My Father's 3rd OHS

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chd19

Member
Joined
Sep 30, 2009
Messages
6
Location
Boston, MA
Hello,

I wrote a couple of months ago regarding my 80year old father's 3 rd valve replacement (bovine). He had the surgery on 12/10 after the surgery being postponed a month due to a bout with strep throat. The surgery was performed by Lawrence Cohn at Brigham and Women's in Boston. It turned out the surgery was more urgent and complicated than previously thought. When he was opened up, it was discovered that his porcine valve that was put in 7 years prior was basicially 2/3rds removed from its sutures. On top of that, one of the leaflets was blown out. Dr. Cohn mentioned that he basically had never seen anyone alive with such a predicament. He was actually planning on getting a mini-stern due to his cath showing no major blockages (a testament to his taking caring of himself), but this obvlously changed when they went in.

Anyway, my dad surprised everyone (including Cohn) w/ his recovery. The morning after surgery he was sitting up in the ICU and talking; and basically 24 hours after surgery he had taken his first walk from his bed to the hallway and back. The following day he was moved to another room in the ICU where he went from receiving 1 on 1 nursing care to 1 on 2. All-in-all he was in the ICU for 48 hours. He then spent 5 additional days on the "step-down" floor where he continued to improve. The ICU staff was great, especially nurses Mary-Kate and Brock. Mary-Kate actually came down to visit him to see how he was doing and make certain he was walking. He did not need to go to a rehab faciltiy and he has had a few visits fromvisiting nurses, which will continue until he sees Cohn again next week. So all in all, he's doing great and the family had a great Christmas with him home.

The following is a list of surgeons in Boston that came recommended to me in my reseach:

Brigham& Women's: Shapiro Center is a state-of-the-art facility that opened up in 2008. Each room there is private and they allow one family member to stay overnight in the room with the pateint (includes the ICU rooms)
Lawrence Cohn - Renowned surgeon; speacializes in valve replacement surgery; performed about 10,000 OHS; he is 72 years old but maintains an active schedule (3 surgeries per week) and is on top of all the latest techniques/technologies

Aranki - I hear he currently has the most volume of all the surgeons in the practice

Chen -I heard he is very involved with his patient's care post-op

MGH:
Vlahakes - Heard great things about not only his skills, but that he has a great bedside manner as well.

Akins - Lots of experience; read he did JimMcNeil's (PBS) valve replacement and Jack Welch's (GE) by-pass

Macgallivary - Heard from some physicians that he is excellent as well
 
What a great update. I'm glad every thing went so well. WOW he sure was lucky, I wonder how low his valve was like that. I'm sure your family had great holidays having this behind you and your Dad doing so well. I hope the rest of his recovery is equally bump free
 
Thanks for all your well-wishes and support. I hope the story of my father gives hope and confidence to all who are about to undergo an OHS, whether it's their first, third or sixth.
 
What wonderful news. So happy to hear how well your Dad is doing. He's an inspiration, for sure.
 
What a situation! It's so nice to read how well he is doing :) .

Did the surgeon have any idea "why" the previous valve came loose? And do you recall what kind of porcine valve it was, who the manufacturer was?
 
When we first met with Cohn in September, he reviewed the ultrasound results and noted that there was leakage around the valve (he obviously didn't realize how bad it was until he went in). When we asked what this was a result of, he mentioned that it's basically because of the previous surgeon's technique (or lack thereof). I believe he had a Medtronic porcine valve. Cohn was quick to say that he (and I believe all of the Brigham) stopped using pocine valves back in 1997. (I'm a bit confused about this since I've heard that Barbara Bush was implated with a porcine valve last year - it could be just based on his preference and experience.)
 
Wow, yeah. WOW.

I make my living partially by tying knots in yarn. So I'm surprised that sutures hold well anyway for so long. However, some can tie knots well and some can't. I'm wondering if there's suture tying questions that are relevant to surgeon choices.

I'm not aware of the usual tie in procedures. Do they usually add an adhesive to the suture to help it hold. If not, is it an option?

As to the leaflet blowout. I first thought this was meant as a blow out and gone, where did it go type of thing? And how if it was, did they retrieve it? But after a thought or two maybe, it was still held on partially. But since the thought is there now, where do blown out materials from a replacement valve go and the possible effects. Still wondering if this was the case here.

Still amazed that your Dad's condition was such that it wasn't considered urgent.
 

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