Surgeon says second valve replacement will be full sternotomy! Yuck!

tigerlily · Jul 27, 2017

Hello all. I recently posted that my bovine aortic valve was showing signs of age and becoming stenotic. I went to see my heart surgeon for a second opinion because I'm having an unrelated surgery August 30. I wanted some assurance that I would be OK for that. My heart surgeon did my first valve replacement in 06. He reviewed my recent echocardiogram and felt that I will need a replacement sometime within a year but he seemed to feel OK about this upcoming surgery. He said to be sure and have my cardiologist follow me and if I noticed increased symptoms to call him. We discussed the surgery a little and he said he would most likely replace this tissue valve with another and if I needed a third, he would do TAVR. I'm 64 by the way. What surprised me though was that he said he would do a full sternotomy for this second surgery. I was hoping surgery techniques had advanced beyond that. I know my surgeon may be thinking about needing room for dealing with scar tissue although we didn't discuss that. Have any of you had second surgeries and how were they done? Was scar tissue at your second surgery a big deal? I wonder what my scar will look like. You can barely see my scar from my first minimally invasive surgery. I know this should be the least of my worries but I just hate the idea of dealing with a scar again. Would love to hear your thoughts about anything I've mentioned. I was also surprised that he didn't suggest a mechanical valve but I guess given my age, his plan makes sense. My concerns right now are how experienced does a surgeon need to be with second/third surgeries and scar tissue and the sternotomy. How awful will that be?

Paleowoman · Jul 28, 2017

Hi Tigerlily - I can't respond to all your particular questions, but I do know that it is the adhesions which make the second and subsequent operations more tricky, so to speak, and that may the reason why your surgeon said he would do a full sternotomy. I think you should make that one of your questions for when you next see him.

Nocturne · Jul 28, 2017

I'm sorry, tigerlily. That sounds awful. I guess one positive thing to look at is that the surgeon said you're unlikely to need a third OHS since TAVR will be an option for you in the future.

pellicle · Jul 28, 2017

All three of my surgeries were full sternotomy. As far as I know its the gold standard for long term best quality results.

Scars fade away, but damage inside can be dangerous

Go with the best option for a best outcome.

mom2angel · Sep 12, 2017

Both of my OHS were full sternotomies. As far as I know, there were no major issues, but I was a child. As pel said, go with the option that should have the best outcome. Good luck!

Eva · Sep 12, 2017

As you said it yourself, the scar should be the least of your worries! It's your health and better chances for better results that's important. I was 57 when I replaced two valves. My surgeon recommended bovine and he he told me then that he would replace them when needed through TAVR! But I was so scared and opted for mechanical. The older we get, the more we are prone to bleeding. So, your doctor doesn't want you to deal with warfarin and adjust the dose, depending on your lifestyle! In my case, I'm a social drinker, and when I drink 4 oz of wine or beer, I need to adjust my dose! At my age now, sometimes it's frustrating! Some may not like me saying this, but this is me...my opinion only!

ask your doctor why his choice for not using mechanical valve!

keep us posted.