Made it to the other side

[mecretired]

My pacemaker wires were pulled a few days after surgery.

 

[Sheenas7]

Sheenas7,
If you have retained temporary epicardial (not intracardiac) pacing leads/wires, you should be able to get an MRI (see below resource). Confirm with your Dr.

Note you may have to go to a larger hospital (e.g. that performs OHS) where the Imaging folks have more dealings with this whereas a smaller facility/hospital may turn you away. After contacting a few imaging facilities and hospitals, my wife was able to find a local hospital that would do an MRI on her while having retained temporary epicardial pacing leads/wires (and 2 St Jude mechanical valves). She was able to get an MRI and had no issue.



MRIsafety.com - Safety Information Article

I have several pacemaker wires left. I have an abandoned pacemaker system with a single lead on the right, which was a Pacesetter rechargeable model from the 70's which lasted 10 years. After that I began with Medtronic. I also have capped RA and RV leads on the left.
Several different insertions over the years. I also have a ton of metal staples from my Open Heart in Ceveland Clinic for my mechanical valve, with Dr. Cosgrove. Because of all that I was told no for MRI for me. Luckily I haven't needed one. I did consider a CT scan once but opted for a sonogram instead. It was easier since for CT scans I have to be programmed before and after by a Medtronic rep. My Micra leadless does not work with a magnet either. Thank you for writing to me. I am always eager to learn.

 

[MdaPA]

I also have a ton of metal staples from my Open Heart in Ceveland Clinic for my mechanical valve, with Dr. Cosgrove.

Sounds like you have a lot of hardware in there!

Small world! My wife had her 2nd OHS (MVR with bovine) in 2000 with Dr. Cosgrove as well.

 

[Keithl]

Hum.....when my wife had her OHS at CC in 2017, they snipped the exposed temporary pacing wires and left the internal wires. They told her they did not want to pull them out because of the risk for internal bleeding (recall her INR was just around 2.5 as they required that for check-out).

Curious as to why they are removing yours but did not lower her INR to remove hers? It's good that they are removing them for you though as my wife has had difficulties finding facilities that will give her an MRI (for non-heart related stuff) because of her retained pacing wires. She has cards with the MRI considerations for her St Jude valves but they don't give such for pacing wires.

Glad to hear you are recovering well!

Same here, they just clipped mine. Over the first year I had a few minor annoyances where the wires poked me and I felt them, but that was no big deal. I asked about having them taken out and my cardio said same thing, there is always a bleed risk. The downside to leaving them in is any time you need an MRI I need to have a chest X-ray to verify the wires are not touching. Also I find that if they use a Tesla 3.0 MRI they will not want to image you with internal wires.

 

[bizinsider]

Sorry I missed this. Congrats. And btw, my 1-year anniversary by the same team is this week. Full sternotomy. Becky, Lars' nurse, said the scar would flatten and disappear. Not totally disappeared yet, but very flat and fading more and more seemingly every day. The upper four inches or so were the first to somewhat disappear - not entirely, but enough to not be a big deal. I do have one question: Why did he leave the unicuspid in the first time?

 

[Unicusp]

Sorry I missed this. Congrats. And btw, my 1-year anniversary by the same team is this week. Full sternotomy. Becky, Lars' nurse, said the scar would flatten and disappear. Not totally disappeared yet, but very flat and fading more and more seemingly every day. The upper four inches or so were the first to somewhat disappear - not entirely, but enough to not be a big deal. I do have one question: Why did he leave the unicuspid in the first time?

Thanks. At the time after visual inspection he determined that the valve, although rare, was healthy and functioning well. He said it could last for life or 10 years, don't know. I guess if I did all the same research that I did for this one, and requested a mechanical valve he may have changed it. But I didn't and misunderstood blood thinners and did not want a mechanical at the time. So, if he did change it, it would have been tissue and ironically might be in this same situation now anyway.
Question on your incisions. Did they make incision on right upper chest and femoral groin arteries for heart lung attachment, and how were they? My groin one is still enlarged/swollen or raised. Very odd. Did not have that issue last time.

 

[bizinsider]

Interesting! And re incisions - no, I think through the neck - central line, maybe? But I also had a vein removed from my leg (minimally invasive cuts) so that was enough down there. Did you ask why they went that way?

 

[Unicusp]

Interesting! And re incisions - no, I think through the neck - central line, maybe? But I also had a vein removed from my leg (minimally invasive cuts) so that was enough down there. Did you ask why they went that way?

They use safer methods now. Fully connected to heart lung machine before chest opening.

 

[pellicle]

Unless you didn’t want to talk about that one

after mine was done, I needed to go do a wee, and there must have been a bit of air in there (as there should be) and on the last bit (when I felt there was more coming) my little bloke farted ...

everyone in my room was wondering why I was laughing (which also hurt)

 

[bizinsider]

They use safer methods now. Fully connected to heart lung machine before chest opening.

Wow that must be a super recent change!

