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Gary, things have moved pretty quickly for you. I am glad to read that one of your doctors decided you really needed the heart cath because a stress test would not have provided the necessary information about a stenotic valve. Now you know because someone has looked at it.

Whichever valve you choose, Gary, just run with it and no second guessing yourself later. There is no one who can tell you which valve is the absolute best for you as an individual. Choose the one that you feel you can live with most comfortably. Once the valve is part of your heart, dedicate yourself to having the best recovery.

Best Wishes

Larry
 
Gary Miller said:
Sorry about the mixup Bill. It was only a few hours after the cath that I posted the results. It wasn't .4 AVA it was AV Max 4.52m/s that is still a big concern(should havwe been replaced at 4.0)! Again I'm struggling with valve choice as the surgeon doesn't reccomended either way. I think someone mentioned that the ON-x isn't really that much better that the SJM except in the Hemodynamics and hinge system from what I can gather, and the tissue valves now being advertised at 15-20 years is not going to show the clinical results for some time. I'm leaning toward a Mech and Coumidin as it might not be as scary as I think hope.I noticed on another thread that some people are taking issue with Cheney getting a new heart at 71 and as health care changes in the years to come will any major surgery be considered for anyone in their 70's due to costs and expected longevity . I know someone mentioned that you can't live forever but when you are very healthy except for this problem its hard to look at just 10 years or so before you might start gettinbg back in the same problem. CT scan Fri, pick valve type and OHS schedule on the 9th.
Click to expand...

Its sounds like you are leaning toward Mech, what ever makes you feel the best about the "down side" -Coumadin for mech, possible REDO with tissue- seems to be the best choice for someone.
FWIW, the earlier generation of tissue valves with the anti-calcification, Edwards Perimount, Medtronic Hanncock II, St Jude Biocore, that are the most common tissue valves used today have been around about 30 years (first used in early 80s) so there are quite a few studies following patients over 15 years and several over 20. They are the valves/studies that show people in their 60s when they recieve their valve (who are still alive 20 years later), about 90% still have their valve and it is doing well at 18-20 years post op or longer.
There are some newer tissue valves that dont have proven track records, that they hope "should" last even longer.
 
Gary Miller said:
Sorry about the mixup Bill. It was only a few hours after the cath that I posted the results. It wasn't .4 AVA it was AV Max 4.52m/s that is still a big concern(should havwe been replaced at 4.0)! Again I'm struggling with valve choice as the surgeon doesn't reccomended either way. I think someone mentioned that the ON-x isn't really that much better that the SJM except in the Hemodynamics and hinge system from what I can gather, and the tissue valves now being advertised at 15-20 years is not going to show the clinical results for some time. I'm leaning toward a Mech and Coumidin as it might not be as scary as I think hope.I noticed on another thread that some people are taking issue with Cheney getting a new heart at 71 and as health care changes in the years to come will any major surgery be considered for anyone in their 70's due to costs and expected longevity . I know someone mentioned that you can't live forever but when you are very healthy except for this problem its hard to look at just 10 years or so before you might start gettinbg back in the same problem. CT scan Fri, pick valve type and OHS schedule on the 9th.
Click to expand...

I stayed out of the Cheney thread, BUT I'm pretty sure the reason anyone (beside political reasons) took issue with him or any 71 year old getting a heart, wasn't about the cost as much as the fact, unlike heart valves, there aren't nearly enough donated hearts that everyone who needs one will get one, so many people of all ages die waiting to get a heart. So To ME, it seems much of the concern is since there aren't enough hearts, should they go to someone that probably won't live that long even with a new heart, or younger people who the odds are much better of living a long life with the donated heart.
 
