Info about Dad

[trishm]

Hi,
I've been getting to know a lot of you over the past few days. I found this site recently during some research. It's been very helpful, thank you!

My Dad, who is 71 has just been told that he needs his St Jude Mechanical valve replaced. He received it 14 years ago. Everything was going well until last year when he suffered two major hemorrhages which resulted in two separate surgeries which were very difficult to recover from. His doctor switched him from Coumadin to Plavix and baby aspirin after the second episode. Last Friday he went to emergency with 140 pulse rate which took over a day to stabalize. Apparently, calcium has built up on one leaflet of his valve and it froze. They will replace it with a pig valve. Not sure which one yet.

Has anyone gone through something similar and have you been able to find another medication other than Coumadin or Plavix that works well? I'd hate to see him in the position of facing another replacement in 8-10 years (pig valve life span?). He's a very strong man but 79 to 80 years old may be pushing it!

Thank goodness he has a terrific surgeon taking care of him. He has been blessed with terrific surgeons over the years. His first open heart surgery was in 1953 in Children's Hospital Boston. Dr Robert Gross took very good care of him then.

I just wnated you to be aware of what happened to him once he stopped the Coumadin and switched drugs.

Thanks again for this terrific forum.

Trish

 

[Gisele]

Welcome Trish

Welcome Trish

I am sure you will find this site very useful in finding information, and everyone here is very friendly.

Although I have never had the problem of calcium build-up on my valve I too am facing the possibility of replacing my mechanical valve of 21 years for a tissue valve due to subdural hematomas. I had a Burr Hole procedure 7 weeks ago and a stroke. I started bleeding a week later when they started the heperin. I am curious as to where your father hemorrhaged. I am also on Plavix and ASA as I cannot take coumadin right now.

Next week I am going back to Boston to see the neurologists and then I can begin speaking to cardiologists about replacing this valve with a tissue valve so that I wouldn't need Coumadin.

Trish, your father's surgery was in Boston. Are you from this area as I am from north of Boston. My surgery was at New England Medical Center.

I am very interested in what happens to your dad as I am going through the same thing. You can PM me if you would like.

Gisele

 

[Nancy]

Hello Trish-

Welcome to this terrific site.

Your dad is surely in a difficult place in his life right now. Have you sought a second opinion from a place like Cleveland Clinic? Maybe they would have a different way of handling his problems. Replacing a pig valve in 10 years give or take, isn't something I would want my husband to have to face (he's 72 years old, and has had 3 valve surgeries, he's mechanical). It sounds as if his doctors feel your dad cannot tolerate Coumadin. Have they done an extensive investigation into the reason for his hemorrhages?

We have another member, Gisele, who is facing something similar. I hope she sees this and tells you about her situation.

 

[LUVMyBirman]

Hi Trish,

Welcome.
Sorry to hear about your fathers situation. I am sure it was very 'unexpected'. Wish him all the best in transition to the tissue valve.

Very interested in the scenario leading to his calcification. I was informed after an echo a few years ago (have had my valve for alomst 5 years now) That there was trivial calcification of the mitral valve prosthesis. It has yet to be deciphered on previous echos. So, not sure if it's dissipated or what? My issue was not calcification to begin with. It was regurgitation prior to surgery. This is very confusing.

Just a theory....does your father consume much dairy products and take calcium? Can calcium cause calcification? Would love to know the answer!

Wishing you all the best. Please keep us posted on his progress

 

[TSH]

Thanks for the post. I found it very interesting as I don't recall ever reading anything about people having significant problems with mechanical valves calcifying. I don't recall any discussion on it in any of our forums. Of course, as a mechanical valve recipient, I am interested. Does anyone have any further information on this topic?

 

[trishm]

Hi,
The two hemorrhages were subdural hematomas. After the second, he was taken off coumadin and it was replaced with plavix and aspirin. That was 15 months ago. In the 15 months he'd been off coumadin he's had 2 TEE's (transesophageal echo) and 1 echo to monitor the situation. All reports came back good until last week. Most recent tests show that one side of the valve has significant build up and that side is not operating. They will replace with pig valve. We have to wait a few days because his blood is not clotting well enough; need to take him off plavix and aspirin, and surgery is set for Monday.
We are not from Boston. His family doctor in upstate NY discovered an abnormality and recommended he go to Boston to see Dr Gross back in the 50's. It was determined then that he had a heart birth defect (coarctation of the aorta, treated in 1953), which eventually lead to his aortic valve replacement in 1991. Being taken off the coumadin apparently caused the current valve failure.
I wouldn't say that he consumes a lot of dairy and he doesn't take calcium.
I will keep you posted as I learn more.

Thanks for your thoughts and wishes,
Trish

 

[hensylee]

Dear Trish - I know the surgery ahead is worrisome for all of you. Please know that your dad is in my prayers as he heads for the mountain climb. Tell him we're walking right along with him (and y'all) to get him over the top. Also tell him from me: GODSPEED

 

[Gisele]

So.......

So.......

The calcification seemed to be caused from the lack of anticoagulants?

Does anyone know anything about this? Looks like I will be doing a little bit of research on this today.

If anyone knows anything about this if you don't mind sharing with me I would appreciate it.

Thanks, Gisele

 

[LUVMyBirman]

Hi Gisele,
Hope you are feeling well. This has struck an interest with myself as well. Would love to know more about it. Wonderful a new member came along just as you were looking for a 'common bond'.

Wishing you both all the best. Keep us in the loop. We care.

