Final Pre-Operative Tests? What do they typically do?

[T in YVR]

Hi,
I had a question for anyone who has been through AVR. I spoke with my surgeon's office yesterday and they said I need to go in and sign consent forms next week. After this, they said I will be scheduled on a subsequent date to go through their Pre-Admissions clinic where they will conduct some basic tests, meet with an anesthesiologist, an operative nurse who discusses what will take place etc. Its sounds like a prep/orientation with some routine tests which include bloodwork, chest x-ray, check blood pressure, EKG, along with some Q&A etc. Only after this takes place do I get informed of the surgery date by my surgeon's office. What an incredibly long process just to get the date...but everyone has to go through this process at St. Paul's in Vancouver. I asked them if they will perform any other more specific/detailed tests prior to surgery such as cardiac catheterization, final Echo, etc and they said 'no'. (I had a TEE (March), CT Scan (no aneurysms) (March) and 2 Echos (latest at end of June)).

Is this normal? Don't they do any other pre surgical testing to make sure they have the entire picture? Or do they only perform these other tests in more complicated cases? As of right now, I am a straight AVR. So, my surgery will likely be in October or early November and will be based on data that is several months old. Perhaps this is fine...I don't know. I always think about that old saying when you are doing home construction projects: "measure twice, cut once"...seems appropriate here too.

Thanks,
Tony

 

[dg_moore]

Hi,
I had a question for anyone who has been through AVR. I spoke with my surgeon's office yesterday and they said I need to go in and sign consent forms next week. After this, they said I will be scheduled on a subsequent date to go through their Pre-Admissions clinic where they will conduct some basic tests, meet with an anesthesiologist, an operative nurse who discusses what will take place etc. Its sounds like a prep/orientation with some routine tests which include bloodwork, chest x-ray, check blood pressure, EKG, along with some Q&A etc. Only after this takes place do I get informed of the surgery date by my surgeon's office. What an incredibly long process just to get the date...but everyone has to go through this process at St. Paul's in Vancouver. I asked them if they will perform any other more specific/detailed tests prior to surgery such as cardiac catheterization, final Echo, etc and they said 'no'. (I had a TEE (March), CT Scan (no aneurysms) (March) and 2 Echos (latest at end of June)).

Is this normal? Don't they do any other pre surgical testing to make sure they have the entire picture? Or do they only perform these other tests in more complicated cases? As of right now, I am a straight AVR. So, my surgery will likely be in October or early November and will be based on data that is several months old. Perhaps this is fine...I don't know. I always think about that old saying when you are doing home construction projects: "measure twice, cut once"...seems appropriate here too.

Thanks,
Tony

I'm scheduled for July 26 at Washington Hospital Center in DC. They do so many of these (AVR) that they have a quick routine. Separate appointment with the surgeon is optional - I go in July 23 for pre-admission testing at which time they do the tests (I had a cath with my cardiologist last week and my arteries are clear) and give me the briefing about what to expect and what comes after, etc. If the surgeon is available after this is finished, he will meet with me and answer any questions; if not, he will meet with me before the surgery on Friday morning. It all seemed pretty casual to me, but then I realized that it's not casual at all, just efficient. I feel like I'm approaching the top of the roller coaster, and the vertical plunge is about to start at any second :eek2:. For the medical team it's just another day at the office.

Good luck!
Dave

 

[Heart Of The Sunrise]

Tony and Dave...wow seems like just yesterday I had the same, concerns, comments and questions. I am 4 months post-op. This is my 7th week back at work.
Before you know it your surgery will be over... a success...your recovery will be going fine. You too will be saying the waiting is the hardest part. Best of Luck!!!:thumbup:

 

[dg_moore]

Tony and Dave...wow seems like just yesterday I had the same, concerns, comments and questions. I am 4 months post-op. This is my 7th week back at work.
Before you know it your surgery will be over... a success...your recovery will be going fine. You too will be saying the waiting is the hardest part. Best of Luck!!!:thumbup:

Thanks! I know I have a tendency to over-think and over-analyze things, and this is no exception. In moments of clarity I realize that these guys know what they're doing and I just need to relax and put myself in their hands. In moments of near-panic that's not so easy to do, but ...

Dave

 

[Heart Of The Sunrise]

Dave:I do the same exact thing. Being an engineer I treated my condition as an engineering project.
I have posted this video link before. It is my surgeon describing the exact same condition and surgery that I had. The only difference is that this patient choose a tissue valve... and I went mechanical. http://www.youtube.com/watch?v=d5jGG4sH2Cc

 

[Jkm7]

I had TEE about 5 weeks before my second surgery and Cath about 4 weeks prior.
I met with my surgeon and my surgery was scheduled for one month from that meeting. It would have been sooner if he had an opening but he was fully booked.

Pre-op testing was EKG, blood, urine, chest x-ray, meeting with anesthesiologist and physical exam by PA. This was at Mass General in Boston and is their normal routine to do this day prior to surgery.