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CT Scan Results are in!
Findings: No dilation of the ascending, transverse, or descending, thoracic aorta. No abnormality seen of the great vessels. No evidence for dissection. No abnormality of midiastinal structures. Lungs are clear. No abnormality of upper abdomen. (Dense calcification in region of aortic valve.) From some of the video's I’ve seen of the operation it’s critical that the surgeon gets all of the calcified debree out of the annulus before valve sizing and sewing in place. Maybe he can break it all out in big chunks and not have to worry about the fragments falling in. Anyway we talk to him Thursday in the AM for the second opinion. I think if he is as good as advertised I'll push for the OHS date. I'm starting to have too many blah days lately. That feeling in the back of your head when you get up too fast really pounds now! I post more on Thursday. Hey Gymguy you are the man! I hope I can do half as well as you are doing.
 
Hey Gary,
Whatever date you choose I will be sending lots of positive thoughts/energy your way. You will go into it prepared and once you're done you will tackle each thing with power of knowledge that this forum has instrumented you with and do really really well. Honestly, the number of details people have shared here left me with no surprises when I was in the hospital. Also, there is a great book that, in addition to this forum, has helped me beforehand - http://www.amazon.com/gp/product/1887841075 I should put this in my signature and advertise it. Also, maybe we can get the author of the book to endorse this forum in there as a resource as well.

Either way, please keep us updated with the date, hospital name, etc. Everything will be alright.
 
Got my Date
We just got back from the meeting with are second opinion surgeon. Dr James Lonquist; He's our guy, we both really like him! Residency at the Unversity Texas at Houston, Fellowship at the Texas Heart Institute Houston. He told me "you are going to feel a lot better after this, we'll take good care of you" It's a straight valve replacement going with the On-x mech. He has toured the On-x factory and was very impressed said those guys helped designed the first bi-leaflet valves. It was tuff calling the first guys nurse to cancel my next appointment with him ( they are in the same surgical group) she wanted to know why? We just told her we were going with Dr Lonquist "ok I’ll tell him" she said. I feel really bad about rejecting any one that can perform this kind of miracle but like everyone says you should be very comfortable with your surgeon. The pre-op is 16th April and AVR on the 20th (hope the other surgeon isn't on call that weekend lol)! My wife was very quiet on the way home. After all these years its really going to happen. I finally got her to start reading the posts here and she is feeling a little better I think. Especially after the gymguy's surgery. But I told her that if we did half as good as that I would be very happy!
 
Gary, good luck with everything, I am in waiting room with you for 2 yrs now, but at least i only get winded bad, but still recover pretty quickly. Hang in there
 
April 20th, 2012 is the date then!! I updated community calendar - http://www.valvereplacement.org/forums/calendar.php?do=getinfo&e=2023&day=2012-4-20

Tell your wife to talk to my wife, this thing is hard as hell on families. Especially, if you have little ones. On the positive side, the amount of relief that she will get when you are awake and on the other side will be tremendous. From there on things will be a lot easier on her, and everyone else. Next 15 days will be hard on everyone in your family. You need to show them that you are strong and confident and assure them that everything will be ok and just to believe in the system/process and keep in reassuring them. If you appear strong about it, it will rub off on everyone. Your confidence will drive their confidence and positive thought. Do not, if at all possible, breakdown or feel weak, go in STRONG and come out STRONG.
 
Don't forget - this is very,very routine to these surgeons and their teams. they have it all down to a science. i think I posted ( but things a few weeks ago are kind of blurry to me) that the day before my AVR and aneurysm repair, a nurse called and said I would be started at 7:30 am and would be done between 1:05 and 1:15. I thought that was kind of silly to give an end time like that but you know what? I was done at 1:10. Amazing!
You will be OK and looking back at all of this in no time.
Good luck!!
 
Gary: Looks like you're all ready to go. I didn't pick my valve until 8 pm the night before surgery! Take it as easy as you can prior to the surgery and try to relax. The surgery is absolutely routine, particularly in your case with everything else being in such darn good shape. I had a mess of other things to fix, but it still went extremely well. One second I was in pre-op getting wheeled off to the OR (I have no memory of the OR), the next second I was wide awake in the ICU even though it was 10 hours later and a whole lot of things had happened. Good luck! And don't fret about offending the first surgeon. It happens all the time.
 
