Concerns about heart beat starting back after taken off heart lung machine

[Phyllis Jean]

My Aortic Valve surgery has been rescheduled for Oct. 15th 2004. I know it sounds silly, but I am really concerned about my heart resuming it's beating after they take me off the heart-lung machine.

Has anyone ever heard of someone dying because their heart didn't resume beating? Does it just automatically start beating on it's own, or do they have to use something else to get it started? I am so scared. I need some re-assurance.

How long does Aortic Valve surgery usually last if there are not any complications? How long did yours last? How long can you stay on a heart-
lung machine without it causing brain damage, stroke, or something else?

Please help me! Phyllis

 

[geebee]

Worries are normal

Worries are normal

Oh Phyllis, I feel for you so much. I have had 3 surgeries and each time I had new fears that crept up and, no matter what your doctor or others tell you, they are real to you.
In two of my surgeries, my heart was restarted with a "paddle zap" (I am sure there is a technical name but this one works). After the other surgery, it started on its own. I think it is different for everyone.
I have not heard of anyone dying from their heart not starting after coming off the heart-lung machine. That is NOT to say it might not have happened, I just don't anyone and I have a bit of experience in meeting heart surgery survivors.
Again, I do not know the specifics but my surgeries have lasted from 3 hours to over 8 hours, so you can be on a heart-lung machine for quite awhile and still be fine.
I have a mitral replacement valve so I cannot say how long an aortic valve lasts. I would assume, if it is not a tissue valve, it has the longevity of the mitrals. My 3 surgeries did not result from valve failure, they resulted from other issues that are quite rare. In fact the only reason I had the original valve replaced during my third surgery was because it was a valve that had had some problems and my surgeon felt it made sense to get it out while he was operating.
I have a wonderful, perfectly normal life except for watching the "coumadin issues". Therefore, if you are getting a valve that does not require coumadin, you will be even further ahead of the game.
I cannot tell you not to worry because it won't work. Just be reassured by all the many people who post on this website that are leading wonderful lives due to the miracles of modern medicine. I will share with you that, just before I fell asleep prior to my third surgery, I looked up at everyone in the operating room and said "I hope you are all having a great day". They are smiled at me and said "we certainly are so you can have more great days". I am sure I had a smile on my face when I fell asleep. I also had the fastest recovery of any of the surgeries.
Keep smiling and God bless,
Gina

 

[Kay]

Yeah, that one too!

Yeah, that one too!

Hi Phyllis,

You mentioned your concern about your heart not starting up again. Gotta add that one to my 2 scary issues -- the TUBE, and being flat on my back WITH the tube in my throat! Glad you asked that question. A couple of years ago when I was first diagnosed, I worried about that all the time. But then the surgery seemed so far away so I relaxed and forgot about it. Now with the surgery looming, I started worrying again, but this time focusing on the dreaded tube! I mean, I have been FOCUSED on that tube!!!

Reading all the replies on this board is helping me immensely. It's such a source of comfort to know I'm not alone in my fears and concerns. Others have been there, done that, survived and are sharing their experiences with us. The posts on this board help to put it all in perspective and while I can't say I'm exactly relaxed about my concerns, I feel like I'm facing them now and am definitely progressing in the right direction. Information is power, and there is a ton of it on this site. I feel so much better prepared for my cardio and surgeon appointments now. Before this board, I was just going in blind, armed with all my fears!

My AVR will most likely be 3-4 weeks after yours. I'll find out when on the 27th. I'll really be wanting to keep up with your progress since you'll be forging the way ahead of me! You're in my prayers starting this minute. Please keep us posted.

 

[ALCapshaw2]

Hello Phyllis,

I can understand your concern, but having known many people who had similar surgeries, I expected to come through it all OK. We have over 1000 members who represent SUCCESSFUL valve replacement surgeries so the odds are highly in your favor. Did your surgeon tell you what would happen if you did NOT get your valve replaced? Think about THOSE ODDS and surgery begins to look pretty good!

The statistics for first heart surgeries on otherwise healthy people under the age of 60 are greater than 99% survival rate. I believe most people's hearts start back as they bring your body temperature back up. For those who don't respond, they can use the 'paddles' to give your heart a 'jump start'. If you are still concerned, that would be a good question to ask your surgeon.

There are a lot of studies going on to try to determine what causes cognitive issues such as short term memory loss. Several potential causes have been identified, including the quality of the filters used, length of time on the heart lung machine (I think the 'cross clamp time' is the relevant issue here), and rate at which your body is warmed. One study showed that if the warming rate was slowed down to add another 10 to 15 minutes, that there was less incidence of cognitive issues. That would be a good request to make to your surgeon.

