Father needs valve replacement, need questions answered please.

[Forky]

Greetings,

I am new to this forum as I came across it over the internet while looking for information. I have found all of your posts very helpful in answering some of the questions I have. I am hopeful you can help me some more.

My father has been diagnosed with aortic stenosis just recently. He has had a known valve problemt for years (leakage primarily) but it was never thought to be bad enough to warrant surgery. To make a long story short, last week tests confirmed aortic stenosis. From my understanding they make three measurements while inside they heart examining it. One is the surface area of the opening remaining open, one is the gradient, and one is basically the speed at which the blood passes through. Anyway, my dad's was rated sever in all three measurements.

We met with the cariologists (University of Minnesota) and they explained that surgery is the only way to fix the problem and the prognosis for leaving it as-is is poor.

We are set to meet with the surgeon this Thursday. What I have been trying to research is what affect my dad's pre-existing conditions could have on the surgery.

My dad: he is 69 years old. he has been a diabetic for 30 years. In 1999 he had to go on Kidney Dialysis and in 2000 he received a kidney transplant. IN 2005 he received a pacemaker and in the Fall of '05 he lost his Kidney function from fluid problems (heart and kidney related). He has been back on dialysis since October of '05. He has had a lot of trouble with flash pulmonary adema during the pacemaker procedure and the 'bout last fall. He has never had a heart attack and has no blockage in his arteries.

What I am wondering is if what affect the diabetes,dialysis/kidney failure and his past history have on his chances for coming through the surgery okay?

I would appreciate anyone's insight and comments. We have been down very tough roads before so I can take bad news.

Thanks,

Chad

 

[Lynlw]

I'm sorry i can't help you with what you are looking for , but wanted to welcome you and let you know you are at the right place to get the answers you need. I'm sorry your dad has been thru so much already, lyn

 

[PJmomrunner]

Welcome Chad. I'm sure you will be received warmly and many people will be along to offer you support. You've come to the right place!

What I am wondering is if what affect the diabetes,dialysis/kidney failure and his past history have on his chances for coming through the surgery okay?

This is a question that can only be answered by CT surgeons and, I suspect, you'll like the answer more from a very highly skilled, very highly experienced surgeon at a high-volume facility. At the very least you should get a second opinion, if not a third or more. Many studies have been done that support the idea that patient outcomes are better at high-volume facilities. The Mayo Clinic is a very obvious example of the type of facility you should seek out for your dad.

I hope you will keep us informed of your dad's progress as you navigate through yet another medical process.

 

[hensylee]

Welcome to VR, Chad. If there are opinions and experience you can glean from others, it may just be right here in VR. It sounds like you have a very iffy situation. I do hope somebody here can give you some pointers or at least share some experiences. The others will be checking into this thread soon so just give it a little time.

 

[ALCapshaw2]

Greetings Chad,

I'm assuming the measurements you spoke of are from an Echocardiogram. Is that right?

The fact that all 3 measurements (and they are related) are severe, pretty well confirms that his valve needs to be replaced. Yes, replacement is the ONLY cure for such problems.

Due to his other issues, I would only consider a Very Experienced High Risk Heart Surgeon. The Mayo Clinic is rated as the #2 Heart Hospital so that would probably be your best and certainly closest choice. The #1 rated Heart Hospital is the Cleveland Clinic. One of their respected surgeons went to Northwestern near Chicago not too long ago.

For this surgery, I would expect you really want a "BEST of the BEST" kind of surgeon and not just a "good local" surgeon unless he has lots of experience with your father's conditions and a good track record to back it up. I would go ahead and interview your local surgeon, but also make an appointment at Mayo Clinic for evaluation and recommendation of their best High Risk Surgeon.

A TEE (TransEsophageal Echocardiogram) is often used to confirm the need for surgery since better images can be seen from the ultrasonic transducer that is run down the patients throat until it is right behind the heart.

