging news from those of you who touched all the bases and lived to talk about it. Had my heart cath today and my LAD is 60-70% blocked. Aorta is 4.6 and bicuspid valve is shot - .6 area, peak gradient 129, mean 80. So, I need the trifecta. Aorta complicates AVR and CABG further complicates all. Somehow, I have "no" symptoms, but I have a job where I sit on my arse all day and haven't played squash since COVID shut down last March. So God only knows how I would feel if I actually did something strenuous. In any event, anyone out there had a total rebuild like I need? Likely will let Doc Roselli at Clevland Clinic have the honors. Comments, observations, condolences, etc.

 

[Chuck C]

Ok, looking for a little encouraging news from those of you who touched all the bases and lived to talk about it. Had my heart cath today and my LAD is 60-70% blocked. Aorta is 4.6 and bicuspid valve is shot - .6 area, peak gradient 129, mean 80. So, I need the trifecta. Aorta complicates AVR and CABG further complicates all. Somehow, I have "no" symptoms, but I have a job where I sit on my arse all day and haven't played squash since COVID shut down last March. So God only knows how I would feel if I actually did something strenuous. In any event, anyone out there had a total rebuild like I need? Likely will let Doc Roselli at Clevland Clinic have the honors. Comments, observations, condolences, etc.

I just wanted to give you my support and wish you luck. We are both going to be having surgery soon, and looking forward to comparing our successful recovery stories. For getting a surgery like yours, I wanted to say that you are at the right clinic. They do complex surgeries like that at Cleveland to the point where I believe it would be accurate to say that they are routine for them. I was watching a video with two of their surgeons, Lars Svensson and Doug Johnson, discuss their outstanding outcome statistics and Lars pointed out that a substantial number of those involved CABG as well (I think it was almost half). I am sure that you will come through this fine. Best of luck!

I'm editing the post, as I looked up the Cleveland Clinic video with Svensson and Johnson. Svensson notes that over the past 6 years their survival rate was 99.5% for AVR, which includes reoperations and complex operations as well. The numbers are overwhelmingly in your favor and many others here have spoken very highly of the Cleveland Clinic

 

[pellicle]

Hi
its a biggie no two ways about it.

I didn't see your age, but if you're basically fit then you'll recover well. I don't imagine the operation will take more time "on the pump" than my last one did ... so you'll be fine.

My last one was AVR, and aneurysm with complex arch anatomy.

how old are you? Because that matters (perhaps put that in your bio, or just mention it).

 

[gpr100rs]

Hi
its a biggie no two ways about it.

I didn't see your age, but if you're basically fit then you'll recover well. I don't imagine the operation will take more time "on the pump" than my last one did ... so you'll be fine.

My last one was AVR, and aneurysm with complex arch anatomy.

how old are you? Because that matters (perhaps put that in your bio, or just mention it).

63 yrs old, decent shape, diet, weight, etc. Also, not sure if they'll do a cabg or stent, but the blockage was sort of the cherry on the "what else can go wrong" cake. Thx for your reply

 

[gpr100rs]

I just wanted to give you my support and wish you luck. We are both going to be having surgery soon, and looking forward to comparing our successful recovery stories. For getting a surgery like yours, I wanted to say that you are at the right clinic. They do complex surgeries like that at Cleveland to the point where I believe it would be accurate to say that they are routine for them. I was watching a video with two of their surgeons, Lars Svensson and Doug Johnson, discuss their outstanding outcome statistics and Lars pointed out that a substantial number of those involved CABG as well (I think it was almost half). I am sure that you will come through this fine. Best of luck!

I'm editing the post, as I looked up the Cleveland Clinic video with Svensson and Johnson. Svensson notes that over the past 6 years their survival rate was 99.5% for AVR, which includes reoperations and complex operations as well. The numbers are overwhelmingly in your favor and many others here have spoken very highly of the Cleveland Clinic

CC does a great job getting its state-of-the-art procedures out there and is certainly one of the top centers in the world. Good luck with your upcoming procedure. Going with mechanical - On X?

 

[bizinsider]

Ok, looking for a little encouraging news from those of you who touched all the bases and lived to talk about it.