 

[Chuck C]

Hello again from the other side. Luckily, I was part of the 98%. Made it thru the surgery this past Friday fine. The wait was worse, and glad it is over. Recovery so far is going well, even better than last time. And I had a full sternotomy this time vs. mini-sternotomy “keyhole” last time in 2013. Then, my enlarged ascending aorta was replaced with Dacron graft. Now the unicuspid valve, which was diagnosed as severely stenotic with calcification, was very heavily calcified.

Currently on day 4 and very minimal pain. Just acetaminophen for past 2 days. Fentanyl for ICU was effective but short lived and with wild side effects. Hallucinations, go from chills/shaking to sweats even though temp was normal. Guess I don’t have to worry about becoming an addict!

Surgery done at Cleveland Clinic by Dr. Lars Svensson (same as first surgery). Was in ICU for 2 days which is minimum protocol now. Had 4 drain tubes vs. 2 last time. That part sucks when they remove the tubes, although feels better when out. Was walking on day 2 in ICU. They said I could have been released today due to my recovery, but have to wait for INR level to drop before heart wires can be removed. So, probably Thursday with wire removal tomorrow.

The valve. So, as I mentioned in a previous post I spoke with surgeon right before surgery and left the final decision to him as to which specific valve would be best for my anatomy. So even though he was a SJM proponent and I thought we were going in that direction……he sized both brands and determined that the On-X was best for me. So, I now have a 23mm On-X. I’m fine with that as it was my first or initial choice. I believe they are very similar with minimal unique characteristics.

Valve noise: I can’t really hear it, and I have very sensitive hearing. It was even hard using the stethoscope. It is very muffled. I’m wondering if the Dacron graft combined with the chest muscle are noise suppressing.

Thanks for all of the very helpful information.

A final comment. I strongly recommend the Cleveland Clinic for any heart related issue. Simply the best. I noticed improvements in the process since 2013.

Great news! Thank you for the update! Looking forward to hearing all your updates as you continue your recovery.

 

[Unicusp]

Wow that must be a super recent change!

I was surprised as well. But remember we are talking about The Cleveland Clinic!

 

[Unicusp]

Great news! Thank you for the update! Looking forward to hearing all your updates as you continue your recovery.

Thanks. Recovery going very well. Out of surgery now 9 days and feel close to normal with minor incision(s) pain, but no pain with the big one which I measured at 11.25". Walked about 2 miles yesterday and only 1 mile today due to rain. Lung capacity seems to be coming back quickly. No shortness of breath during walks. Slept on my back and both sides last night with no issues. They must have wired the cage really well. First outside INR test tomorrow.

 

[bizinsider]

Two miles in 9 days?! That's impressive. Took me much longer than that but I remember specifically the day, probably a few weeks into it, when I didn't have to slow to a crawl to avoid chest tightness when walking up a certain hill on my route. It was an amazing feeling and is the moment I appreciate the body's ability to heal. It was all, as they say, uphill from there... by six weeks I was at 3 miles and at 2 months at 4 and back to my old self and abilities. I think it took another month or two before I could do certain exercises that could stress my chest. I did whatever it took to avoid injuring the sternum area. Decided that was the place NOT to try to be a hero!

As for the way they wire the chest: Lars's folks do it the old fashioned way ... with wires. They're adamant about that. But I was on my side pretty quickly (his nurse said no restrictions on that) and it healed very well. My local cardiologist was impressed, and it takes a lot to impress him since he is protective of the way his surgeons do things.

 

[Amy]

Wait, what? No chance of getting them to use superglue??

 

[Unicusp]

Wait, what? No chance of getting them to use superglue??

Hello. They wire the sternum (bone) together internally and use internal dissolvable sutures. Maybe they do use glue on the outside as I can't see any evidence of sutures. Heals fast.

 

[esvaja]

Thanks! Wire pulling time. Hope for no bleeding! Lowered INR to 1.6 for it.

In 2011 I had my wires pulled. I'm really freaking out that they would leave them. Someone said they sometimes felt the ends of them because they didn't (poking through the skin)
Isn't that like a wound directly to the heart? I'm not happy & it is happening 4/20/21

 

[Keithl]

I have 8 wires,the top one I think I can feel if I really try, but I just leave them. I was more annoyed by the abandoned pacing wires the first year as they cause potential MRI concerns and would poke me occasionally. After the first year they stopped battleground me so I am good. Cardio said pacing wires can be removed, but she said it is a risk as they are attached to the heart. If I need an MRI I need check X-Ray before to make sure the pacing wires are not touching and in a good place.

 

[Amy]

I have 8 wires,the top one I think I can feel

8 Sternal wires? Wow. I’m wondering if they could be what’s causing the random new aches I feel here and there in my chest the last few mornings. Don’t know how many they used but it might be in the surgical record I’m going to request tomorrow.

So funny, the gap between the information they provide and the details we are so curious to know. (I.e. what new things have you added to my body)

 

[Keithl]

I never felt any aches or pains due to the sternal wires. What I did have was occasional poking from the abandoned pacing wires for the first year or so then nothing. I am 2 weeks from my 2 year surgery anniversary.