Minimally Invasive AVR Recovery Details

[nlex]

Hi. I'm new here getting ready for above surgery on April 28. I'd like to know if anyone has had this procedure and what the days after surgery are like (when did drain-tubes come out, etc.) and what at home recovery is really like (when were you able to go up stairs, did you nap much, little/much pain?). Thanks for setting real expectations.

 

[Paleowoman]

Hi - I had "minimally invasive AVR" (nearly all isolated AVRs are "minimally invasive" these days). I was in hospital for seven nights. The pain was pretty bad and the pain meds they gave me (tramadol and codeine) weren't that effective…I suspect every hospital will be different as regards meds. My drain tubes came out on the second or third day - there was no pain with them coming out which shows expectations are impossible as most people say they hurt coming out and mine didn't. They don't discharge you until you can do stairs and everything okay so you'll be able to go up and down fine (though it does get completely exhausting if your only toilet is upstairs !). I couldn't sleep lying down for several weeks (due to pain in sternum) so slept on the sofa propped up, gradually being able to lie down - bliss. My recovery wasn't smooth though and by week three post op I was quite bad due to my digestive system kind of shutting down which a gastroenterologist I was referred to said was due to surgical "insult" or "shock" and the analgesics and pain. Pain got much better by about week five or six. Got very tired easily, also lifting things can be a problem at the start, I think many people experience that, so it's good to have someone around to help. Everyone is different so it's quite impossible to forecast what recovery will be like for you.

I put "minimally invasive" in inverted commas and would include a kind of sarcasm if there were a font for that. The word "minimal" is misleading. The difference between "minimal sternotomy" and "full sternotomy" can be as little as an inch or so. The length of my sternum is just over five inches and my "minimal" incision is four inches long - practically the full length of my sternum. The word "minimal" only refers to the length of the incision, the rest of the operation is the same as "full" - the heart is stopped, the lungs are stopped, and you're on the heart lung machine for however long it takes the surgeon to complete the job. Afterwards you are in ICU and high dependencey just the same as the effect on the heart is the same for "minimal" or "full" sternotomy.

Expectations are impossible. There are peope who sail through with no complications and have a quick recovery with either "full" or "minimal" sternotomy and others who paddle a bit ! I was very fit and strong before surgery and so I was surprised that I ended up worse, but I do have other conditions and maybe it was something to do with that ? And, as I said, having the drain tubes out was easy for me yet my expectations were that they would be painful !

All the best for you to have a smooth recovery !

 

[Red]

Hi Paleogirl,

Thank you for that. I have requested a 'minimally invasive' and assumed that the 'minimal' applied to both the sternotomy and the incision - you live and learn.

Wishing you a speedy and as bump free as possible return to your self.

Gerri

 

[dwhist]

I went in for a minimally invasive surgery. Doctor said he would cut half way down sternom and access heart that way. When they took me into the surgery and did a TEE, when I was out, they found the heart had enlarged more than they thought and was deeper in the chest. He did not feel comfortable doing it without a full cut. He later told me once I hit I think he said 6 weeks, the recover would be no different. Maybe when the bones had fused together?

I was one of those with no real pain. Surgery on Tuesday morning, tubes out Wed late morning sent home on Sat, slept in own bed from that point on second floor. Got home on Sat from Hospital and went for hour long grocery trip with wife with no problem.

I had a leaking valve with no BAV, so bad tri-valve. I had no symptoms going in. I think because I was exercising up to the end, I recovered easier.

That was my experince but as Paleogirl says, everybody is different.

Good luck and keep us updated on progress.

 

[Paleowoman]

Hi Paleogirl,

Thank you for that. I have requested a 'minimally invasive' and assumed that the 'minimal' applied to both the sternotomy and the incision - you live and learn.

Hi Gerri,

It is to both the incision and the sternum but it's not as "minimal" as the word implies and it's still a major cut to the sternum, and of course, the work on the heart is the same.

As dwhist's sureon said, recovery is no different. Maybe the sternum is more secure though since it's not completely cut ?

Ah dwhist - I was exercising right up until surgery, doing heavy weight lifting, and the day before hospital admission I did a six mile walk no problem, and I was completley asymptomatic going into surgery. I think I was too low in weight - one needs some reserves

 

[Red]

Hi Paleogirl,

Thanks to the 'heads up' I got from finding this forum, I have been putting weight on in preparation for my op., now there's something I never thought I would be doing, usually it is working to take it off. I had a BMI of 21 when I had my pre op assessment so hopefully having some reserves will help.

As I am a veggie, any tips on increasing Iron levels ?

Gerri

 

[epstns]

Can't speak to the diet precautions, but IIRC, there "used to be" a movement to do simpler, isolated AVR by cutting only a portion of the sternum - and calling it minimally invasive. When I discussed it with my surgeon, his response was that the recovery is really the same, and he was much more comfortable with a full sternotomy to have best access to the heart. I trumped the whole discussion when I presented with an artery blocked enough to qualify for a bypass as long as he was in there.

 

[knotguilty]

I had what they call a mini AVR. Minimally invasive. They cut between the ribs, horizontally, just above my right pec and went in through that way. I do believe they cut one rib to be able to get in there better. I don't remember any pain at all, other than the incision and having to cough or sneeze. When I took my pain pills in the hospital it was so I could sleep better. By the third day, they get you up and walking. The forth day I did stairs. When I got home, I may have took one or two doses of pain meds. I was in the hospital 4 days, went home on the 5th morning. The drain tubes came out just before I went home. I did sleep as much as I wanted when I got home. But started walking right away, first to the end of the driveway, then the end of the street, then around the block, etc. Once you go through the surgery and realize you had a valve replaced, everything else is nothing. I really actually did a brake job on my sons car within two weeks of being home. I wouldn't recomend that though, take your time and just get healed and get better. Hopefully your recovery will be a fast one.

 

[extraordinary]

my surgery was on 2nd of April
tube came out the same day but it was really bothering me and hated it …
i was in sooo much pain the first 5 days then day by day it gets better, my back was hurting me so much can't even lay down to sleep !
i've been discharged after 12 days … and since then it only starts to get better it's just a matter of time, time will heal everything don't worry ...

 

[Katesmom1007]

Hi. I'm new here getting ready for above surgery on April 28. I'd like to know if anyone has had this procedure and what the days after surgery are like (when did drain-tubes come out, etc.) and what at home recovery is really like (when were you able to go up stairs, did you nap much, little/much pain?). Thanks for setting real expectations.

Where are you having surgery? If you don't mind, who is your cardio, I'm from the area and seeking opinions.
Also sending my prayers for a speedy recovery!

 

[joanpieroni]

Hi, I just had AVR March 27th and I am doing great. I was very nervous leading up to my surgery day but I knew I had a great surgeon to do the replacement. When I went for pre-op testing the hospital told me step by step what to expect. They even had me watch a short video on what to expect. The morning of my surgery I went into the operating room at 8:45 am, the last thing I remember is moving onto the operating table. I woke up in the CICU around 7 pm with a breathing tube. That was removed and I was very comfortable. I was in the CICU for 1 more day. I would say the most uncomfortable thing was the chest tube. On the 3rd day that came out and I had no more pain. I was moved to a step down care room and started walking and sitting in a chair. I made sure I did the breathing exercises every hour. On the 4th day I was comfortable, no pain at all. I went home in the morning of the 5th day. I am 49 years young and chose a tissue valve.