Memory issues

[TomAlbers]

Good day, I am a veteran of this site many moons ago, had AVR and aortic root repair with an aneurysm patch back in 2000. Have had a great almost 13 years but I've worn the tissue valve out and have to go back for a replacement. My question is if there are any members that have had repeat surgeries and specifically how the 2nd surgery compared to the first. I have to admit, it was long enough ago that it is a blur to me. I have talked to Rob and he has graciously given me his perspective and issues he had with the 2nd surgery. My main concern is memory issues as I feel like that has been a problem since my first surgery. I worry about even more issues and if anyone has experienced those, or if they have any information on helping the brain with memory. My cardio says he doesn't believe the hype that being on the heart/lung machine has any issues with memory. I think there is merit in the assumption, but maybe it's just age. My wife worries that I will be more of an idiot than I already am, to the point she is afraid I won't remember how to get home. Her exaggeration but I get her point. I have to have a different surgeon due to insurance issues, but my new surgeon says that AVR surgeries are much improved with technology over the past 13 years. They now put everyone on an insulin pump as they have determined that the stress of the surgery causes the body's blood sugar to be way out of whack and with the insulin pump the body heals much faster. I know they gave me a drug that they called I don't remember medicine so I wouldn't remember much of the post-op, like the breathing tube, catheter, etc,. I guess anything else that is new would be good to know, but hopefully when I go in for final consult I'll get those answers. Thanks and have a great weekend....

 

[Jkm7]

I had two OHS in four years and my second was considerably easier on me.
Same surgeon, same Mass General Hospital and lots of the same nurses, techs and staff but the moment I woke from the second surgery I knew that truck had not hit me as hard that second time as the first.

My first surgery they did not check my insulin level as I had never had a high blood glucose test in the past. The second surgery, four years ago, they checked my blood sugar for the first three days post op and I'm told I received insulin once or twice though I don't remember it. When my tests were back in normal range, they stopped testing and providing insulin. I was told the same thing that heart surgery can mess with insulin levels temporarily.

I feel I might have had some small amount of memory loss from the two surgeries but nothing all that significant. Maybe what I think of as some memory failure may just be because each day I'm a day older.

I agree there has been much advancement in heart surgery since you had yours 13 years ago. Seems many of us have very short hospital stays, we are out of CICU fast (of course, some exceptions but many of us), and we are back on our feet faster it seems. I healed very quickly my second surgery.

All best wishes....... what you may not remember that most of us agree the wait is the worst part of the whole experience.

Have you decided whether you will get a mechanical or tissue valve this time?

 

[OldManEmu]

Tom welcome back to VR.
I had my first surgery in 2004 and a redo in 2011 as a member you can view my profile.
I found my second surgery much easier than the first because I hadn't had endocarditis for 8 months before hand and wasn't in class IV heart failure.
My first surgery was 20 days in hospital my second was 5 days.
The only time I have had memory issues is when I was on beta blockers, I have commented on my issues with this class of medication a number of times on VR, to the point that I refuse to take this class of medication long term unless I have heart rhythm issues and I do not have heart rhythem issues. I took beta blockers after both surgeries while my heart healed. After my most recent surgery I discontinued beta blockers with the cardios OK 3 months post surgery.

 

[OldManEmu]

Tom welcome back to VR.
I had my first surgery in 2004 and a redo in 2011 as a member you can view my profile.
I found my second surgery much easier than the first because I hadn't had endocarditis for 8 months before hand and wasn't in class IV heart failure.
My first surgery was 20 days in hospital my second was 5 days.
The only time I have had memory issues is when I was on beta blockers, I have commented on my issues with this class of medication a number of times on VR, to the point that I refuse to take this class of medication long term unless I have heart rhythm issues and I do not have heart rhythem issues. I took beta blockers after both surgeries while my heart healed. After my most recent surgery I discontinued beta blockers with the cardios OK 3 months post surgery.

 

[TomAlbers]

Thanks, I plan to go with another tissue valve. I do not want to mess with Coumadin. My cardio maintains tissue valves are much better in terms of how they are preserved, should for sure get a least 20, and ku med is doing a research fellowship already for valve replacement through artery in leg. He maintains that in time, Europe and Canada are already doing it, splitting the sternum will be done only for transplants and rare cases.

 

[TomAlbers]

Hi old man, lol, question, what type of valve did you opt for 2nd time?

 

[Jkm7]

Thanks, I plan to go with another tissue valve. I do not want to mess with Coumadin. My cardio maintains tissue valves are much better in terms of how they are preserved, should for sure get a least 20, and ku med is doing a research fellowship already for valve replacement through artery in leg. He maintains that in time, Europe and Canada are already doing it, splitting the sternum will be done only for transplants and rare cases.

In U.S., they are now doing trans-catheter (percutaneous) valve replacements on patients too ill to have traditional OHS. My surgeon at Mass General along with many others said the same thing about trans-cath replacements.

