Howdy - AVR coming up!

[DJ-Rae09]

Yes. I was on metroprolol for about 3 months to control my blood pressure. This is a beta blocker and it seems almost all are put on a beta blocker after surgery. From my understanding, the purpose is to control blood pressure during the recovery period, so that sutures can heal properly.
I was also on amiodarone. This was because I had two episodes of afid in recovery. Afib is very common after valve surgery. My surgeon indicated that about 40% of patients have at least one episode of afib in recovery. The good news is that for the vast majority it is transitory. I only had to be on amiodarone for about 6 weeks, as I recall.

Got it....thanks!

 

[pellicle]

I have mild aneurysm at the ascending and mild-moderate at the root. So I think its up to the arch. but will check with my surgeon.

make sure you specifically ask about the well known genetically based association between Bicuspid Aortic Valve (BAV) and Aneurysm.

 

[DJ-Rae09]

make sure you specifically ask about the well known genetically based association between Bicuspid Aortic Valve (BAV) and Aneurysm.

I will ask the surgeon on Tuesday. He showed me the SJM valve and sleeve when I had the initial consultation.

 

[Dano64]

DJ-Rae09,

Best wishes to you on a successful procedure. This is a good site to hear stories from people who have been through it. I had my first BAV replacement in 2001 at the age of 37. I was reading more stories then about complaints with the noise of mechanical valves and there wasn't any discussion about self-testing INR levels, and I too enjoyed my libations. So, I went with a homograph that lasted 21 years and would have kept working if not for the aneurysm that needed replacement in February this year. This time I went with the Inspiris Resilia valve. This is my 12th week out and I feel pretty good. While I don't relish another OHS, and still plan to avoid that if possible, my brain has been trained to not want to deal with Warfarin for the rest of my life or get used to the clicking sound in my chest. I am comfortable with my choices and I would only say that it is amazing that you have choices to get back to a normal life with modern medicine.

 

[Chuck C]

Question, were you on any other medication post operation and into your recovery? Apart from Wafarin....

Yes. Like most valve surgery patients, I was put on a beta blocker to control my blood pressure. This is because things are a little delicate after surgery and you don't want big blood pressure spikes putting pressure on the sutures while things are healing.
Also, because I had a little afib in recovery, I was put on amiodarone, which helps control heart rhythm and helps prevent afib.
I was off of the amiodarone after about a month, once my cardiologist was able to establish that my rhythm was consistenlty normal.
I went off of the beta blocker after about 3 months.

 

[Chuck C]

make sure you specifically ask about the well known genetically based association between Bicuspid Aortic Valve (BAV) and Aneurysm.

This is good advice. There is some subjectivity often when deciding to fix a borderline aneurysm or wait. If one is choosing mechanical with the hopes of being one and done, in my view this should lean heavily in favor of replacing a borderline aneurysm rather than take the chance that another OHS will be needed down the road if it continues to enlarge, and they usually do.

My aneurysm was way below the guidelines for needing replacement, but my surgeon, knowing full well that my hope was to be one and done, made a judgement call and replaced it with a dacron sleeve. He also indicated that, based on his decades of experience, the tissue of my aneurysm appeared to be the type that will continue to enlarge. Of course, there is no way to know for certain whether it would have or not, or whether it would have reached the point of needing repair, but I feel that he made the right judgement at the time, significantly reducing my chances of needing another OHS.

 

[DJ-Rae09]

make sure you specifically ask about the well known genetically based association between Bicuspid Aortic Valve (BAV) and Aneurysm.

I meet with my surgeon today. and I'm getting the Dacron sleeve for the root and ascending aorta, so up to the arch.

 

[DJ-Rae09]

This is good advice. There is some subjectivity often when deciding to fix a borderline aneurysm or wait. If one is choosing mechanical with the hopes of being one and done, in my view this should lean heavily in favor of replacing a borderline aneurysm rather than take the chance that another OHS will be needed down the road if it continues to enlarge, and they usually do.

My aneurysm was way below the guidelines for needing replacement, but my surgeon, knowing full well that my hope was to be one and done, made a judgement call and replaced it with a dacron sleeve. He also indicated that, based on his decades of experience, the tissue of my aneurysm appeared to be the type that will continue to enlarge. Of course, there is no way to know for certain whether it would have or not, or whether it would have reached the point of needing repair, but I feel that he made the right judgement at the time, significantly reducing my chances of needing another OHS.

Confirmed today with my surgeon I'm getting the Bentall procedure which replace the aortic root and ascending with the dacron sleeve, along with the SJM valve.

 

[pellicle]

I meet with my surgeon today. and I'm getting the Dacron sleeve for the root and ascending aorta, so up to the arch.

good to hear ... that's the best way towards "one and done"

 

[Stevebav]

I have similar (2.75 cm of dacron) although 'commit' trigger was the aneurysm deciding to start steadily growing rather than valve performance. My surgeon said after operation that it helped him minimise length of incision having the sleeve attached to the valve beforehand and, given people's inclination to share scar pictures on, i think he may have told the truth. Good luck with your op & recovery

 

[DJ-Rae09]

I have similar (2.75 cm of dacron) although 'commit' trigger was the aneurysm deciding to start steadily growing rather than valve performance. My surgeon said after operation that it helped him minimise length of incision having the sleeve attached to the valve beforehand and, given people's inclination to share scar pictures on, i think he may have told the truth. Good luck with your op & recovery

Thanks Stevebar. How was your recovery period post Op?