 

[kimcdougc]

Dave & Tony, I am now 8 weeks post op and it is even hard for me to realize I had surgery of any kind, much less OHS. I remember that there is really not much anyone can say about the anxiety before surgery. Reading all the good folks post here are what helped me the most pre surgery. You just have to bite the bullet and have it done. You will be so happy when you are on the other side of the mountain and all you have to worry about is your recovery. Waiting is truly the hardest part of it all. Please let us all know when you go in for your surgery. It really isn't that hard of a process. Just saying I was where you were at 9 weeks ago. - Kim

 

[Heather Anne]

If it's any comfort, I'm going in for my pre-op stuff on July 29, and my surgeon said they weren't going to do a catheterization or ECHO either. I've never had a catheterization, and my last ECHO was in April. He just didn't think either test was necessary. I'm at UCSF in San Francisco.

 

[Agian]

Thanks! I know I have a tendency to over-think and over-analyze things, and this is no exception. In moments of clarity I realize that these guys know what they're doing and I just need to relax and put myself in their hands. In moments of near-panic that's not so easy to do, but ...

Dave

Yep, that describes me to a tee. When I get anxious, my mind tends to wander, I catastrophise and go through the worst-case scenarios.

 

[ski girl]

They can do all the tests in the book, but nothing beats actually getting in there and having a look! During surgery they're prepared for any eventuality such as aorta being bigger/smaller than the tests showed, needing to put Dacron grafts in, implanting a pacemaker . . . .

This is a massive operation to us but to the surgeons it's not a particularly tricky one. My surgeon is regarded as the best in Australia and he describes himself as a plumber!

Good luck from down under

 

[T in YVR]

Thanks for the insight. Heather Anne - your situation sounds very similar to mine - all the best for your surgery in Aug.

Yeah, I was taken aback when I first met my surgeon (and on every interaction with other people involved in this - from the Cardiologist to the assistants etc.) on how casual they are about it. It truly is no big deal to them. I guess the tests they have done thus far are enough - they saw the images, read the results, etc. Can't wait to get a date and get this over with...this sounds pathetic but I am a huge NFL football fan and have season tickets for the Seattle Seahawks. I'm trying to time my surgery so that I miss as few games as possible (in addition to just wanting to get it done before any major symptoms emerge and so that I can get on with my life...
Tony

 

[Rachel]

Can't wait to get a date and get this over with...this sounds pathetic but I am a huge NFL football fan and have season tickets for the Seattle Seahawks. I'm trying to time my surgery so that I miss as few games as possible (in addition to just wanting to get it done before any major symptoms emerge and so that I can get on with my life...
Tony

NOT pathetic at all! I say if you need it, get it done and get on with your life - and sounds like you've got a great thing to look forward to!!!!

 

[Shellbell]

Tony -

a fellow Canuck here -43, I am scheduled for AVR and ascending aortal repair in September - and at Toronto General's Peter Munk Cardiac Centre I am having the same pre-admission day a week before surgery. Sounds exactly the same, meet the nurse, anesthesiologist, etc. I did have an angiogram in June, but have never had a TEE or catscan. Those tests can give them all the info they need, i think, and are less invasive than the cardiac cath anyways. I was sent home 3 years ago after being on the table for my cath by a cardiologist who felt the need was not yet there for invasive testing. ( omg talk about relieved LOL ) Sounds like they were able to determine the same things from the catscan, like a lack of blockages, that they found from my angio.

As far as football, dont feel bad cuz i tried to push surgery back till my cottage was closed. Pleasure before pain, right? No such luck but like you said, the docs know best. I am with you in trying to not let the mind wander to negativeland but its hard, one minute i can be strong and fine and then the next i am a scared kid feeling sorry for myself. Sometimes it hits me upside the head like a frying pan. Heres to getting over the fear and on to the recovery.

Best wishes.

 

[T in YVR]

Thanks for the info ShellBell. Sounds pretty similar to me...Looks like we'll be having surgery around the same time - I am supposed to be operated on some time in late Sept or early Oct. Date TBD....

Tony

 

[Bryan B]

Not all patients require a cath, that is something I would discuss with your surgeon and ask him why he doesn't think you need one. I don't know how old you are but most surgeons don't do one on younger patients. I think most if not all surgeons do a TEE right before they start the surgery (you will be out already) so they get a really good look at everything before they start.

 

[gerrychuck]

...this sounds pathetic but I am a huge NFL football fan and have season tickets for the Seattle Seahawks. I'm trying to time my surgery so that I miss as few games as possible (in addition to just wanting to get it done before any major symptoms emerge and so that I can get on with my life...
Tony

Ah, well, I guess if my only other option was to root for the Lions, I'd probably be a Seahawks fan too

Gerry (Riders Rock: 6-1!)

 

[clay_from_nj]

Not all patients require a cath, that is something I would discuss with your surgeon and ask him why he doesn't think you need one. I don't know how old you are but most surgeons don't do one on younger patients. I think most if not all surgeons do a TEE right before they start the surgery (you will be out already) so they get a really good look at everything before they start.

My docs definitely wanted to do (and did) a cath before my surgery, and I am 47, which I have been told by just about every medical person attending to me, is VERY young. I have never had a TEE (unless it was when I was out cold) - threatened with it a couple of times, but not done it. I also had caths done before and after my surgery as a child, but that was a long time ago, and I'm sure practices have changed since then. Interesting to note, the caths I had as a child were done in my arm rather than my groin, still have the scars to show for them.

 

[T in YVR]

Ah, well, I guess if my only other option was to root for the Lions, I'd probably be a Seahawks fan too

Gerry (Riders Rock: 6-1!)

Ha! Good one...our Lions are only 1 game back. See you in the playoffs