AVR Just Committed to Valve Replacement

[Allen Klein]

Greetings To All

Just yesterday agreed to move ahead on the replacement of my aortic
valve. I am 53, no history of heart problems, am asymptomatic, lead
an active lifestyle. Last week I went skiing with my 2 sons in Killington
Vermont, I can handle the treadmill for better than 1/2 hour at 5-6 MPH
and have soo many doubts about going ahead.
I keep on looking for signs that I need the surgury but,
I can't honestly say that I have any shortness of breath.
I do seem to have some dizziness but only when I close my eyes
and recall having several bouts with severe temperature and shaking
earlier this year and before.

The two surgeons I met with assured me that I have significant aortic
reguritation (Bicuspid Valve From Birth) and will need the surgury sooner
rather than later, but it is not an emergency. Also, my cardiologist who
has been following my condition since I was diagnosed April 2005 has
been a bit equivical about the right timing. My left Ventricle measures
6.5LVD during the echo and he says that the size has remained the
same during the three echos taken April, Sept, Dec 2005.
Also, I was screened for cardiovascular disease and took a Chest CT
scan and told that I wouldn't need to undergo cardiac catheterization,
only valve replacement surgury.

Prior to the committment to do the surgury, my cardioloist said that
since I am in in optimum condition, and, the sooner I do the surgury,
the better the outcome and is hopeful that the vetricular diameter will
return to normal range once the valve has been replacement
and I can resume normal activities.

I am sure that many of you pre-ops have the same fears and
reservations and look forward to hearing from you

I scheduled the surgury for Feb 2006, I am happy with my choice of
surgeon, but I am wondering, am I doing the operation prematurely
or am I taking the bull by the horns?

Also, I am leaning towards the biological valve and the surgeon
says that he uses 80% biological valves in his procedures,
and, if were him, the biological valve would be his personal
choice as well...

Allen Klein

 

[bvdr]

Allen, welcome to this website. I think you have a very wise cardiologist and that you are making an excellent choice. Get it done before permament damage is done to your heart. Some on this board would make that their choice if they could go back in time and pick a different answer. I can only imagine how it must feel to know you are about to have OHS when you feel fine. Others with bi-cuspid valves will be along to share with you but, seeing as its Christmas, the people visiting today will be fewer.

Merry Christmas!

 

[Kate]

Welcome Allen!
I just had my aortic valve replaced this fall and, like you, really had no symptoms to speak of - occasional dizziness and shortness of breath, but little enough that it could just have been from lack of regular exercise. However, my understanding of the aortic valve (and I freely admit not being a medical professional of any sort) is that by the time you have real symptoms, you are already at an increased risk of sudden death and may have done permanent damage. The great news is that this is a very low risk procedure, and chances are very good that you'll be back to your old active self within a couple of months. I'm 38, went with a biological valve and am very happy with my decision. Many others seem equally happy with their mechanicals. Since neither solution is ideal, I think it really comes down to looking at the benefits and liabilities of each and deciding which fits better with your personality and life situation. Best of luck to you! Kate

 

[Granbonny]

Welcome Allen

Welcome Allen

I had no symptoms of heart disease at the age of 62..when I had my surgery....My surgery came from a cath of heart showing I had an aneurysm.. How I got to the Cath of Heart..was from several doctors looking for a reason I was burping?ENT, Gastro man, PCP, ect. After a cat scan and chest x-rays..was referred to a Cardio...someone saw something.Thank goodness.Lost my wonderful B/I/L..15 years earlier..His dissected..and he had no symptoms, either. .....B/T/W..still burp..but it's aerophagia..swallowing of too much air.I can control it..but not a bad heart. ...Plan on your coming home from surgery. Get a recliner..plan on a nice warm place to walk..for several weeks. maybe a mall....You will feel better each day..but..remember, It's ( open-heart surgery) is NOT a fast recovery.......Take one day at a time.and by spring..you will be back doing most things you do now. Bonnie

 

[tobagotwo]

Allen, they have taken in cyclists for emergency valve surgery whose valves were almost entirely closed. They routinely come out saying they felt fine until they fainted during the race.

For some reason, bicuspid valve owners are often quite atheletic and fit, and also often have very clean arteries. It sounds like you fit that profile. It makes it that much harder for you to accept, but it also abets your recovery.