Gary like most of us that have had our valves replace we feel so much better after surgery. Best of luck with your upcoming surgery.
 
Don't feel bad about letting the surgeon know you went with someone else, because they have to know that the patient needs to be completely comfortable for things to work out well. You'll be back home from your surgery before you know it.
 
Gary,
Well I shall have you in my thoughts come the 20th. Take the time to relax. These surgeons have done this same job on lots and lots of people. For the heart team it's just another day at work. Trust them and they will help you. In my case I was wheeled into the OR at 7:30am and the surgeon had the job done and me in the ICU by 11:00. I woke up, not in a lot of pain, just hotter than hades and then back to sleep. I was in hospital for 4 1/2 days. Didn't have any bumps that I didn't create myself by pushing too hard and now almost 4 years later I feel 1000% better. So just as the time winds down, ask questions if you have them. Give your honey a nudge and have her come on board to ask anything she wants cause we have your back. :biggrin2::thumbup:
 
Feeling Good, Blah, and Bad
I had to get this out and make sure I'm not making this up in my own mind. Sunday I was playing ball with the grandsons, pitching, hitting ground balls, and fielding. I was just having a good day. Monday was back to chest pressure and dizziness. Today is good so far, it really makes you wonder if you are going to transition to the always bad sooner than expected. 8 weeks ago this was not so noticeable but now that I will be having the AVR in 10 days, it on my mind a lot. I'm curious did the symptoms start to accelerate the closer you got to the date or I just haven't noticed them that much this past year. AVA 2008 (3.54) 2010 (4.02) 2012 (4.62) maybe the symptoms are directly proportional to the velocity in some people. Did anyone else notice the symptoms progressing this way? Anyway no wonder people become so fragile emotionally before the OHS. Dental appointment today (hope I don't need a root canal) Monday is Pre-op appointment.
 
Gary,
I don't know about you since I am not in your skin. Anyway, I did note that as I got closer to the "big day" I was getting SOB sooner than I had previously. But I chalked it up to panic and denial. So just keep on eye on all the small wonderful things in your life cause soon all this will be but a memory that will fade in time. Still will be thinking and praying for a successful surgery and bump free recovery come the 20th.
 
I was more aware of symptoms that I had jut "blown off" before. I also think some of the symptoms were more from anxiety than from my heart problems.
 
Glad to her you now have a date!
Good luck for monday and the 20th, i'll be thinking of you :)
Love Sarah xxx
 
Personally, I think it’s normal to notice symptoms you had just “blown off”. With my step son, a lot of his behaviour we attributed to ‘laziness’ pre-surgery. Now, it’s obvious that as much as some was laziness, a bunch wasn’t. Also, he did get a lot more symptoms in the 4 months prior to his surgery, even though we didn’t tell him until a couple weeks before. He got angina from walking up 6 stairs from his bedroom, just standing in the shower, out of breath needing to stop from walking to the bus stop. But when he was having fun (gym class, street hockey), for some reason he could go for a long time.

Also, but not exactly related, my DH recently got an MRI on his knees and they found a ton of issues (torn ACLs, MCLs, and cartilage). Suddenly he is finding he’s a lot more sore than he was prior to the appointment when he just figured everyone dealt with this kind of hurt everyday. Not the same organ, but same situation of being told things are worse than you thought they were, and then suddenly you realize that your pains and aches are justified!
 
Pre-Op done.
Nurse said I set a local record blowing into the O2 meter. Wife always knew I was full of hot air! Pre admitting on Thursday night for a 5:00 AM AVR mini Maze Friday morning. Had some palpatations last night and some bouts of it today. Its must be my secret spaghetti sauce from last night (half German half Irishman and I love Italian), i must have walked 3 miles trying to get the gas out. Won't be anymore of that after Friday. Do they send you home from the Hospital with less than target range INR (1.5-2.0 at least) or very close to it?
 
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