GPR, welcome to the club. Your membership card is in the mail! Pellicle is president.

I had the full shebang at the CC. Aortic valve, root and ascending aorta with a CABGx1 thrown in as a bonus. Full sternotomy.

Here we are, one year and two days out, now 68, and if it wasn't for the scar, which is fading, I would never know anything was done.

You are in great hands and if you are in halfway decent shape you should come through with flying colors. Your positive attitude and especially your sense of humor will be your best friends. There are no straight lines. I had a complication from an incidental finding but it was more of an annoyance than anything.

So here's the deal: I didn't know I would need a CABG until my surgeon told me the day before surgery. It was the first time I became somewhat concerned, because my goal was to be on the HL machine as little as possible. So I asked him, "How much time will that add?" He replied, "Seven minutes." And so it was. I went back to being happy and upbeat and, in all, while I was lights-out for five hours, I was on the HL machine for about 70 minutes. (Otherwise it would have been about an hour.)

I was home on Day 11 and sitting at my desk, kind of working, Day 12. Importantly, however you visualize this, you will NOT be a vegetable or incapacitated or anything like that. There will be restrictions for up to eight weeks on lifting things, but by eight weeks I was walking 3+ miles. I didn't need a recliner or anything like that. If you follow the protocol, especially with the spirometer they give you to blow into and the walking, you will probably be amazed at the speed of the recovery and how you get over certain hurdles to new levels of your old self. We're talking only a few weeks for that to happen - again, assuming you are in decent shape. Longer, I am told, if you are not. But even then....recover you will.

Your surgeon: People love Roselli. In fact, it's hard to find any surgeon there that people talk poorly about. Mine was fantastic. It's the system - the way they do things. As one guy told me, CC is a machine, but in a good way. I found most of the medical staff to be highly personable and caring. Things ran like clockwork. I didn't like my first step-down nurse and mentioned it to my surgeon's nurse practitioner and - presto! - I had a new utterly amazing nurse.

I echo what George said about the CC videos. He seems as obsessed as I was. They are without question the best out there and I have scoured the world for videos like these. Johnson has a series on what to expect before and after surgery. They're very good and comforting.

Symptomatic: I thought I was asymptomatic but, in retrospect, had been noticing some tightness in my chest when I walked up super-steep hills. (Otherwise I walked quickly and didn't have the fatigue so many have.) My doctors seem to think the tightness was likely my valve rather than the 80% blocked marginal obtuse artery, but nobody knows for sure. I will say, since you need a CABGx? - be glad you found it before it found you. I had passed the pre-surgical stress test with flying colors, but they advised me that the results are only about 70% accurate. The angiogram said, "Not so fast!" They say had I not known I had the blockage I would have likely started to suffer angina or had a heart-damaging heart attack. For me, that angiogram the silver lining of having to have heart valve surgery. Oh, and when I exercise I am faster than ever, with reserve power I never knew I had. In other words, I probably had "symptoms" that I didn't realize were symptoms. A lot of folks seem to say that.

Feel free to reach out with any questions.

Cheers.

 

[Chuck C]

CC does a great job getting its state-of-the-art procedures out there and is certainly one of the top centers in the world. Good luck with your upcoming procedure. Going with mechanical - On X?

I'm going with mechanical, but St. Jude. My surgeon strongly favors the St. Jude, although if a patient prefers Onyx he is happy to accommodate them.

 

[gpr100rs]

GPR, welcome to the club. Your membership card is in the mail! Pellicle is president.

I had the full shebang at the CC. Aortic valve, root and ascending aorta with a CABGx1 thrown in as a bonus. Full sternotomy.

Here we are, one year and two days out, now 68, and if it wasn't for the scar, which is fading, I would never know anything was done.

You are in great hands and if you are in halfway decent shape you should come through with flying colors. Your positive attitude and especially your sense of humor will be your best friends. There are no straight lines. I had a complication from an incidental finding but it was more of an annoyance than anything.

