On this side of the mountain for the 2nd time

[Guest]

Hello to all, First an update on my Mom - she had AVR on 8/08/17 and is doing remarkably well. She went home on day 4 post op and went back to work this past week at 8 weeks out. She has also lost 25 pounds or so! I'm so happy that things have been going so well for her. Update on me - I was scheduled for redo AVR on 9/13 and delayed surgery to 9/20. I chose a mechanical valve; however, the surgeon was not able to fit me for a mechanical because my valve opening is too tight. I learned when I woke up from surgery that I have a bovine valve. I had no idea that there was a possibility that I would not be able to receive a mech valve. Clueless. This was never mentioned to me by my cardiologist or surgeon. All discussions were simply "it's up to you." I have no choice but to reconcile myself to the fact that I will face another replacement at some point. That was the first hiccup. On 9/22, the nurse practitioner removed the pacing wires and I began bleeding and the chest tubes filled up with blood. It was very scary for my husband and me. And my right lung collapsed. This all happened within minutes and I was rushed back to surgery, chest reopened, stitched up inside, another round of fluids and anesthesia, etc. I am very thankful that the nurse practitioner and staff. They all remained calm, acted quickly to get back into the OR, and saved my life. I am especially thankful for the nurse practitioner's command of the situation. She had the nursing staff call the OR to get a room ready and call my surgeon to meet her there. She did her job and I will be forever thankful. I ended up with 3 blood transfusions, just to give you and idea of how much blood I lost. I will say that this recovery is going very, very slowly. I don't have my pep back in my step yet. I am feeling better than I was a week ago, just wishing things were moving along a little faster. That little hiccup did a number on me and the collapsed lung didn't help. I use the spirometer everyday but I still can not get it above 1250-1500. And I cough a lot. A lot. As in all day some days. It's ridiculous! I will post more soon. Lisa

 

[Lisa2]

This is my post. I don't know why it doesn't show up as me because I was logged in. Or why my post looks like one paragraph when I didn't type it that way!

 

[Paleowoman]

Lisa2

Or why my post looks like one paragraph when I didn't type it that way!

Hi Lisa - sorry to hear you have had a rough time with your redo AVR The issue with your post appearing as one big paragrapgh is because there are several technical problems on the forum at the moment. There are a lot of other issues such as buttons don't work and so on - Hank is looking into it. Do keep us posted on your recovery {{{hugs}}}

 

[Paleowoman]

Lisa2

I chose a mechanical valve; however, the surgeon was not able to fit me for a mechanical because my valve opening is too tight. I learned when I woke up from surgery that I have a bovine valve. I had no idea that there was a possibility that I would not be able to receive a mech valve. Clueless. This was never mentioned to me by my cardiologist or surgeon. All discussions were simply "it's up to you."

I don't know if this might explain, but I was referred to a surgeon recently because my replacment valve of three years is "small", ie too small, and he said the only way forward would be to do aortic root replacement so that a bigger valve could be put in BUT another surgeon has already told me that even with aortic root replacement or aortic root enlargement there is no guarantee that a bigger valve can be put in.

 

[Paleowoman]

PS - can't do edit and post went....to continue, the smallest mech valve must be a bit bigger than the space the surgeon had to insert a new valve so he must have had to chose a tissue valve which, I suspect, fits in a smaller space than the smallest mech....does that make sense ? Do ask your surgeon when you get a chance and let us know.

 

[pellicle]

Well ****, thats a bum ride. I hope it smooths out and things get better soon. Best Wishes

 

[Lisa2]

Paleowoman, yes, you have it right. The tissue valves are more flexible and can be fitted into a smaller space. He tried a 19 mech, the smallest he was willing to go, and it was too large. He said he could have possibly fit a 17mm but that is more of a child's size and my result would have not been good. He said I would basically have gone through all of that and ended up with the same gradient, heart function, etc. as I had before surgery.

 

[pellicle]

Lisa2 as I understand it the problem isn't flexibility its that (both) smaller diameter (thus smaller surface areas) make the opening pressure higher with the mechanical than is desirable and (importantly) panus is a more significant problem in smaller diameter valves. There may be other reasons, however tissue prosthetics still have a stainless steel ring for stitching and holding their shape.

 

[pellicle]

even wikipedia has a good page on this:

 

[pellicle]

this is the link (which I forgot to add) https://en.wikipedia.org/wiki/Artificial_heart_valve

 

[pellicle]

even on this page the metal wire frame is visible: http://www.edwards.com/eu/products/heartvalves/pages/magna.aspx

 

[Lisa2]

Thanks, Pellicle. I do,plan to ask the surgeon when I see him next week. I am sure that the word "flexible" was just a poor word choice in an attempt to dumb it down for me to understand....also, I was still under the influence when we had the initial conversation so perhaps I heard something he didn't actually say

 

[ottagal]

Lisa,
So glad that the surgery is behind you, but very sorry to hear about those bumps and 'surprises'. I wish you GodSpeed and no more surprises.

One day at a time...be gentle with yourself. You know the drill.
BTW...those nurses are walking angels!
Also, glad to read that your Mom's surgery went well.