A Left and Right Heart Catheterization will likely be requested by any skilled surgeon before surgery to fully assess the heart and lungs.

Hope all goes well for your father.

'AL Capshaw'

 

[Kathleen]

Chad
I live a tiny bit south of you in Shakopee. The U has a great reputation and the surgeons there would certainly let you know if he needs to go to the Mayo since the aortic stenosis will be coupled with the kidney issues. Have you picked a surgeon to meet with yet? I did have one of my surgeries with two surgeons the second was Dr Lyle Joyce. He was at Abbott at the time but now is with the U. I have had 4 open heart surgeries and a lung surgery at Abbott Northwestern. They are both excellent hospitals and when you add the Mayo which is a just a short distance he should get some excellent care from any of the hospitals. I did not choose the Mayo since they were not a preferred providor of our Federal Emplyees insurance plan.
Kathleen

 

[Forky]

Thanks to all who have replied:

Al: he had both an echo and an Angiogram or heart catheritzation. From what I understand, they noticed a change with his echo and the angio type tests confirmed their findings.

Kathleen, the surgeon we are to meet with is Dr. Liao (sp?). The cardiololgist highly recommended him and I will be going to the appointment as well.

Please feel free to keep sharing your thoughts. I never gave a lot of thought to another opinion. I always considered the U of MN to be a top-notch place but I may have much more to learn.

Chad

 

[Ross]

Forky given his past med history, without a doubt you want one of the top rated hospitals and surgeons on the case, not hometown situation here. I would think he would be high risk and that would be right on par for Cleveland or Mayo.

 

[DeWayne]

Thanks to all who have replied:

Please feel free to keep sharing your thoughts. I never gave a lot of thought to another opinion. I always considered the U of MN to be a top-notch place but I may have much more to learn.

Chad

The UofM has a long history of heart surgery. I am one of the people they used in early days to follow. I was first diagnosed with aortic stenosis in 1957 at the UofM, I did not have the surgery there, I had it at Henry Ford in Detroit, but the UofM followed everything and I had checkups there for many many years. I still remember going in and having 15-20 doctors look and listen to my heart every time I went. Probably part of my fear of Hospitals now lol, but I am sure they were using me to further education of doctors.

 

[gijanet]

Chad.............

Chad.............

Believe it or not, I was on here last year posing the same questions on the bahalf of one of the teachers I work with. Her husband (mid-fifties) is a diabetic, has had a kidney transplant, and is blind from the diabetes. No one on here at the time of my posting had encountered such a combination also needing an aortic valve replacement.

Well, Henry had his valve successfully replaced last year, although it was not an easy task. I remember Janice said it was quite an ordeal just to get all of Henry's specialists together to form an attack plan. I'm afraid I have forgotten some of the details since last year as to exactly what they ended up doing. I do remember that they ended up going with a tissue valve and the surgery was performed in Dallas. Janice retired last year, but I have her phone number and, if you would like me to, I will be happy to contact her. She has a good heart (taught special ed for thirty years), and I know she would be willing to answer any questions that you might have. If you are interested, just drop me a PM with your phone number and personal e-mail addy. By the way, Henry's surgery went well, and he is back at work full-time and has been for quite some time.

Good luck and please keep us posted. Hugs. Janet

 

[ALCapshaw2]

Just for clarification,

I believe DeWayne is referring the University of Michigan

whereas Forky is referring to the University of Minnesota.

'AL Capshaw'

 

[Dennis S]

Surgeon:

Surgeon:

Dear Forky: I am 59 years old and had my aortic valve replaced at Abbott-Northwestern hospital in Minneapolis 1 year ago. I only offer this in case you decide to check it out (it sounds like you are happy with your surgeon). I have a lot of contacts with the medical community in Minneapolis. I talked with friends who were surgeons in other areas. In my humble opinion, the best valve surgeon in the Twin Cities is Dr. Vibu Kshettry, who does his surgeries at Abbott-Northwestern hospital. Please take that for whatever it is worth.