Old Member - MY DAD - PLEASE READ!!!e

[Guest]

Hello Everyone
I was a active member back in 2009, I am back .
My Dad had his valve replaced back in 2009 - St Jude Valve.
The last 5 months he has been slowing down, not being able to breath much after walking and so on.
The cardio doc and surgeon ran tests on him - including a TEE.
The valve that was replaced his leaking severely, the Aorta is enlarged as well but not to the point they do surgery on the Aorta.
But the Valve is bad, and he will need either open heart again or MAYBE a plug/patch surgery if he qualifies.
We are waiting for the surgeon to call my parents to find out what will happen.
I am a WRECK! Is this even normal for a 2nd surgery on the SAME valve? UGH!!!
Please someone or anyone help my mom and I with this!
Is Ross still on here?

 

[tom in MO]

Most valves last longer than 6 years, but if he had a tissue implanted they can fail as early as 2 years. It is normal to have a tissue valve replaced. Many people on these forums have had successful second and more surgeries. Try not to worry, your dad's done it successfully before.

 

[dick0236]

Please someone or anyone help my mom and I with this!
Is Ross still on here?

Ross passed away a year or two ago.

As "tom in MO" says, it is normal for tissue valves to be replaced at some point, but it would be unusual, but not unheard of, for a mechanical valve to be replaced after such a short time. Read thru some of the older posts and you will find that reops are done very often.....and with high success. If your dad has to have a new valve I am sure it will go OK.

 

[Joanne]

The St Jude valve has to be replaced with a new one. It is not tissue. It's the mechanical valve. The surgeon is calling tonight with the results from TEE procedure.

 

[pellicle]

Hi Joanne

I know you are fraught now, but perhaps questions may be a good distraction. As others have said redo-operations are relatively routine as far as this goes, so he should be fine

Is the valve leaking from the valve or around the outside of the valve? Perhaps the aorta has stretched enough to allow / cause leaking around the perimeter.

Is there a blockage of the valve? If for instance there is then there are non surgical treatments available for mechanical valves to essentially allow your body to wash that clean.

Here is one article which discusses that

http://content.onlinejacc.org/articl...icleid=1126505

Intravenous thrombolytic treatment has been proposed as an alternative to surgical intervention.

METHODSIn a four-year period, 32 symptomatic patients with prosthetic valve related thrombosis underwent 54 thrombolytic treatment sessions for the treatment of 36 distinct episodes. All patients had low international normalized ratio values at the presentation

CONCLUSIONIn patients with prosthetic valve thrombosis, intravenous slow infusion thrombolysis given in discrete, successive sessions guided by serial TEE and transthoracic echocardiography can be achieved with a low risk of complications and a high rate of success.

Depending on the results of the TEE this may be a possible answer.

Best Wishes

 

[Northernlights]

Dear Joanne
It's no wonder you are upset. The prospect of a re-op is particularly hard to face when your father chose mechanical presumably to avoid this. Paravalvular leaks are a pretty rare complication, (though DachsieMom has also just been diagnosed with one), so he has been unlucky. However, it is good that the problem has now been diagnosed and can thus be dealt with. Whether he goes for a percutaneous plug or a surgical re-op, it is really worthwhile to go to the best centre you can with the most experience in these, to give you peace of mind for the best chance of successful closure of the leak as well as safety.
All the best

 

[Joanne]

Hello. We just heard from the surgeon. He said it's the valve itself not around the valve.
So looks like it will be another open heart surgery. We meet with the surgeon next Thursday to talk. I'm nervous but trying to stay positive. Any thoughts? Anyone have a 2nd mechanical valve replaced within 5 years???

 

[Joanne]

Hello. We just heard from the surgeon. He said it's the valve itself not around the valve.
So looks like it will be another open heart surgery. We meet with the surgeon next Thursday to talk. I'm nervous but trying to stay positive. Any thoughts? Anyone have a 2nd mechanical valve replaced within 5 years???

