How is reop different than first AVR.

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windsurfer2

Member
Joined
Sep 1, 2015
Messages
10
Location
Virginia
I'm 65 and after 10 years my CE bovine valve has severe calcification and will be replaced when it is required. I'm relearning what it is like to go through this surgery but wonder if there are some differences. All I know so far is that it is riskier though don't know the reasons nor how that might impact decisions I must make. I couldn't find any topic on this though many here have had reops - some several times.

How is reop different?
 
Hi

For the surgeon:

basically the reop is different because of scar tissue. This is not quite what you see on the outside, but of course formed by the same process. When you get a dead animal (such as an uncooked chicken) you can pull the skin easily from the body, but if you were to have cut that chicken deeply while it was alive and allowed it to heal you would see remarkable differences in the skin where the cut was. You would for instance no longer be able to pull it away from the membrane that separates it from the breast muscle. It would be stuck there and you'd have to cut the scar tissue away.

Scar tissue is not single dimensional.

If you had gutted an animal (such as a meat worker or hunter does [I go hunting]) then you'd know that it makes the process of moving organs aside to access what is around or below them difficult or nearly impossible.

Instead of being able to see where veins and nerves are they are then buried beneath scar tissue lumps. This therefore makes it easier to nick or cut the wrong thing. There is for instance an important nerve right where the aortic valve is. Damage to that will result in you needing a pacemaker.

They are getting more experienced at this, but every reop generates MORE scar tissue.

For you:
essentially you'll probably notice no difference in healing time or feelings. Its hard to really know because one can't compare what it would have been like having ones first surgery at this different age. However there is occasionally stuff left lying around behind after the last surgery, staples, sternal wires ... stuff like that. This can provide (if uncovered in the surgery) new places for bacteria to hide. Bacteria are killed off by your immune system, but if they have a corner to hide in then the immune system can't get to them. This can result in prolonged antibiotic treatments.

I would say that in the main you'll be able to sail through with no problems.

Best Wishes
 
each of these subsequent replies were flaged as "JSON ERROR" or "TOKEN ERROR" on submit ... subsequent checks of the front page did not see them, so I tried again
 
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