New here--Mitral Valve Replacement very soon...

[Ella4hubby]

Exactly Jkm7--One opinion.

I just found Dr. Bollings' description of the difference between aortic valve and mitral valve rather interesting...ie the aortic valve described as a simple door but the mitral valve as a complicated apparatus. Thus the possibility of doing up to 27 different things to repair a mitral valve. Also the chance of landing a replacement mitral valve perfectly into the mitral position being very, very difficult...Lots of work to be done to perfect that technique.

As an aside, our cardiologist is quite optomistic about the future development of the transcatheter approach for replacement of the mitral valve...And our surgeon actually told us that in mid October, he was going to try to do a transcatheter mitral valve replacement on an older woman (mid-late 80's), who cannot have OHS because of health problems, and has no other option...Not sure how that turned out... Anyway, as they say: "Only time will tell!"

 

[Adrienne]

Here is an article I read on percutaneous mitral valve replacement:

http://www.valvereplacement.org/for...7-New-here-Mitral-Valve-Replacement-very-soon

 

[Adrienne]

Sorry, I goofed. Here is the article:

http://www.businesswire.com/news/ho...ies-Reports-Cardiovascular-Medicine-Milestone

 

[Ella4hubby]

Thanks Adrienne! Very interesting article...let's hope for good longlasting results in the future.

 

[Mom2izzy]

Dr Bolling was my surgeon...he has tons if experience and is world renowned in the field of mitral valve repair. He definitely does have his own very strong opinions, and when you meet him it's very hard not to let his opinions become your opinions (just part of his personality). In another YouTube video you could see him discussing his research regarding the biggest (not the only) factor to determine repair vs. replacement, which others will also not agree with. I wasn't surprised to hear that he is not banking on the transcatheter approach being available soon because he doesn't seem to be a fan of any type of surgery on the mitral valve where the surgeon cannot "feel" their work. At least that is what he explained to me when discussing robotic surgery as an option. In person, I did get the impression that he believes the transcatheter approach will be an option for mitral valve replacement, but not in 1-2 years...more like 8-10. However, generally, these newer options are available in the rest of the world sooner than they are in the U.S. I know there are some who might think he's full of it, but, hey, he fixed my "unfixable" valve, so I am biased.

 

[Ella4hubby]

Hi Mom2izzy!

How interesting that Dr. Bolling was your surgeon...I just added the comments and link to that interview as an interesting perspective. I have come to realize that cardiologists and cardiothoracic surgeons often have very strong opinions. In my view, they are allowed to...we just have to listen and learn and take some and leave some...I like researching and hearing lots of info, because no one person is "right," at least not about everything anyway.

Our cardiologist is also very negative about minimally invasive approach and robotic techniques--he said to us that the best is for the surgeon to visualize directly the heart and valve, and then to be able to handle it directly also--all this for best results....when we told our cardiologist that my DH's younger brother just had mitral valve repair by minimally invasive approach (though not with robotics), he responded with: "Ask him how he is doing in 10 years..." Not very nice thing to say, but I know what he meant; these are newer techniques and have not been assessed long-range. Our cardiologist is very opinionated--but I appreciate his experience, research and exposure to conferences and other specialists in Canada and the US. He has said that his goal is to get the best care for his patients--as he sees it at this point.

So glad for you that your "unfixable" valve was fixed! I'd give your doctor all the credit he is due. These surgeons are amazing! And as I say, so they are opinionated--that's part of the drive they have and need, to do such difficult and specialized work.

 

[gerrychuck]

Hi Ella4hubby; my history is VERY similar to your husbands, but compressed into a week instead of 3 years. I feel for you waiting to be called in, but the alternative as I experienced it - surgery performed as an 11th hour life-saving emergency procedure - has it's downsides too, although the stress of waiting definitely isn't one of them! I think you are doing the right thing by using this time to thoroughly research the subject and objectively look at all options. I did not have that opportunity; I went under sedation to be intubated thinking I had pneumonia, and came out of sedation 2 days later with a new mechanical valve installed. For the record, I am happy with the choice made for me, and anti-coagulation therapy has so far been very simple, with an INR that stabilized very quickly. I even did a face plant on a bare floor, hitting my head quite hard, with nothing more than a slight goose egg to show for it. Probably a good thing it was a cork floor, mind you

Good luck with whatever choices you make. I know your husband's otherwise robust health will make a huge difference in his recovery; I know it has so far for me. Take care, and hopefully the call will come soon!