Typical single valve surgeries are around 3 hours total, going up to 6 to 8 hours for complex surgeries. I recall one case lasting a couple of days, but that was due to severe complications and is extremely rare... and the patient survived!

In the mean time, try to think of more positive things, like what you are going to do with your improved quality of life after your recover from your surgery.

Best wishes,

'AL'

 

[KathyH]

Hi, I agree with Al, try to focus on the positive issues- how much better you will feel to have the surgery done and over with. It is natural to think about your heart being stopped, but try to put it out of your mind. It is much better to go into surgery with a positive attitude. Prayers will definately help you through this. I was amazed that the surgery was not as bad as I expected, just as other members told me. Take care.
Kathy H

 

[Christina]

Hi Phyllis,

I understand your concern, but have to echo what the others already have said that you'll be fine. 99% of us are.
The heart/lung machine is a scary thought but the surgeons/doctors are experienced and have done this thousands of times before. You need to focus on positive thoughts. This is a life saving surgery and without it you will not live a long life.
Anything can happen though as all surgeries carry risks, not only valve surgeries. I personally know of one 70 year old lady that didn't make it through heart valve surgery. I spoke several times with her over the phone before she had the surgery. I remember her being terrified. I encouraged her, not knowing anything about her. I never met her, although she lived in this city. The doctors were unable to restart her heart after she came off the heart/lung machine. She was put on an artificial heart for a few days to give her own heart a rest, but after 5 days they were still unable to re-start her heart. They had to let her go.
I think it had a lot to do with the fact that she'd been a life long smoker, and the surgeon told the family afterwards that her heart was in much worse shape than he could tell from the echo and cath.

In the mean time you need to stay calm. Everything will be okay. You need to hand it over to a higher power and your medical team. Prayers are very powerful, and we all will say a prayer on your behalf.
Make sure you have someone post for you so we know how you are doing.

Best wishes.

 

[Glenda]

Phyllis, I can also remember worrying so much about this too. I love this web site but I think sometime we learn too much. We go in surgery knowing what's going to happen. All I can say to comfort you is what I did. I went to sleep praying and woke up praying. Regardless of what happened I knew that I would win. I've had numerous surgeries but this was the most serious but thank goodness, God is still in control and He's still working on me.

You most certainly will be in my prayers. Hugs are coming your way.

 

[BSastry]

You'll do just fine

You'll do just fine

Hi Phyllis,

I had emailed you a couple of days ago. The last two days of waiting must be tough for you. I think it is natural for all of us. We have 11 days until my husband's AVR (it's on 10/22) and we are going crazy.
Think of it like this - After Fri, you will have the surgery out of your way and you will be on the road to recovery. I am sure you will be well enough to post your experiences in the post-surgery forum yourself very soon.
We will pray for you on Fri. Take care.

-Bharati

 

[bicuspid_rmt]

Fears about the surgery

Fears about the surgery

I've done some heavy research as an RMT about my AVR and learned that when you get the heart going again, they run stimulus to nodes on your heart that normally receive stimulus from your Medulla at your Brain stem. This will continue until your brain regains control in making your heart pump. This is very common and very predictable aspect of the heart tissue. This is absolutely nothing to worry about. All through surgery, blood is circulated through your body including your brain so at no point is there any ischemic (lack of blood) issue that may indicate any concern in reviving your heart. The heart has a very predictable response, in this situation, when restimulated. I believe that the heart also receives the blood to all the muscle tissue during this time. It is only the valves that are not passing blood (so the repairs can be made). I also understand that when you wake up, if they have the tube still in, they have you drugged so well that you are really not conscious enough for the tube to really be an issue as they don't want to stress the heart at all. My friend who had this done said that the only issue was a moderate dull pain at your chest that didn't last for long. He said that it was much better than he thought it would be. It is the priority for the staff that you remain relaxed after the surgery so you can be assured of that.

 

[tobagotwo]

Phyllis, you know they're not going to do all that cutting and sewing, and then let you fail to come back when all the hard work is already done!

It is surely a scary thought, but so is flying in a plane. You depend entirely upon the pilot and his attention and expertise in the air, and the stakes are just as high in a jet as in the OR.

The hospital will give you things to help you relax, so you won't be as afraid when the time comes.

These people are highly skilled and capable, and they desperately don't want to lose anyone entrusted to them. It's a human thing, a professional thing, even an ego thing. No one is going to fight harder for you than your surgeon.

Best wishes,