Major surgery after AVR and aneurysm repair

[rosalia]

Hi all... just wondering if anyone has had to go through a major surgery some years after a successful AVR and repair for an aortic aneurysm. Are we treated a little differently in hospital even if we feel healthy and all is well? I will be scheduled for a hysterectomy soon and am wondering how being a heart patient, albeit a healthy one, affects outcomes of surgeries, especially the general anesthesia. I am expecting antibiotics for sure...

Thanks for any input

 

[DachsieMom]

I have not, but are you on warfarin? If so, I assume you will be closely monitored, need to get off warfarin before surgery and perhaps put on heparin.

 

[pellicle]

Hi

I agree with the above , we're not treated differently but our AntiCoagulation Therapy will change.
Unless you have other significant issues with respect to AC Therapy (like a history of strokes) then as a plain old Aortic Valver you'll just undergo:

• cessation of warfarin therapy a few days prior to surgery,
• perhaps commencement of Heparin injection
• no AC therapy at all for the first 24 hours
• commencment of Heparin and restarting of Warfarin
• when INR is in range discontinuing of heparin

Its no big deal, and there is no reason to be anxious about discontinuation of Warfarin for that period around surgery.

You might find my blog post around one of my "procedures" interesting reading
http://cjeastwd.blogspot.com/2017/12/perioperative-management-of-inr.html

Best Wishes

 

[rosalia]

Thank you very much for your replies! I am not taking any blood thinners currently. I am definitely going to read your blog!

 

[Astro]

I think your risk is no different to non heart patients. You are not on blood thinners which could increase the risk of bleeding/wound hematoma. Your well functioning heart should cause no problems for the general anesthetic.

They will probably give you a shot of antibiotics to protect the valve/graft (which they tend to give anyway for a hysterectomy).

Wishing you an uneventful surgery and speedy recover.

 

[pellicle]

Thank you very much for your replies! I am not taking any blood thinners currently.

ahh ... I assumed (incorrectly) you were a mech valver ... if you're tissue prosthetic then its even easier.
*(notes to self to read presented data more carefully)

 

[rwsp768]

Had my AVR in 2005, then in 2015 had a major heart attack and they had to do a by pass. Let me tell you it is 10 times harder as they had to cut through all the scar tissue and recut the sternum. Man I woke up in ICU thinking they had beat me with rubber hoses and base ball bats, even asked the doctor if that had happened he just laughed and said anytime we have to open a person more than once it is hard on them.