 

[Gisele]

Thanks Gina

Thanks Gina

I have my weekly cardio appt tomorrow. I will ask him about calcification. I am sure that it doesn't happen too quickly and shouldn't be an issue for me just yet. However, I do not want to resume Coumadin, so this could become an issue for me.

I go to Boston next week.........what a relief, so I can get that out of the way. I have my list ready for the neurologist, but I know better than to ask any cardiac surgery questions at that visit. When that is out of the way, I can pursue the cardiac surgery and whether or not it is possible for me.

As much as I always said I would never go through OHS again now that I am facing these options I would rather do that than have another subdural. Guess I will wait it out and see what is in store for me.

Trish has been great and e-mailed me this morning. It is so wonderful to have someone else (as unfortunate as it is for her dad to go through this) to compare notes with.

 

[Blanche]

Some time ago the topic of ingested calcium from food or supplements and its relationship to calcification and vavles came up. At that time we asked both Al's cardiologist and his internist. Al has osteoporosis and takes a large dose of calcium and Fosamax. Both of his doctors said that ingested calcium has nothing to do with calcification of valves or atherosclerosis. Hope this helps. You may also want to read the following. http://www.heartcenteronline.com/myheartdr/common/articles.cfm?Artid=191&startpage=2
Hope this helps.
Blanche

 

[trishm]

Hi,
Dad had his surgery on Monday. He is doing really well. They replaced his mechanical valve with a pig valve, repaired an aneurysm on his aortic root and did two bypasses. His surgeon said his old mechanical valve was covered with clots (thrombus)and was in bad shape (no mention of calcification, only clots). I don't know if the timing of his valve failure is typical (15 months off coumadin) or not. I just want to be sure to pass his scenario along to you, as we all know information is extremely helpful. Also, you may already know this but the Plavix in his system caused extreme bleeding during the procedure and they needed to go back into surgery a few hours into his recovery for a few more hours of work. The more people I talk to the more I find out that is not so unusual, although very scary.

I'll be sure to stay in touch. Believe it or not, my Dad will be back in surgery in a few months for his carotid artery.

Best to all,
Trish

 

[Ross]

That's great news Trish, I'm sure your relieved too. Hopefully he will have an uneventful recovery from here on out. It's darn lucky those clots didn't break free and cause him to stroke out. I'm happy for all involved. Keep us updated when you can.

 

[fyrfytr]

Hi Trish,
I am glad to hear that your dad is doing good. I hope his recovery goes as good. Let him know we are all thinking of him and wishing him the best! Please keep us posted on his recovery.

Dave
________________________
Surgery: 4/21/03
Aortic Aneurysm Repair
AVR, with a St. Jude Mechanical
Heart Center of the Rockies

 

[Nancy]

Hi Trish-

Good news about your dad, and it sounds as if things got done just in the nick of time.

Pass along good wishes for an uneventful recovery.

 

[hensylee]

Goodness, Trish. He was teetering on dangerous, wasn't he. And going for more surgery soon. The next one shouldn't be as hard for you as this one. Wish him well and he is in my prayers. As you are.

 

[Gisele]

Trish

Trish

I was glad to hear that your dad is doing OK. I just came home from Boston and the neurologist I saw today told me to stay on Plavix. No coumadin for me!

I am curious about the clots on his valve. Was his valve a mechanical valve? Also, did they suspect clotting? If so, did he have any symptoms?

Just curious as I was admitted last night as my left hand went numb. I was discharged this morning so that I could go to my neurology appt and my CT scan was negative.

The neurologist said to hold off my valve surgery until I am six months post op. I don't know if I can endure that anxiety! I was also told I can't drive until Dec. I was expected to be told that I could drive as of today-what a disappointment.

I hope your father does well in his recouperation. I will be thinking of him.

 

[trishm]

Thank you everyone for your thoughts and prayers! Today was a good day.

Gisele, it sounds like your scenario is very similar to my father's regarding no coumadin and subdural hematomas. He too was told no more coumadin! He had a mechanical aortic St Jude valve. This is complicated but here is his recent bio: During a recent stress test to prepare for a carotid artery procedure he was told there was an abnormality to his blood flow. They scheduled a catheterization but before his scheduled appt he went to ER with high blood pressure and high heart rate (134). They did catheterization and found one leaflet was not working so they followed up with an echocardiogram and a TEE. All tests confirmed one side of his mechanical valve was not functioning. Two cardiologists and two surgeons consulted and decided the valve needed to be replaced with a tissue valve. They also found he needed two bypasses and he needed repair of an aneurysm on his aortic root. He had been on Plavix for 15 months. They needed to wait a few days before surgery to allow the Plavix to be out of his system. It appears that it was inevitable that the mechanical valve would not funtion normally without coumadin. As for symtoms, this too is complicated based on his two recent craniotomy procedures. Over this past year he suffered from terrific headaches, reduced stamina, couldn't tolerate outside summer heat, and went into a-fib for the first time (now has a dual pacemaker). Not sure if any of this had anything to do with his valve issue.
I have met a number of people recently that have endured a second valve replacement and they would tell you the same they told my Dad... you can do it! I am so glad your doctors are talking to you about replacing your mechanical valve with a tissue valve. And just think, maybe only a baby aspirin for your valve medication!

We'll catch up again soon!

Trish

 

[trishm]

update

update

Hi,

Just wanted to update everyone about Dad's recovery. He is doing really well; it's been three weeks already since his surgery. Thank you all so much for your thoughts and prayers. He asks often how everyone from the "forum" is doing.

Best Regards to All,
Trish

 

[Nancy]

So wonderful to hear, Trish. BIG congratulations to your dad!