Surgeries after VR

[Nocturne]

Are there any special considerations for people who want or need to have surgeries after undergoing VR?

I am thinking in particular about a penile prosthesis, which I am likely to want at some point in my life as I am having issues at the ripe old age of 43 (ain't atherosclerosis grand?). I have read that there was some controversy over this particular surgery post AVR, but then that a recent study had found that it wasn't as problematic as previously thought.

Still, any implant surgery can result in infection, and infection can lead to endocarditis -- right?

 

[pellicle]

Hi

Are there any special considerations for people who want or need to have surgeries after undergoing VR?

if you've had a mechanical valve they prefer you to reduce your immediately INR prior to the surgery (no big deal if you ask me), and for tissue valve I'm unaware of anything.

Depending on other medical problems you have the anesthesiologist may have some other questions for you.

Still, any implant surgery can result in infection, and infection can lead to endocarditis -- right?

this is not how I understand it.

An infection usually remains localised to a site. Especially with prosthetics (implants) the infection is actually often attached to that. It is the presence of a foreign object which gives bacteria a place take cover. A wall to back up against so to speak that makes it difficult (often impossible) for the body to clear it. The bacteria does not usually then circulate through the body because if it was "loose" then it would be quickly mopped up by the lymphocytes in the blood.

Generally speaking you have different bacteria involved in the infection of a prosthetic VS the sort that get into the blood (and don't have far to go) in the mouth at dental procedures. Even then there is enough of a "weak link" in the incidence of endo from that that that various authorities consider it worthwhile not taking the trivial step of not prescribing antibiotics.

So if you have a prosthetic that becomes infected (and it will likely be soon after surgery) it will be treated with antibiotics. Indeed I'd expect you to be on antibiotics as a prophilactic straight after surgery anyway.

 

[Nocturne]

OK Pellice, I kind of hoped that was the case. Otherwise we'd be hearing about AVR folk having issues with knee replacement surgeries, etc.

 

[epstns]

Nocturne - I don't have "that" sort of implant, but my pacemaker is another type of implant. These are all too common among valve patients, and other than standard antibiotic prophylaxis, the docs weren't overly worried about my pacemakers. I am on device number 2 over the past 5 1/2 years, and have had zero repercussions from either of them.

I guess there is an elevated level of risk, but not likely anything that the docs cannot prepare for, and the post-op infection rates are probably quite low. Just be sure they know about your valve, and be sure to ask them what precautions they are taking for you.