Stenting and other issues post AVR?

[Nocturne]

I was wondering if there were any issues with stenting (emergency in the event of a MI or otherwise) after an AVR, and if mechanical or tissue valves presented different levels of challenge/complication.

I'll likely be on the edge of a heart attack for the last few decades of my life, if I make it that far, and wonder if prosthetic valves present any special problems. I am imagining that mechanical valves might interfere with a surgeon's ability to snake in and place a stent. ???

 

[honeybunny]

I'm certainly not an expert in this field but to the best of my knowledge, stents are used when there are blockages in the arteries en route the the heart. So the valve type shouldn't affect a doctor's ability to insert a stent. My brother had three place about 2 years ago; the doctor went through the groin and were nowhere near a heart valve.

 

[Nocturne]

OK, so the catheter used for the stent does not enter the coronary arteries via the aorta?

 

[honeybunny]

Not to my knowledge. This image shows where my brother's incision was. You can Google "stents in coronary arteries" to see more images.

 

[epstns]

While a prosthetic valve may not (I don't know for sure) affect future stent implantations, it definitely can affect the angiogram done to assess the need for stents. When I needed a cath last summer prior to my pacemaker lead revision, they initially were telling me that they would enter via my radial artery (in my wrist). I questioned the applicability of this approach due to my prosthetic aortic valve. All of the tech's and even the cardio resident were totally sure that they could use the radial artery. Then when I asked the interventional cardiologist who was to perform the procedure the same question, she said "Oh, heavens no! I'm so glad you brought this up. We will have to use the conventional femoral artery access point." And this was at the top heart hospital in Chicago. I still wonder what would have happened to me if I was just their typical patient who says "Whatever you say, doc." Probably would have awakened to a patched, unused incision in my wrist along with the plug in my femoral artery.

 

[pellicle]

I still wonder what would have happened to me if I was just their typical patient who says "Whatever you say, doc." Probably would have awakened to a patched, unused incision in my wrist along with the plug in my femoral artery.

Some things you just don't want to test...

http://mobile.abc.net.au/news/2016-...-removed-after-misdiagnosis-of-cancer/8042688

 

[epstns]

Ouch! I can't imagine the messy lawsuit that would have ensued had this taken place here in The States.

This is also why we often counsel new members to check out the statistics and reviews of any doctors/surgeons/specialists they use.