Surgery on Valentine's Day

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jklump

jklump

Well-known member
Joined
Feb 4, 2011
Messages
64
Location
Dayton, Oh
Feb 14 I will be having my Aortic Valve replaced and part of my aorta repaired. About 3 1/2 years ago I was diagnosed with AV Stenosis. I have had yearly echos and 6 mo visits with the cardio since. Last year the valve area was .9, this year .8. the mean pressure gradiant last year was 31, this year 34. I realized in Jan. that both numbers are going in the wrong direction. I am probably having minor shortness of breath issues at this time. Sometimes at night I wake up with heart beating rapidly and breathing heavy. I think my symptoms have been so gradual that they have sneaked up on me. The cardilogist said while I have not reached the critical stage, I was at a point where the surgery is justified. I just don't want to wait until I have these major symptoms that eveyone talks about. The "sudden death" thing does not appeal to me!
Now that I know there is a problem with the aorta. I say "Git'er done".

I decided to go the tissue route. I don't want to fool with blood thinners the rest of my life. This forum has been a wonderful tool for me. Everyone I talk to ask me how I became so knowledgable about valve replacment. I read it here.

Having surgery Feb 14 at Kettering Hospital Dayton. Ohio Dr. Peter Pavlina
 
Morning, and welcome to the group!

Valentine's Day is an appropriate day to have life saving heart valve replacement, and I imagine in years to come, you'll also find Valentine's Day, 2011 to be one of the most memorable ones.

We'll get you on the surgery calendar and be with you in spirit as your start on this life saving journey.

Godspeed!
 
Hi, jklump, and welcome! It seems that your situation is a bit like mine -- aortic stenosis with very gradual progression until you decide "It is time." I'll be a couple of weeks behind you, with my valve replacement and bypass on March 1.

Go Class of 2011!
 
Duffey said:
Morning, and welcome to the group!

Valentine's Day is an appropriate day to have life saving heart valve replacement, and I imagine in years to come, you'll also find Valentine's Day, 2011 to be one of the most memorable ones.

We'll get you on the surgery calendar and be with you in spirit as your start on this life saving journey.

Godspeed!
Click to expand...

Not only that but Feb 14th is also "Congenital Heart Defect Awareness Day" http://tchin.org/aware/index.htm

Welcome. I agree with you thoughts about it's better to have surgery now, before you have any big symptons. Not only will being in the best shape possible going iinto surgery help with your recovery, but you also have less of a chance ending up with permanant damage.
There is alot of great info here in the "stickeys" about before and after surgery, but if you have any questions just ask, most likely someone else has experience with whatever you are asking about.
 
Saint Valentine's Day is a great day to have the VR and any associated repair needed! I had mine just after the hearts and flowers day, but I was at the hospital for pre-op stuff on Valentine's and had a great excuse for extra flirting with the cute nurses. :D

Sounds like you are going in well-informed and with a great attitude. You are exactly right that it's much, much better to get it done before symptoms become severe.

We'll all be your Valentine's buddies next Monday and will be rooting for a good, smooth recovery for you afterwards. Looking forward to your continued posts.
 
Yup, what everybody already said!! Your story is fairly similar to mine -- though my surgeons decided at the last minute (while I was out cold) that I did NOT need a graft on my Aortic root after all, so they skipped that part of the surgery. The only downside of going in for the VR while you're just barely symptomatic (as I did, too), is that it will take you a bit longer post-op to feel as strong and fit and "normal" as you did the day before the surgery. That's purely a psychological downside, which hasn't caused any serious problems for me. I'm ~9 weeks post-op now, and my cardo fitness is pretty close to what it was before the surgery. (Of course, my prognosis and my life expectancy are WAY better now, with a new valve instead of the old one that was circling the drain!! :) )

If I'd had my AV replaced ~6 months sooner -- when I had absolutely no symptoms at all -- the psychological burden would have been harder, but I probably wouldn't have needed to have my Mitral valve repaired at the same time. Trade-offs. . .

Good luck, good healing, and keep us posted here!
 
Thanks so much to my new found friends that have wished me good luck! Spent 4 hrs at hospital today doing pre-testing. My wife and I had a nice hour long talk with a nurse about the whole procedure. The nurse seem more concerned about my wife's state mind than mine. Wife is doing lots better after the talk. I will also be having a replacement on the aortic root. The valve will probably be bovine. I will make them give me all of the details when I am able. Being from an engineering background, I have a tendency to ask a lot of questions about how stuff works.

John
 
jklump said:
Thanks so much to my new found friends that have wished me good luck! Spent 4 hrs at hospital today doing pre-testing. My wife and I had a nice hour long talk with a nurse about the whole procedure. The nurse seem more concerned about my wife's state mind than mine. Wife is doing lots better after the talk. I will also be having a replacement on the aortic root. The valve will probably be bovine. I will make them give me all of the details when I am able. Being from an engineering background, I have a tendency to ask a lot of questions about how stuff works.

John
Click to expand...

John, do ask away with those experts. I had aortic root replacement as well. It is a fascinating process. It was hard for me to grasp it all beforehand -- I did the best I could in researching my valve/root replacement device -- and I've been learning more on this site ever since. With your engineering mind, you have an advantage. Knowledge is a good thing, It is amazing what medical science can do. Again, my very best wishes to you....
 
