Complicated Heart Valve Case

[westes]

My admin's father in Russia has an extremely difficult heart valve operation in front of him, and I am wondering if there are any new techniques or drugs that we should bring to the doctors' attention.

The basic history of the case is that he had a mini-stroke about one month ago. He was hospitalized, only to get a septic infection from a catheter in the hospital. Things got worse when he then got an infection in the heart, and this destroyed one of his heart valves completely. Apparently he had a congenital defect in the heart but it had never caused problems until now. He also came down with pneumonia.

Probably due to the complete failure of one of his valves, he has started clotting, and his left arm is swollen now from clots. He has begun to show some signs of kidney failure as well.

How someone can go from being extremely healthy, without significant ongoing health problems, to this level of messy complications in just one month is pretty startling, but that is where he is.

The doctors have said that he must have a heart valve replacement because the disfunction is too severe for him to live without it. At the same time, the doctors fear that the surgery will kill him, as the clots in his arm will probably travel to other parts of the body. I guess they are concerned about pulmonary embolism. Stopping the heart completely and using the heart lung machine is sometimes associated with causing more clotting as well and strokes. I heard that they lower body temperature as part of this procedure and that causes clotting as well.

The doctors considering all of these facts have said that his chances of surviving with so many complications are around 10% at this point. Obviously these aren't good odds.

We are looking to see if there are any new surgical techniques or drugs that might be of use in a case like this one. For example, is anyone doing valve replacement orthoscopically now, or using a technique that does not require the heart lung machine? Are there any anti clotting drugs that are new that would help to clear the clots in the arms before attempting surgery?

Any insights are appreciated.

 

[hensylee]

suggestion: go to About.com, heart disease/cardiology, find Dr Rich and ask him these questions. He is an EP, keeps current on EVERYTHING heartwise - will not give you advice over internet, but might update you on surgical/heart related new procedures.

In meantime, read all you find here - never know. My heart goes out to your friend and family. The odds sound nearly insurmountable, don't they. They are in my prayers.

God bless

 

[ALCapshaw]

That does sound like a severe case.

I've never heard of anyone NOT being put on the Heart Lung machine for Valve Replacement. I don't believe it is possible to remove and replace a heart valve without stopping the heart.

Interestingly, I have seen where Bypass Surgery IS performed in Siberia where heart lung machines are rare and expensive by ICING the patient. The surgeon must operate very quickly to prevent problems from the lack of oxygen supply to the brain / body. I expect valve replacement surgery would take longer and probably not be an option for this technique.

His best option would be to get to a country that has better / more advanced hospitals, such as Finland, Germany, Canada, or USA.

'AL'

 

[Nancy]

Hi Will-

Welcome to this terrific site. What you have described is certainly a complicated situation. Is this poor man able to travel to the US? The Cleveland Clinic is one of the best in the world and also tries to make foreign patients welcome.

Maybe if they could stabilize this man's infection and get his bloodclots dissolved with some anticoagulation, and get him on some good heart drugs, they could buy him enough time to get to an excellent facility.

It is possible to recover from some pretty devastating medical complications. One of our members, Ross has had such a situation. My husband is also a guy who has had some pretty terrible things happen. There are also some other members who have had major complications. I'm sure these good folks will speak up.

I hope he can get the help that he needs.

 

[Nancy]

Here's the link to Cleveland Clinic

http://www.clevelandclinic.org/services/

 

[EVELYN]

Hello Will

I absolutely ditto what Nancy just said. This person is much better off in the USA, especially at the Cleveland Clinic. Is he able to get to this country if he gets stablilzed in Russia? It certainly sounds serious. But I, too, like Nancy have NEVER hears of heart surgery without the heart/lung machine....even minimally invasive. You certainly have much to sort out, but I think first and foremost is to get the pneumonia, clotting and infections cleared up. I truly do wish you my best. Please let us know how this turns out and what you decide.

Evelyn

 

[sylviayasgur]

hi will!
i'm so sorry to hear about this difficult situation.
joey's uncle just recently went through a similar situation. it is really tough for the doctors to take any action because the patient is like a time-bomb with all those clots.

i don't remember where i read it, but i think it must be an experimental procedure where they are actually trying to conduct open heart surgery "off the pump". i know i'm not dreaming, but i can't, for the life in me remember where i read or heard about it... i'm sorry.

i will let you know if i recall any of it...meanwhile i think the other suggestions are fine ones.
good luck and i'm sorry i couldn't help more. please let us know what happens...
stay well, sylvia

 

[Zipper]

Hi all,

My husbands open heart surgery in Aug/01 was done 'off-pump'. So, yes, it is done for CABG (cardiac artery bypass graft) and the reported recovery time is easier on the patient. As far as valve replacement goes, I do not know of any done off-pump' (without heart-lung machine). My husband and I both have same Doc and surgeon but mine was 'on pump' as I had valve replacement as well as CABG. Someone may know more info on this, however. I can only speak from my personal experiences.

Take care and best wishes,

Zipper *~*

 

[hensylee]

Zipper, I believe you are right. News came out a while ago about this surgery but was not done on valvers.

This will be a really good situation for us to follow closely, if we can, since so MANY questions come to VR. If we can't answer, often we have at least heard of something we can pass on - like your message, Zipper.

 

[joy]

Hi Will, I think we all agree that this person needs to come either to america, or another country with better medical resources. I'm not sure if I am right about this, but on ask.com they talk about vr without a pump. I don't know.. a cardio would know more. If possible, his chances of making it are better here.