 

[pellicle]

Hi Joanne

Any thoughts? Anyone have a 2nd mechanical valve replaced within 5 years???

the news sounds very distressing, but did you read my post about cleaning valves with a prodceure? That your {fathers} mechanical valve is leaking is almost unheard of. I would be pressing to ensure that diagnostics had been done to be 100% sure that its a valve that needs replacing NOT a valve that needs cleaning. I have never read of a a mechanical valve which needed replacement which had not actually broken. What I have read is that valves are replaced which could have been cleaned.

About a year ago there was a lady here who had a leaking mechanical valve and she was facing replacement, the surgeons were saying "surgery" and I pressed her to double check the results. They finally decided to allow the treatment that is above and guess what - it worked. She did not need another surgery.

If you can, push that they make clear to you that it is not a blockage. Then after the surgery demand to see the report on the valve they took out.

It could be pannus growth blocking the valve (which cleaning therapy above won't help) or it could be thrombosis (which is what the cleaning will likely fix).

Surgeons love surgery ... so everything looks like a surgical solution to them.

Best Wishes

 

[Joanne]

I will bring this up to the surgeon on Thursday. Thank you.

 

[pellicle]

Joanne

print this:

http://content.onlinejacc.org/data/Journals/JAC/22916/06549.pdf

and take it along

 

[pellicle]

also

download this for your own reading:

https://www.dropbox.com/s/b67vlrylhn...n-518.pdf?dl=0

begin reading at about page 28, about obstructive valve thrombosis (and maybe quiz your dad or anyone near to him about his warfarin therapy see if he missed any doses for extended periods or his INR was low)

Particularly page 30 is the words which may help you. Where thrombosis is the cause of the leaking valve that process had great results.

Lastly: ask your surgeon:
* why he/she thinks that the leak is not caused by thrombosis (obstruction) as they may have a reason (or may not)
* if they are unable to rule out obstruction by thrombosis what is their risk assessment of surgery VS this treatment method followed by surgery if this treatment is not successful

remember, if there are complications in surgery (which perhaps could have been avoided) the surgeon goes home safe and sound but your dad doesn't.

 

[Joanne]

My dad told me the surgeon reached out to the coligation center to go for his INR for the last few years. Also my dad has a blood condition for over 20 years. Thick blood. There's a name for it antiphosi...something like that sorry. But we are all nervous. So we go Thursday.

 

[Joanne]

My dad told me the surgeon reached out to the coligation center to go for his INR for the last few years. Also my dad has a blood condition for over 20 years. Thick blood. There's a name for it antiphosi...something like that sorry. But we are all nervous. So we go Thursday.

 

[Joanne]

My dad told me the surgeon reached out to the coligation center to go for his INR for the last few years. Also my dad has a blood condition for over 20 years. Thick blood. There's a name for it antiphosi...something like that sorry. But we are all nervous. So we go Thursday.

 

[Joanne]

antiphospholipid syndrome

 

[pellicle]

antiphospholipid syndrome

Makes me even more suspicious that thrombosis is the culprit.

I hope that the treatment ( tissue plasminogen activator or urokinase) I have suggested is available to him.

Keep us posted

Best Wishes

 

[Joanne]

I will mention this Thursday. The surgeon mention leaflets. I'm so worried. We all are. We will do our best. Something needs to be done because my Dad loses breath even when he walks. So he rests all day for now. He has full trust in his surgeon. Maybe his INR should have been different with this blood condition. We are not sure. But we hope to hear more Thursday. I know that the surgeon is reaching out to his colleagues at Columbia Presbaturium. We are just puzzled. Trying to keep Dad in good spirits.

 

[Paleowoman]

Wishing your dad the very best Joanne. I looked up antiphospholipid syndrome and it seems like it can cause problems with valve replacements. Your dad's surgeron sounds like he is investigating this thoroughly and I'm sure he will be doing something for your dad. It's the waiting that is so hard when a person is not well, even when it's a few days.

 

[Agian]

I know what it feels like to have sick parents. Big hug, Joanne.