Hi John,
I'll be a week behind you - scheduled to go into hospital on Monday 21 Feb and surgery on 22 Feb. You might even be home by the time I'm on the table. I've known about the valve forever but now it's time (I'm nearly 43). How old are you?
I get dizzy if I stand up quickly and am often tired but can walk easily for an hour without being puffed. The symptoms for this can be varied and so gradual.
I'm seeing the surgeon tomorrow morning to go through the whole procedure.
Good luck for yours.
Allison
 
Hi Allison! You're long way from Dayton, Ohio
I'm 61. I really don't get tired, but do have serveral odd feelings at times that I can't expain. The Doc said that at my age there was a 80% chance that the tissue valve would last 20 years. From what I've read, 20 yrs seems like a very opimistic length of time. I've been reading 10-15. One of the tougher moments when I decided to do this was picking up the phone and making the call to the surgeon. I then realized that it was time to do this.
I am new to posting on this forum, but it has been a fabulous comfort to me to be able to communicate with other people who are sharing this experience. I'll keep in touch.

John
 
John, The 20-year expectancy you were quoted is probably the expected useful life span of the newest generation of valves. These valves have not been in use for long enough, though, to know how long they will actually last. The shorter span you've heard and read is the actual life span of the previous generation of valves. I was told the same 20-year expectancy by my surgeon (and I do trust him), but he explained that it is based upon the manufacturer's projections. The older valves do usually last 12-15 years.

The other point buried in here is that in patients older than 55 or 60, the valves do not calcify as quickly as they do in younger patients. This is due to the more active immune systems of younger patients. (Remember how fast we used to heal after injuries? And now?)

I'm just over 63 now, and I had no qualms about choosing the bovine pericardial valve.
 
HI John,

I am new to this forum as well. It has been a Godsend to me. I am a nurse but I learned so much more from these wonderful people. My husband is also an engineer and does ask a lot of questions about my procedure. We see the surgeon again on the 22nd of this month and a surgery date will be given to me at that time. I want to hold off til the first week of April if he lets me. The reason being on March 1st, we had a trip planned since last summer, and also for work reasons as well. My cath is next week. That should be easy...been there...done that. I also want to go the tissue route. I really don't want to be bothered with Coumadin. I am 58. You will be in my thoughts and prayers along with everyone here. Keep your faith....we get so much positive energy from Him. God bless you.

Jeri
 
epstns said:
John, The 20-year expectancy you were quoted is probably the expected useful life span of the newest generation of valves. These valves have not been in use for long enough, though, to know how long they will actually last. The shorter span you've heard and read is the actual life span of the previous generation of valves. I was told the same 20-year expectancy by my surgeon (and I do trust him), but he explained that it is based upon the manufacturer's projections. The older valves do usually last 12-15 years.

The other point buried in here is that in patients older than 55 or 60, the valves do not calcify as quickly as they do in younger patients. This is due to the more active immune systems of younger patients. (Remember how fast we used to heal after injuries? And now?)

I'm just over 63 now, and I had no qualms about choosing the bovine pericardial valve.
Click to expand...

I believe the 80% still doing well at 20 years in people older than 60, probably is from the actual studies of the Perimount valve, that started in the early 80s (82?) and were used in 4 centers in the US, during trials. One was CCF and I can't think of the other 3 right now. There ARE newer versions, but many people still get the Perimount that does have a real track record of longterm use.

ps here it is, it was done in 2002 and was 17 years. http://ats.ctsnetjournals.org/cgi/content/full/73/5/1460
 
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The study showing the longest durability times with tissue valves was just published in 2010, done in Toronto on "my" well-established pig valve. It's entitled "Hancock II Bioprosthesis for Aortic Valve Replacement: The Gold Standard of Bioprosthetic Valves Durability?" by Tirone E. David, MD, Susan Armstrong, MS, Manjula Maganti, MS, in Ann Thorac Surg 2010;90:775-781, abstract at ats.ctsnetjournals.org/cgi/content/abstract/90/3/775? . Unfortunately, there's no free copy online, AFAICS, but I do have a fax copy.

It found about 85.2% "freedom from structural valve deterioration" (the most meaningful measure) after 20 years in the 60-70-year-old group, which is consistent with what your Doc said, at least for that valve. But at 61, your odds would presumably be worse than that average, sorry! (The <60 group hits 50% at 15 years, which is a lot worse.)

The Hancock II in this study outlasted the CEP (cow) valve by a few years in all the published studies so far, as discussed in detail in this article -- hence the "Gold Standard" claim. BTW, if you do read studies, be careful about the difference between "structural valve deterioration" and "explant" or "reoperation", since they're not the same. (Quite a few older or sicker patients aren't fit for re-ops when their valves deteriorate, and they show up as successes in the studies that count "explants"!)

There's always a tradeoff between tried-and-proven valves and state-of-the-art new ones. The horse-pericardium valve that one of the guys here just got (by ATF? ATS?) seems like a nifty design. But at ~5 years old, it naturally doesn't have any 20-year durability stats. There aren't many tissue valves with 20-year or even 15-year records, and the Hancock II and the CEP seem to lead that pack.
 
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I was not trying to start any discussion about valve choice when someone has already decided what they were getting, I simply wanted to reassure John that the stats his surgeon gave him about that valve most likely WERE based on how long valves have lasted in poeple and not just what the manufacture hopes for.
 
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