 

[Lynlw]

In U.S., they are now doing trans-catheter (percutaneous) valve replacements on patients too ill to have traditional OHS. My surgeon at Mass General along with many others said the same thing about trans-cath replacements.

Even better tFDA just approved the Sapien TAVI for high-risk but operable patients too.

 

[Jkm7]

Even better just approved the Sapien TAVI for high-risk but operable patients too.

That is very good news. The future is here.

 

[OldManEmu]

Tom
The second time I elected to have another tissue valve, I let the surgeon choose the make and model and I now have a Perimount Magna Bioprosthesis by Edwards Lifesciences.
My first valve a Medtronic mosaic porcine valve was still functioning OK and only had a small deterioration from when it was implanted. The surgeon estimated it was likely to last another 3-4 years. When the first valve was implanted I was told to expect 10+ years and this appeared to be accurate.

 

[Jkm7]

Do you mind if I ask why you had a new valve implanted if the surgeon thought you could get 3-4 years from the one you had?

Thanks.

 

[OldManEmu]

Jkm7
I had to have an aortic aneurysm repaired that had crossed the 5cm trigger point. The aneurysm was there at the time of first surgery however it was deemed to risky to repair given my extremely poor physical condition associated to the heart failure. The aneurysm stayed stable for almost 6 years after my first surgery and my heart function had returned to normal in this time. It was thought best to do the repair and replace the valve at the same time rather than just do the repair and then have another surgery in only 3-4 years time for a valve redo.

 

[Jkm7]

Ahh, makes sense.
Thank you for being so kind to explain.
Hopefully that was the last open chest surgery you will need.

 

[TomAlbers]

Thanks for information, how long did they project your new valve to last? I think the Internet says 20+ years

 

[ottagal]

Hi Tom,

I just wanted wanted to welcome you 'back' to the site and glad you found us. Wishing you all the very best with your upcoming re-do surgery. You have received some encouraging info from the 'second time around' experts. Sorry, I can't help you with this question as I am still on my 1st valve. Another member that comes to mind that had a redo is Scott.Eitman.

My understanding is that the 20 plus years is from a study based on individuals 60 plus. If you are interested in doing a search, I know it has been referred to many times on the forum. Sorry, I just don't remember where. If I can dig it up I will post it again.

 

[TomAlbers]

Hi ottagal, and thanks for the information. I do know that the more active you are, the less likely to get extra years. I trust the good Lord will take care of things, with five kids, one being 4, I don't see myself slowing down anytime soon. I'll do search of older posts and look for the info you're talking about. Peace,

 

[Jkm7]

I'm not sure that is accurate about the more active you are, the less likely to get extra years from your valve. Actually I don't think that is the case.
You may wish to check with your surgeon/cardiologist.
Mine both advised me being active would not compromise longevity of my valve.

 

[Debbrn]

Hello,

I have a complete different defect than yours. I have had 4 hearts with 3 of them requiring the heart/lung machine. I was 6 years, 25 years and 44 years old when I had my OHS that required the heart/lung machine. I may have had a mild short term problem with mental processing after my 4th surgery, but I think most of the was gone after 3 months. Before my last surgery there were times that my processing and memory was affected because I was so exhausted. The 3rd and 4th surgery I had my pulmonary valve replaced and my tricuspid valve repaired. With my 3rd surgery my immediate recovery was longer, but getting back to baseline only took about 6 weeks. With my 4th surgery my immediate recovery was amazing. But, it did take about 3 months to get back to baseline line. About 6 months after I felt fantastic for me. My endurance was so much better. I am continuing to feel better and better 2 1/2 years later.

Debbie

 

[Luana]

My question is if there are any members that have had repeat surgeries and specifically how the 2nd surgery compared to the first... I have to have a different surgeon due to insurance issues, but my new surgeon says that AVR surgeries are much improved with technology over the past 13 years. They now put everyone on an insulin pump as they have determined that the stress of the surgery causes the body's blood sugar to be way out of whack and with the insulin pump the body heals much faster.

It's impossible to know how you'll react with any given surgery. Your second surgery recovery may be much easier, much more difficult or about the same. If your overall health has changed since your first, that may well play a role, too. People can go into surgery with what surgeon considers "excellent health" and still have complications.

As for the insulin pump, I've not heard of that as standard at all; it may be at the hospital(s) he practices at, but doubt it's everywhere from those I know who've had surgery in the past few months. Insulin after VR is standard; I doubt the pump is. Insulin pumps make life easier for insulin-dependent diabetics, though multiple daily injections of insulin (they don't hurt) makes far more sense for short-term use.

 

[TomAlbers]

Thanks for the info to both of you. I am not a diabetic, I believe his statement was this is cutting edge procedure for them, it is a research hospital so that may be the reason. I guess I'll find out. As far as memory, that is good news. I do know I suffer from sleep apnea and that may have issues with short term memory as well.