 

[Ella4hubby]

Hello gerrychuck! Another fellow Canadian!

We are still here into week 4 waiting...We have decided to go with the tissue valve for various reasons, but mainly for the possible long-term issues with Coumadin use... My DH will have to be on Coumadin for first three months after surgery, so we shall see how that will go. Another concern for us is that my husband cuts himself shaving almost every day--(of course no razors while on Coumadin) but his skin is fair, and fragile...so not sure how the whole bumping and bruising would go...

my history is VERY similar to your husbands, but compressed into a week instead of 3 years. I feel for you waiting to be called in, but the alternative as I experienced it - surgery performed as an 11th hour life-saving emergency procedure - has it's downsides too, although the stress of waiting definitely isn't one of them! I think you are doing the right thing by using this time to thoroughly research the subject and objectively look at all options. I did not have that opportunity; I went under sedation to be intubated thinking I had pneumonia, and came out of sedation 2 days later with a new mechanical valve installed.

Thank you so much gerrychuck for sharing your experience...yes that is cause for pause--could definitely have been my husband as we too, with that episode 3 1/2 years ago, were under the impression that it was pneumonia or some viral lung infection--I kept asking the doctor what it was, but he was rather vague...

I now understand that the edema the radiologist was talking about in the report was "pulmonary" edema--a back up of fluid from the heart into the lungs...the doctor thought it was the kind of edema where your ankles swell--which you can get with serious late-stage congestive heart failure. He looked at my husband's ankles and said they looked fine!

Anyhow, nothing to do about it now, but I do see how a sudden hospitalization and surprise valve replacement surgery could turn your world upside down!!

I see that this is very recent...How are you doing now?

Glad the coumadin has turned out to be easily stabilized. We are now hearing of several aquaintances or friends of friends who have had a mechanical valve replacement and they are all happy with their (or their doctor's!) choice...

 

[gerrychuck]

Again, very similar experience. My lungs were full of fluid, also pulmonary edema as it turned out, to the extent that my chest x-ray genuinely alarmed the radiologist and technicians (one of whom was a personal friend). I was hit with every antibiotic and antiviral known to man over the next 2 days with no improvement, and in fact continued to deteriorate. I ended up intubated and on the vent for 24 hours, and the correct diagnosis finally was made via an echo and I was rushed into surgery. Great fun, but all's well that ends well, and I am doing very well post-op. I am now 6 1/2 weeks post-surgery, and the past 2 weeks in particular have seen tremendous improvement. My shortness of breath is hugely improved, I can go up and down 2 flights of stairs without any particular difficulty, and I'm doing 25 minutes a day on the treadmill. I must be getting better, because I'm starting to get really restless and anxious to return to my normal pursuits!

With regard to long term Coumadin use; you might find it interesting reading in the "Active Lifestyles" and the "Anticoagulation" section of the forum. There are people, skiing, kayaking, flying aerobatics, heck, even using chainsaws while on anticoagulation. Lots of great information there, which I found extremely encouraging. The consensus (and this mirrors my experience to date) is that being on anticoagulation has not materially affected most people's lifestyle very much. In my own case, I'll probably give up waterskiing (my faceplant wipeouts are truly epic), will start using a helmet when I return to skiing, and if Transport Canada in their wisdom allow me to return to flying, I will probably take it easy on aerobatics, but otherwise I intend to pretty much carry on. Don't tell anyone, but I even shaved with a razor for the first time this morning

Hang in there; the wait will soon be over, and the long recovery process will begin. I am sure your husband will do great, and progress quickly from pathetic to annoying in no time at all! I know that's how it's worked for me and my wife Take care and good luck!

 

[Ella4hubby]

Thanks gerrychuck...Wow! What a scenario! My husband didn't look that bad, but felt strangely unwell. Especially when trying to talk--had trouble finishing a sentence without running out of breath. And any deep breath brought on a strange cough. Walking anywhere, and I mean from one room to the other here at home, and he was totally winded! It really scared him and me, as he has always been very active, never sick--perhaps the rare cold, like once in 5 or so yrs...... Well, who knows if he had received the correct diagnosis at the time, that he wouldn't have been whisked off to surgery as well, and ended up with a story just like yours!

