Open Heart Surgery Graduate from Iowa in the United States

[3mm]

Hi - I had open heart surgery on Sep 14th, 2023 to repair my mitral valve and replace my aortic valve with a mechanical On-x valve. My surgery was at Mayo Clinic in Rochester, MN. I am very fortunate to live just 3 hours south of Mayo, so it was easy to work with them. My surgeon was Dr Daley from Mayo. He and his entire team were wonderful people to work with. They took excellent care of me, and everything went very smooth. My recovery is progressing well, and I'm getting stronger every day.

My heart story started 1 year ago when I was making arrangements for knee surgery. A cortisone shot in the left knee led to a swollen knee, which apparently was a Staph Epi infection. This became endocarditis which did severe damage to both my mitral and my aortic valves. We easily killed the infection, but I was very weak then. Hence, I choose to wait several months to regain my strength before having surgery.

 

[pellicle]

Hey

We easily killed the infection, but I was very weak then. Hence, I choose to wait several months to regain my strength before having surgery.

Really sad story, fewer people now need heart valves due to endocarditis than before due to antibiotics, however I anticipate this will change over time.

Glad you were able to recover and join us as survivors of heart valve disease.

Best Wishes

 

[Seaton]

Hi Mark and welcome.
Sad to hear of your endocarditis episode but very glad things have gone smoothly on the surgery and your strength improving.
Wishing you a good and steady recovery going forward.

 

[Chuck C]

Welcome to the other side and welcome to the forum!

I'm glad that the surgery went well and thanks for sharing your experience.

 

[Gail in Ca]

Thanks for sharing your story. These nasty bacteria’s really do damage to the heart valves in such a short time.
I’m happy that we can be fixed after all that damage! Recover well!

 

[slipkid]

Wow.. That's terrible (the infection from a cortisone shot) & shouldn't have happened in the first place (right?).

Did anyone look into WHY the cortisone shot caused a staph infection?

How does that even happen? Dirty needle? Contaminated product in the needle? Lack of properly cleaning the knee off by the nurse/dr b4 the shot? What????

 

[HokieHaden]

Thanks for sharing your story. I'm very sorry you had to go through all of that. I am facing OHS/SAVR and aorta repair in 1 week, and I look forward to being on the healing side of it all.

 

[pellicle]

Thanks for sharing your story. I'm very sorry you had to go through all of that. I am facing OHS/SAVR and aorta repair in 1 week, and I look forward to being on the healing side of it all.

hope it all goes "unremarkably" and is an "event free" recovery

 

[3mm]

We don't know how the Staph Epi got inside my body. Some of the infectious disease Drs guess that the Staph Epi was hiding inside me for a while from some previous injury, and the cortisone injection just gave the Staph Epi a place to start growing. Fortunately, antibiotics killed it quickly, but that also killed the evidence, so we don't know where the Staph Epi first got inside me.

Dec 15th and 16th I had no heart murmur according to several Drs exam notes, A couple days later, I had a noticeable murmur, untrasound (TTE) showed serious valve damage, but a fluid sample from my knee showed no trace of bacteria. By Dec 22th my blood cultures were clean. So the bacteria destroyed the heart valves pretty quickly. Meanwhile, I felt pretty decent except for a stiff, sore knee which forced me to use crutches. I did have a fever; that is part of what led the Drs to suspect infection.

 

[carolinemc]

We don't know how the Staph Epi got inside my body. Some of the infectious disease Drs guess that the Staph Epi was hiding inside me for a while from some previous injury, and the cortisone injection just gave the Staph Epi a place to start growing. Fortunately, antibiotics killed it quickly, but that also killed the evidence, so we don't know where the Staph Epi first got inside me.

Dec 15th and 16th I had no heart murmur according to several Drs exam notes, A couple days later, I had a noticeable murmur, untrasound (TTE) showed serious valve damage, but a fluid sample from my knee showed no trace of bacteria. By Dec 22th my blood cultures were clean. So the bacteria destroyed the heart valves pretty quickly. Meanwhile, I felt pretty decent except for a stiff, sore knee which forced me to use crutches. I did have a fever; that is part of what led the Drs to suspect infection.

being in the hospital is where infections come from. Not all use the steps of washing the hand before touching the patient. And the hospital will never admit someone did not follow cleaning the hands Protocall.

