Second tricuspid valve OP

[heartstream]

Hi, I have not been on here for a while. I love this site it helps me so much every time I read!

I have just found out I must go back in for a mechanical valve after a failed repair to the tricuspid valve 2 years ago.

They are very concerned about clots due to the size of my heart, and the fact it will work well once a mechanical valve is fitted. This my doctor says can cause the heart to throw out clots.

Secondly they are very concerned about the risks of endocarditis and believe it is fatal after a second heart op.

The risk factor has gone up also from 2% to 10% for fatalities.

Does this all sound correct and has anybody survived endocarditis after a second op. I am only 45 but I must have the op or I will go into heart failure within a few years.

 

[kfay]

There are very few people on here who have had any work done on their tricuspid valves, much less had them replaced. I had mine replaced 5 years ago with a porcine valve at the age of 45. I've never heard about the size of your heart being an issue with clots, but rather, putting a mechanical valve on the right side of your heart definitely puts you at a higher risk of forming clots than if that same mechanical valve was on the left side of your heart. The pressures on the right side of your heart are much lower than your left which is what increases your chances of throwing a clot with a mechanical valve. Also, since the pressures are lower on the right side, tissue valves will last longer than they will on the left side of your heart. I personally would really question a surgeon about putting a tissue in on the right side. If you let them go ahead and do it, you will probably (or should be) have to maintain a higher INR to help decrease your chances of developing a clot on that mechanical valve.

This past surgery was my second and I was given a 2% risk.

 

[Gail in Ca]

I've only had aortic valve replacements, but I did survive endocarditis after my 2nd surgery to replace a tissue with a mechanical aortic valve.
I got it 8 1/2 yrs after my valve was replaced. After being treated, I did need a 3rd surgery to replace my aortic valve and repair my mitral due to the staph infection messing with my valves and the tissue around my aortic mechanical. Getting endocarditis is rare, and getting it again after having it once is only a 1-2% rise in risk, according to my infectious disease doc.

 

[Agian]

Are their concerns about endocarditis related to a second heart op in general, or specifically because it's the Tricuspid?
There are a few people on this site who have had two or three OHS.

 

[heartstream]

Hi

Thank you for your replies.
So maybe the risk is higher for tricuspid valve second OP patients?

Endocarditis seems to be a real concern for my doctor but Gail you say it is not as much a risk according to your doctor that is good news.

Ultimately who knows what will happen I will just look after myself and have faith all will be well.

Thanks again

Ron

 

[Agian]

Get your doctor to clarify what he meant by it.

 

[heartstream]

I am back this week for pre-op appointment so I will be talking to him about all this.

We don't really get to see much of our surgeon just the cardiologists who work around him and they can be different every time. So we also get conflicting views most of the time.

In other countries do you get to speak to your surgeons regularly?

 

[Debbrn]

I was born with tetralogy of fallot. Secondary to those heart problems I developed tricuspid valve regurgitation. I have had my tricuspid valve repaired twice along with replacing my pulmonary valve both times. Those surgeries were my 3rd and 4th heart surgery. I see the same cardiologist all the time. Since I chose to go across the country for my last heart surgery I talked to the surgeon on the phone a month before surgery and then spoke to him in person the day before surgery. I have never had endocarditis, but I have never been told that the risk is higher with each surgery. I've never thought to ask the question.

Debbie

 

[Agian]

I am back this week for pre-op appointment so I will be talking to him about all this.

We don't really get to see much of our surgeon just the cardiologists who work around him and they can be different every time. So we also get conflicting views most of the time.

In other countries do you get to speak to your surgeons regularly?

Not in Australia. What you can do is ring his secretary and tell her you have some questions. Ask her what the best way to approach Dr X is. She might tell you to email, get him to ring you, or make another appointment.

 

[pellicle]

We don't really get to see much of our surgeon just the cardiologists who work around him and they can be different every time. So we also get conflicting views most of the time.

In other countries do you get to speak to your surgeons regularly?

In my state of Australia (and the states do vary) we see the surgeon much more that the cardiologist. I only saw the cardiologist at the angiogram and then in followup months after.

Surgeons are quite busy and may lack social skills too. But then I'd rather have a surgeon who is great at the job than a smooger who pats me on the head and buries the mistakes.

Sometimes you need to learn to be zen and know that knowing will not change what is.

 

[heartstream]

Yep mine, although great,is a bit strange. After my last op (a repair which failed) he was about to walk past me and took an obvious diversion down a hallway. I noticed it and as me and my wife passed it we waited on the other side when he saw us go by he came out. He was avoiding the conversation about the failed repair and future operations.

I have seen about. 9 different cardiologist in 1 year.

I am not sure i will actually get to see my surgeon before my op.
Omits

 

[tom in MO]

Per "In other countries do you get to speak to your surgeons regularly?"

I am in the US. I spoke to my surgeon before surgery about the procedure. When I set the date, he had me come in for pre-op stuff and I saw him again. I was always encouraged to call with any questions, both before and after surgery. I spoke to their nurse or physicians assistant when I called. During my hospital stay I saw a surgeon every day and my surgeon's physicians assistant every day. My surgeon came in during his rounds (every 3 days) and at the end to release me. About 6 weeks after release I went in for my final appointment and saw the surgeon for the final time.

 

[heartstream]

I have only seen mine twice in 2.5 years and they don't like questions. We don't get a choice on what mechanical valve we want. I don't even know what one they are doing.

We are lucky in the UK to have NHS. However, it is very over worked and this does effect the quality at times.