I met with the surgeon on Thursday he says it’s time to operate to change aortic valve and ascending aortic artery, no definite date yet the scheduling department will call me in a couple of weeks, this is starting to get real!
I was leaning towards a mechanical valve, doc says he will do either kind I’m 63yrs. He explained the pros and cons of both types along with the TAVI procedure to repair a bio valve if needed down the road. I asked about being a candidate for the TAVI, Doc said what eliminates a lot of people is the distance between the aortic valve and the coronary arteries,(too close together) In my case with a synthetic artery there is enough space between built in to do a TAVI procedure. Now I am rethinking the valve choice there is still time to change my mind a couple of times.
Hi "Stan" coincidentally I went through an aortic valve replacement at the end of November 2023 which was a breeze, I went into the OR/Cath Lab (this hospital is one of the very few that have combined an OR and a cath lab). My first valve was a porcine valve at age 59 (Feb 2011) along with an aortic root replacement. I was fortunate enough to have a "rock-star" level surgeon do my first procedure (open heart surgery) during which he had me on the table for less than 1 hour. The reason he recommended the tissue valve for me was because of my "young" age and I definitely did not want to be on prescription blood thinner(s) for possibly the rest of my life. My surgeon prescribed an extended release baby aspirin (81mg) BID to follow up with my tissue valve.
Also, my sister-in-law had the exact same open heart procedure (6 hours on the table), although she went with a mechanical valve. She is required to take warfarin or equivalent for the rest of her life which, of course, is not a positive in her opinion. Also, she has complained about the "noise" of the mechanical valve. Apparently, the clicking sound annoys the heck out of her.
I listened carefully to my surgeon he was confident and reassuring in outlining the procedure so I was surprisingly relaxed about my upcoming procedure. Also, his experience in terms of sheer numbers (12,000 surgeries and 4,000 valves) and many of those included infant children with congenital heart valve defects. It is amazing for me to imagine the hand eye coordination necessary to successfully perform these procedures on infant hearts.
He and I agreed on the tissue valve for my specific needs, age and outcome expectations. I was happily surprised by the outcome. He had me closed up and on my way to recovery in under an hour. One of the positive elements in the decision to go with the tissue valve was his assurance that by the time I would need to replace the tissue valve 10+ years down the road, the TAVR procedure would be noticeably easier and better than in 2012.
One of his team at the hospital had already been doing pioneering work in the TAVR procedure since 2007 which included training almost 100 surgeons from many countries. And so it turned out that this second doctor would be my choice for the TAVR in 2023. After a pre-op angiogram determining that my coronary arteries were clear and that I was a good candidate I scheduled the procedure.
I checked in on Tuesday and went home on Wednesday - 24 hours later. The first night's sleep in my own bed was amazing, I woke feeling much better than I could remember in a long while, rested and refreshed. By the way, the first surgeon who did the open heart valve replacement in 2012 was just down the hall on standby during my TAVR. He was my backup surgeon, in case we had to resort to open heart. He told me "you don't think I would put that scar on your chest and not be here for your replacement valve do you?" I said "of course not, will you commit to be here for the next one?" He replied, "Yes, and all of the ones thereafter, you're still a young man..."
Needless to say, this team of specialists, the hospital, and the procedures have earned my lifelong gratitude and respect. I do realize how blessed I am to have had these folks in my life.
Whichever valve you choose, best wishes to you Standardvelocity!
