OHS advances , regurgitation level, Cumadin, Grow Your Own Valve

[alan_delac]

Hi,

Brisbane, Australia, 42 years young, bicuspid aortic valve and will need an operation eventually.

About Open Heart Surgery
I spoke to a friend at work recently. He told me about his dad that went through his second bypass surgery and that his recovery was much quicker and better than the first time that was about 10-15 years ago. He said that "technology" of Open Heart Surgery has improved significantly since then. Does anyone know more about this? Is it true? Where do the improvements come from (anaesthetics or something else)? My cardiac surgeon mentioned that the second surgery is not a big deal these days.

Regurgitation level (1-4)
Does anyone know how is regurgitation level measured? What does it mean technically (like % of blood returning to heart)? Is it accurate or just estimated? On my recent echo I had feeling it was estimated.

Cumadin
Lets assume someone with a mechanical valve going sailing and at some point being 2 days away from the nearest doctor. Person cuts itself (easy thing to do on a sailboat) and can't stop bleeding. Can you do something to quickly change chemistry of blood for a short period to stop bleeding?

Info about Grow Your Own Valve
I spoke to my surgeon about Grow Your Own Valve (pig valve striped of all cells leaving only collagen). Some of these valves were used here in Brisbane in a clinical trial. Unfortunately, according to my doctor, the valves had to be replaced. It seems the valves turned out to be too weak structurally. It would be interesting if we could get some conformation or comment from the manufacturer.


Regards

Alan

 

[Tom F.]

I cannot reply to some of what you ask, but my doc is of the opinion that for some people, perhaps many, multiple open heart surgeries are not that dangerous. He has one patient that has had five. We did not chat long about it, but he told me that the technology for doing the surgery is improving rapidly, especially as it relates to anesthesia.

As for the echo, I was told that the echo (as opposed to the TEE) is not the best measurement of regurgitation, but it gives the docs enough to make an informed estimate. They also look at the sounds they hear, and whether you have any swelling in your feet etc. I maybe think that it might be more art than science to it.

 

[xtremlee]

I have saw on TV where they grow human ears on the backs of mice but I have yet to see a heart valve on a mice back.
It would be nice but I dont think its gonna happen anytime soon.
Lee

 

[RCB]

Apples and Oranges

Apples and Oranges

Certainly OHS has improved in all phases of the procedure,
so that surgery now carries a lower mortality rate than it did for the same procedure years ago- but marginally. Also each additional OHS you have increases the risk- no dr would argue
other wise- the key is how much. It is kind of like differential calculus- trying to figure out a value of an unknown at any point of time while two diametric inputs affect a limit. If you could
quantify inputs A or B then you could determine risk. Sorry to say,
all we have is statistics, which are historical, but often do not
extrapolate well.
Reguratationis a measure of the volume of blood that passes
by the valve (think leaks) after it has closed. All echos are,
to a certain degree, a matter of interpretation and operator skill.
The difference between a 2 or 4 should be clear, but the difference between 3.9 and a 4.0 is a judgement call.
On coumadin- it depends on how badly you are cut. People
have bled to death who weren't on coumadin. Most minor cuts
can be treat with pressure to the wound site. If it is bad and you
can't stop, burn it or put a tourniquet on it.
Bio-engineered valves have been promised for over twenty years. I remember very well the image of a human ear growing
on the back of mouse under its skin. This was a press release
by Advance Tissue Science about 1995, where they promised they
would be growing production human heart valves by 2000. Today
ATS is in Chapter 15, SRI( a division of St. Judes I think) bought
all their intellectual property and no valve- but they promise it in
ten years.

A sage on VR.com has said.....Make your plans for today, not
what might be developed tomorrow. Good advice indeed!