Hello everyone,
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With McCarthy gone I have been referred to Dr Sabik for surgery. I have yet to meet him but will in the next few weeks.
My question is, has anybody else picked the use of a oversized bioprosthetic ? How have you felt? Any problems with placing a large valve into smaller plumbing? Does this cause your heart to overwork to compensate for the nonrestrictive blood flow that you now have? Or are you feeling like superman who could run a marathon? Of course any input or help would be appreciated.
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Mk from Columbus
Hello Mk - You raise a question that I've had for quite some time, although our situations are a bit different. In my case, I underwent a pulmonary valve replacement (my 3rd) a couple years ago, and they implanted what my cardiologist considers too narrow of a bioprosthesis. This is a Medtronic Mosaic valve -- you heard that right: Pulmonary position[1]. My symptoms include SOB and right side hypertrophy. Along with A-fib/flutter likely caused by right side enlargement.
Now I've read that surgeons err on the side of small and I cannot explain why haemodynamically (I suppose too little pressure to open the leaflets could be a bummer), but for very active people, a narrow valve hits it's threshold much earlier than either side of the valve would like. You end up with a severe gradient, ergo upstream constipation and downstream starvation.
I'm 38, and cannot go past 12 minutes following the
standard treadmill protocol. This after being a multi time state champion cyclist in the chrono, is a fair number of steps down. And while I can set aside the vanity of needing to keep up with grandmas on my morning constitutional jog (they kick my arse every time), the fact that I'm experiencing other potentially damaging side effects means I'm getting down to brass tacks with my sawbones about what to do. To wit: My cardiologist is right now corresponding with Cleveland Clinic (and UCSF) about what to do with my case. I would not be surprised at all if the doctors you named overlap with the ones on my cardiologist's rolodex, or at the very least the ones she is communicating with might have opinions coinciding with
Sabic et. al. given they are all under the same roof.
I will be sure to bring this up with her during our meeting Tuesday 5/4 next week and report back if there's anything to share. Valve selection is a tough choice. Suerte, amigo.
[1] Pulmonary and aortic valves are similar enough that this can work -- my first surgery was a
Ross procedure.