 

[QuincyRunner]

My understanding is that the Staphylococcus bacteria, even when circulating in the bloodstream, which is very common, will not cause endocarditis unless there is a pre-existing irregular heartbeat, like a heart murmur, that will give the bacteria an opportunity to grab hold of the interior lining of the hear and/or a heart valve. So Mark, did you have any known issues with your heart before the cortisone shot in the knee? My own endocarditis was caused by a teeth cleaning that introduced the Staphylococcus bacteria but I was innocently unaware that my existing heart murmur would allow the bacteria to set up shop on my mitral valve.

 

[3mm]

I did not have any known issues with my heart prior to the cortisone shot in the knee, but I will ask when I see my family doctor. I also had not heard about a pre-existing condition allowing the bacteria an opportunity to find a home on the valves. But I do remember my surgeon mentioning that he suspected pre-existing damage to the valves.

 

[vitdoc]

Staph epidermitis by it's name lives on the skin and is found widely. It is a normal skin flora. When it gets in places it doesn't belong like a knee joint after a steroid (or any other injection) it can grow and form an abscess. The abscess can seed the blood with bacteria which may adhere to heart valves or go elsewhere.
When the heart valves are seeded you have endocarditis which can eat up the valves.
So there is no mystery about what is going on. Anything that places bacteria into the blood stream can lead to endocarditis. So dental work, iv drug abuse or an abscess can cause the same problem.

 

[QuincyRunner]

But VitDoc, doesn’t the seeding of a heart valve with bacteria still require a preexisting irregular heartbeat for this to occur? This as opposed to bacteria-laden blood just flowing harmlessly through the valves of a healthy heart beating along at a steady sinus rhythm?

 

[vitdoc]

Supposedly increased turbulence may be a risk factor in getting valvular infection. But plenty of probably normal valves get infected as witnessed by the considerable numbers of IV drug users who get endocarditis. Irregular heartbeat has as far as I am aware had any correlation with infection.

 

[pellicle]

But VitDoc, doesn’t the seeding of a heart valve with bacteria still require a preexisting irregular heartbeat for this to occur? This as opposed to bacteria-laden blood just flowing harmlessly through the valves of a healthy heart beating along at a steady sinus rhythm?

Non valve patients get endo and may become valve patients

Valve patients get endo and may get redo

I understood it was more related to scar tissue inside the chambers and valves surfaces. Although I didn't think this was more than conjecture

 

[V__]

Supposedly increased turbulence may be a risk factor in getting valvular infection. But plenty of probably normal valves get infected as witnessed by the considerable numbers of IV drug users who get endocarditis. Irregular heartbeat has as far as I am aware had any correlation with infection.

Thanks a lot for the information. Just to be sure, did you mean that "Irregular heartbeat has NOT ... had any correlation with infection" ?

 

[QuincyRunner]

Yes, I would like clarification too. VitDoc acknowledged that turbulence "may" be a risk factor for valvular infection, although assuming that an irregular heartbeat contributes to turbulence then I think this is pretty well established. During turbulence the blood pools up while swirling in a heart chamber, typically the left Atrium, which makes it susceptible to infection since the bacteria is treading water so to speak. This is why the ADA for years required antibiotics before dental work for anyone with an irregular heartbeat, and still requires it for people with a mechanical heart valve (which creates turbulence) or anyone with a previous history of endocarditis.

 

[pellicle]

I understood it was more related to scar tissue inside the chambers and valves surfaces. Although I didn't think this was more than conjecture

https://www.sciencedirect.com/topic...nates from,occurs on the damaged endocardium.

 

[QuincyRunner]

Thanks Pellicle. So in layman’s terms it sounds like the irregular heartbeat causes turbulence which in turn causes the scarring which is what the bacteria is then able to grab hold to. Much like high blood pressure causing scarring of the interior lining of the arteries that allows plaque to stick resulting in atherosclerosis. By-pass or valve replacement, take your pick.