The reason the surgeon is pushing the surgery now is that he wants to do it before your heart develops damage that won't reverse after the surgery. The heart returns (remodels) to its normal size once the extra workload is relieved by the surgery. If you wait until the symptoms are pronounced, permanent damage may have occured. No one can tell precisely at what point that might happen, as each case is individual, so they go by their personal experience as physicians.

I went with a biological valve at age 52. It will mean one more replacement in my lifetime, but I am game for that. My opinion is that the best tissue valve choices are the Edwards bovine valves or the Medtronics porcine Mosaic or Freestyle valves.

You can also look into the Ross Procedure, in which your pulmonary valve replaces your aortic valve. The pulmonary valve, which is under much less pressure, is then replaced with a homograft (human valve) or a xenograft (animal tissue valve).

At your age and fitness level, you will probably do very well through this OHS, and your recovery will most likely be largely complete in six weeks. The main issue for you may well be just waiting for the sternum to heal.

As far as the surgeon, my personal take would be that he should be doing at least 100 AVRs a year to get to open my chest. And the hospital should be doing a good number of OHSs, so the nursing staff is skilled.

Best wishes,

 

[aussigal]

Hi and welcome...

i am another BAVer...I unfortunately have an aneurysm that is worse than my valve . My dodgy valve which is apparently still working ok.This is a great second home for me and I'm sure many others.

I look perfectly healthy ( well almost except for the grey complexion !) and my family and others have found it hard to believe I need this kind of operation. I went through Denial for a while then realised it was my life I was playing games with here and to stop being silly and just go get it sorted instead of staying in denial.

I look forward to following your story abd wish you great successes..
ton

 

[ALCapshaw2]

I second all of the above.

Conditioned athletes often report NO symptoms because their bodies are trained to be highly efficient and they can do more with less. This can lead to permanent damage to the heart if they wait too long. That is why surgeons prefer to operate before the heart muscles / walls are damaged from having to work too hard to pump blood through smaller and smaller openings.

YES, it takes a "Leap of Faith", but believe the NUMBERS and do the right thing.

Best wishes,

'AL Capshaw'

 

[EVELYN]

Hello Allen and welcome!!!

You said it yourself, 'TAKE THE BULL BY THE HORNS." If your surgeon and cardio both feel it is time, even with NO symptoms, then guess what????

My husband, Tyce, had AVR 3+ years ago. He, too, was asymptomatic for the longest time. The, with absolutely no reason he said he had "trouble sleeping." Well, he went into afib, was in the hospital for a week and had OHS three weeks later. Our cardio had told us that it probably would be within a year in January....Tyce had surgery in June. The second the cardio was called to the hospital, his words to Tyce were...."That's your sign, let's go and get it done." We have never looked back and are very glad he had the surgery before any irreversible enlargements occurred.

I know, it sounds crazy, especially when you feel absolutely fine, but get it done and over with before anything bad happens that they can't "FIX."

Good luck....we'll be here for you.

Evelyn

 

[bani]

Hi,

I had severe symptoms several months before my surgery (bicuspid, too). Thought is was just stress. The cardiologist was surprised that I had not fainted yet. Fortunately, no damage was done to the heart itself at that point. I agree: Have it done now, then you don't take any risks.

 

[Shine_on_Syd]

Allen, It is good that you set a date. There is a lot that goes into making that decision and once you set the date you have a big monkey off your back.
I had AVR (tissue) too at age 53. Like you I was totally asymptomatic. I regularly ran road races 10Ks, 1/2 marathons, inline skate competitions, played in an organized hockey league. No problems. Then during an annual physical my PCP discovered a heart murmur. An echo showed severe aortic regurgitation, not bicuspid, but a tear in the aortic valve leaf,
He and the cardio grilled me...do you have SOB? are you tired?, etc. etc. I said no I feel just fine and am aerobically fit.
The decided to put me on a 6 months echo watch. The heart was amazing at compensating for my severe regurgitation, but my LV walls began to thicken with the extra work load.
They said it would be a call when my left atrium wall thickened and my LV reached 6.+ CM. They explained I could easily cross over the line to CHF, which was to be avoided at all costs. Like Bob said, they want to cathc it before you have ireversable damage..
I was still asymptomatic before the surgery and ran 4 miles two days before the AVR.
I let the surgeon make the call on surgery date and all is well ever since. My LV returned to normal size almost immediately after surgery.
And also as Bob said, given your age and fitness level, consider the Ross. It was my procedure of choice.