oceanspray
New member
First some history. Very active 67 year old male, first diagnosed with moderate mitral valve prolapse in 1998. Asymptomatic. Echo in September 2010 shows progression to “severe”. Without symptoms, cardiologist will check another echo in 6 months. April 2011 shows slightly more LV dilation, but heart function good (EF 60% or more, no stenosis). Another echo in May 2011, a stress test (no issues), and cardiologist says the MV needs to be repaired NOW with heart fairly healthy and before further deterioration. Set up consultation with surgeon. I have gone through series of pre-surgery procedures... blood work, x-rays (OK), carotid scan (OK), cardio catheterization (OK), and TEE. Results of pre-surgery TEE suggests surgeon will go for a repair, my best possible outcome. We discuss “Plan B” (what if valve not repairable), and after much thought, research, discussions with Primary Care, cardiologist, surgeon, and brother-in-law doctor, I decide, with concurrence from surgeon, to opt for an Edwards pericardial valve. Primary reasons for tissue selection? At my age, going into my 70’s, coumadin increases risk of internal bleeding and stroke. I also have concerns over the clicking noise of a mechanical (very light sleeper, no ticking clocks, even in adjoining rooms). Slower age-related life style, and blood chemistry should improve longevity of a tissue valve. Surgeon also notes that reop options 10-15 years from now will certainly change from today, to include trans cath repair/replacements.
Now my current issue. Repair surgery planned for mid-June cancelled repeatedly because of “cold” symptoms that started the end of May. Symptoms included high temp (104), no appetite (lost 12 pounds in 2 weeks), could not sleep, extremely weak, coughing, et al. Primary Care puts me on Z Pack, a 5 day course of azithromicin, That knocks down temp, and improves other symptoms. Mention my regularly scheduled dental cleaning mid-May, which includes prophylactic amoxicillin. PCP orders blood cultures, which confirm endocarditis. Immediately put on 30 days of daily IV’s of Rocephin. PICC line installed, and doing home infusions until July 29. Follow-ups with PCP and surgeon scheduled for August 3. I’ll assume surgery to follow.
My question. Has anyone been through a similar situation... endocarditis right BEFORE surgery. What effect did that have on surgery regarding a repair or replacement? On replacement, did endocarditis force a change of valve type (from tissue to mechanical)? Surgeon told PCP that endo does not rule out a repair, but will make that call once inside. He’s always stated he’ll do whatever would provide best possible outcome. Just looking for some real-world experiences before meeting with surgeon.
Now my current issue. Repair surgery planned for mid-June cancelled repeatedly because of “cold” symptoms that started the end of May. Symptoms included high temp (104), no appetite (lost 12 pounds in 2 weeks), could not sleep, extremely weak, coughing, et al. Primary Care puts me on Z Pack, a 5 day course of azithromicin, That knocks down temp, and improves other symptoms. Mention my regularly scheduled dental cleaning mid-May, which includes prophylactic amoxicillin. PCP orders blood cultures, which confirm endocarditis. Immediately put on 30 days of daily IV’s of Rocephin. PICC line installed, and doing home infusions until July 29. Follow-ups with PCP and surgeon scheduled for August 3. I’ll assume surgery to follow.
My question. Has anyone been through a similar situation... endocarditis right BEFORE surgery. What effect did that have on surgery regarding a repair or replacement? On replacement, did endocarditis force a change of valve type (from tissue to mechanical)? Surgeon told PCP that endo does not rule out a repair, but will make that call once inside. He’s always stated he’ll do whatever would provide best possible outcome. Just looking for some real-world experiences before meeting with surgeon.