Thanks for input on Coumadin and lifestyle--my concern is less for lifestyle and more for longterm issues...but as some have mentioned, even with a tissue valve a person can still end up on anti-coagulants longterm, because of other problems--irregular heart beats, or having a small clot after the surgery. Anything is possible. We'll deal with that if and when it comes. A friend of ours who is a GP, counseled us on this--do a pro's and con's list assigning a value to each one, etc. But the best advice he gave was: "Either way whatever you choose, at some point in the future you will probably regret your decision." Sounds a bit negative, but I got his point--there is no perfect decision (oh, don't I wish!), and you can't know the future. Kind of put it in perspective for us.

You mention

if Transport Canada in their wisdom allow me to return to flying

Assume you are a pilot? My husband served in the Can. Armed Forces, way back when, flew as a navigator out of Bagotville, QC on CF 101's. He loved the flying but settled back to earth after about 9 years (inclg Military college - RMC Kingston). One of our best friends is an Air Canada pilot based here in Montreal...fun to follow his travels and experiences.

Thanks for sharing your recovery experience...we are not looking forward to it, but I think my husband will do well, all things being equal. He is not a complainer and has a high pain tolerance in general. But of course, we shall see!

 

[gerrychuck]

My symptoms were virtually identical to your husband's; the difference being that I got steadily worse and fortunately, he didn't! With regard to the mechanical/tissue choice, there is no question that it is an entirely personal choice based on a wide range of individual circumstances. From what I understand from my reading here, there really is no right or wrong choice; both options have their pros and cons.

Yes, I am a private pilot. I have the privilege, however, of getting to fly with several pilots who are in a different league altogether: My son, who is an RCAF flight instructor here in Moose Jaw, and my hangar-mate, who flies for WestJet after a Canadian Forces career that included the F-18 Hornet, jet instruction here in Moose Jaw and 4 years as a Snowbird! I am incredibly lucky to be able to learn from guys like that. Your husband flew in the legendary Voodoo, did he? Quite the old airplane. I understand that the US Air Force sent a delegation up to Canada at one point to see how the heck we kept ours in the air for so long

 

[Ella4hubby]

Very cool that you get to fly with and learn from those individuals...

Your husband flew in the legendary Voodoo, did he? Quite the old airplane. I understand that the US Air Force sent a delegation up to Canada at one point to see how the heck we kept ours in the air for so long

I've been reading your responses to my husband and he broke out laughing at this last comment! Yes the venerable Voodoo. He loved it. I really enjoy airplanes too, though I have no background specifically in aviation--just growing up with a Dad and 3 brothers who loved anything mechanical, that drove, rolled or roared--at any given time an assortment of cars and motorcycles were in various states of repair/disrepair in the garage or driveway, and I was very often called on as an assistant to help with repairs--you get the picture! I loved the airshows where you got to see such a variety of airplanes up close and/or tearing across the sky!

About 15 years ago, when my husband was about 45 years old, we happened to be back in the area of Bagotville and discovered that they have an actual CF 101 Voodoo mounted with (fake of course) burners lit, nose pointed up sky-ward. Brought back memories for sure...There is also a museum they've set up just outside the base, and inside the museum, my husband found a picture of himself when he was involved in an anniversary celebration of 425 squadron...sobering moment--said it made him feel real old to be memorialized in a museum!!

Fun & Games!

 

[gerrychuck]

Your childhood home sounds like my place right now! I am between motorcycles at the moment, however Glad I gave your husband a laugh. The Air Force is, in my humble opinion, one of our national icons with an incredible history and heritage, and in my (fairly extensive) experience with Air Force people I have almost invariably found them to be exceptional individuals as well. It was truly one of the proudest moments of my life when my son had his wings pinned on him this spring. He had the rare honour of being given both USAF and RCAF wings, as he finished his training at the Euro Nato Joint Jet Pilot Training Program in Texas. He was flying a plane almost as old as the Voodoo: the T-38 Talon. Nothing like flogging a 50 year old airframe around at 500 feet and 400 knots! At any rate, he jokingly says he has aviation dual citizenship now