 

[DJ-Rae09]

good to hear ... that's the best way towards "one and done"

Yep, that's the plan now.

I did ask the surgeon about the On-x valve....apparently the On-x and the graft doesn't come in 'one piece' like the SJM does.

 

[pellicle]

On-x and the graft doesn't come in 'one piece' like the SJM does.

thats why my surgeon picked the ATS (which did) ... however that was in Australia (Queensland) back in 2011, I understood it is available now.

https://www.cryolife.com/products/on-x-heart-valves/ascending-aortic-prosthesis/
I would tend towards the one piece arrangement and ask why he's not?
Seems logical to reduce surgical complications.

I'd also ask about the ATS (now Medtronic Carbomedics or something similar) and ask what his reasons are for not preferring that?

Seems a reasonable question IMO

 

[bizinsider]

One thing I'll promise you - once you're recovered (actually immediately after surgery) you will never know you have Dacron in you. You won't feel any different. It becomes part of you.

 

[KLS39]

Welcome to the forum.

I had a Bentall procedure last year as well as a repair to my innominate artery. I was also nervous leading up to the surgery but was strangely calm on the morning of the surgery. Check out the thread on what we did not expect in regards to our surgeries. I know for myself I had a few "surprises".

I struggled for a long time to get my INR in range. One was because I was adding back all the green veggies I love and two because my cardiologist office was slow in increasing my dose to a level that worked for me. I started testing at home last November and even that was a struggle for me. I have a Coagsense machine which involves pricking your finger, collecting your blood in a small tube and getting it in the machine all in 15 seconds. Took me a while to master that. My INR did drop when I started working out more rigorously. It also seems to drop and rise if there is a change in my diet. Eating a good amount of broccoli three days in one week caused it to drop. Traveling to Serbia and having a hard time finding my usual amount of greens caused it to rise. My cardiologist will tweek my dose a little and I will adjust my diet to get back into range.

I was on Metoprlol for five months because I had a high resting heart rate. Once I started becoming more active I was able to stop it. I also added back caffeine at that time.

My aneurysm was also below guidelines but like Chuck's surgeon, mine also replaced it while replacing my valve with a On-X valve. My INR range is 1.5 - 2.0 but I aim to keep it up at 2.0 to 2.5.

I haven't heard the clicking in a while but I do hear the thumping when it is quiet. I'm used to it now and mostly find it comforting.

Best wishes to you.

 

[Stevebav]

Thanks Stevebar. How was your recovery period post Op?

Recovery was pretty much what the surgeon predicted as 'the norm' : discharged on wednesday afternoon following a saturday morning operation. 6 weeks later "signed off" by surgeon back to local cardio/GP team by which time I was walking 3 mile plus per day. returned to full-time (desk bound) work on 10 weeks. after 1 year I was running up to 45mins (5-7ks). I wouldn't say I was especially fit - average hieght/weight for 56 yr old male. I did try to strengthen core in weeks building up to operation so I could get out of bed/up from chair without using my arms to push on and I'd say this was a great help in the 1st few days post-op as I was able to move from bed to chair to rest-room without worrying (too muchj) that i was going to bust my chest and avoid additional pain

 

[Chuck C]

I did try to strengthen core in weeks building up to operation

I think this was a very good idea. Also, just getting in top physical condition in general, to the extent it can be done safely, is a good idea leading up to surgery.

 

[Deepak khanka]

Got it....thanks!

Good luck DJ-Rae09

 

[Timmay]

Hi Tim!

Looks like you and I (I'm also a Tim) will be going into the hospital around the same time. Gotta ditch this crudded up BAV . My surgery is scheduled for 2 weeks from now (May 25th).

Like you, I'm a bit nervous about the Warfarin too. But reading Chuck and pellicle's posts really help me relax about it. When I see others living "normal" lives and doing "normal" things it really increases the Hope factor in my brain . Hopefully it is doing the same for you too.

Good luck man. Did they give you an actual surgery date yet? We might both be on the other side around the same time!

Tim

 

[DJ-Rae09]

Hi Tim!

Looks like you and I (I'm also a Tim) will be going into the hospital around the same time. Gotta ditch this crudded up BAV . My surgery is scheduled for 2 weeks from now (May 25th).

Like you, I'm a bit nervous about the Warfarin too. But reading Chuck and pellicle's posts really help me relax about it. When I see others living "normal" lives and doing "normal" things it really increases the Hope factor in my brain . Hopefully it is doing the same for you too.

Good luck man. Did they give you an actual surgery date yet? We might both be on the other side around the same time!

Tim

Hey Tim,

Ta for the reply! Yes, sounds like we'll be having the Op and recovery similar time. I have 2 tests to go (coronary angiogram and catorid ultasound) then I will book the operation around early June.

Yeah this forum has really helped calm my brain too around the Wafarin monitoring and getting back to normal post operation. I don't mind a beer so that was my main concern of course with Wafarin

Good luck with your surgery too and stay in contact

Gotta ditch this crudded up BAV

Haha yeah, it's not great is it we going in for an 'upgrade' valve which will perform like a normal AV.