So here's the deal: I didn't know I would need a CABG until my surgeon told me the day before surgery. It was the first time I became somewhat concerned, because my goal was to be on the HL machine as little as possible. So I asked him, "How much time will that add?" He replied, "Seven minutes." And so it was. I went back to being happy and upbeat and, in all, while I was lights-out for five hours, I was on the HL machine for about 70 minutes. (Otherwise it would have been about an hour.)

I was home on Day 11 and sitting at my desk, kind of working, Day 12. Importantly, however you visualize this, you will NOT be a vegetable or incapacitated or anything like that. There will be restrictions for up to eight weeks on lifting things, but by eight weeks I was walking 3+ miles. I didn't need a recliner or anything like that. If you follow the protocol, especially with the spirometer they give you to blow into and the walking, you will probably be amazed at the speed of the recovery and how you get over certain hurdles to new levels of your old self. We're talking only a few weeks for that to happen - again, assuming you are in decent shape. Longer, I am told, if you are not. But even then....recover you will.

Your surgeon: People love Roselli. In fact, it's hard to find any surgeon there that people talk poorly about. Mine was fantastic. It's the system - the way they do things. As one guy told me, CC is a machine, but in a good way. I found most of the medical staff to be highly personable and caring. Things ran like clockwork. I didn't like my first step-down nurse and mentioned it to my surgeon's nurse practitioner and - presto! - I had a new utterly amazing nurse.

I echo what George said about the CC videos. He seems as obsessed as I was. They are without question the best out there and I have scoured the world for videos like these. Johnson has a series on what to expect before and after surgery. They're very good and comforting.

Symptomatic: I thought I was asymptomatic but, in retrospect, had been noticing some tightness in my chest when I walked up super-steep hills. (Otherwise I walked quickly and didn't have the fatigue so many have.) My doctors seem to think the tightness was likely my valve rather than the 80% blocked marginal obtuse artery, but nobody knows for sure. I will say, since you need a CABGx? - be glad you found it before it found you. I had passed the pre-surgical stress test with flying colors, but they advised me that the results are only about 70% accurate. The angiogram said, "Not so fast!" They say had I not known I had the blockage I would have likely started to suffer angina or had a heart-damaging heart attack. For me, that angiogram the silver lining of having to have heart valve surgery. Oh, and when I exercise I am faster than ever, with reserve power I never knew I had. In other words, I probably had "symptoms" that I didn't realize were symptoms. A lot of folks seem to say that.

Feel free to reach out with any questions.

Cheers.

All I can say is WOW and thanks for taking the time to reply, I'm literally coming to tears. It's VERY comforting to hear from someone who who's been through the complete ringer and is doing well both physically AND mentally. When I heard about the blockage I'm like what next?? The key for me is the hope of returning to an active life, and you certainly are proof that is possible even after a very complex operation. Many thanks my friend! What valve did you go with? Any second thoughts about that? Do you mind mentioning your surgeon? Dr. Roselli is booking three months out and I might need something sooner.

 

[bizinsider]

GPR, my surgeon was Lars Svensson. I went with a bio, but I'm also much older than you are, so I likely have one replacement following this, via TAVR - assuming another valve doesn't fail or something else unexpected happens – if this valve goes somewhere near the distance of 8-15 years. The valve he chose for me was an older tried/true one called the Edwards Perimount. A new one, the Resilia by Edwards, gets a ton of chatter and my surgeon was the lead in testing it. I may not have been the right candidate for it. I'm sure Dr. Roselli will have an opinion. They make you choose the tough part: mechanical vs bio - that's YOUR choice to anguish over. They then tend to pick the valve, though, via this forum and others, I've seen patient input on that. As for "returning to an active life," the odds are heavily in your favor. I'd worry more about getting in a bad car crash. I'm not saying this is the most fun you'll ever have had in your life, or that it is not a big deal. It ain't fun and it IS a big deal. But many many people will tell you its bark was worse than its bite. And I can tell from the way you write that you are going into it with the right attitude and humor. It's all part of the journey. The scar will be your souvenir. This is a great read: The Scar | By Jeff Green

I found reading as much as possible, including studies - knowing the risks and rewards - helped me immensely. Rather than denial, embracing it! After all, there is no other choice!