Surgery set for June 1st. Dental work this week. Nervous!

[pgammo]

Hello all,

I have set my surgery date for June 1st at 7am. I will be having my bicuspid aortic valve replaced with an On-X valve. I will be using Dr. Dembitsky through Sharp Memorial, here in San Diego.

I am really nervous and on anxiety medicine, so I was looking for some words of encouragement for BAV'ers. I am 25, married, with two children and one on the way.

I also need a root canal and deep cleaning, so the surgeon recommended I do it before the surgery. I called my dentist and he is accomodating for me, which is awesome. I go in for an "emergency" root canal tomorrow and deep cleaning the weeks following. He prescribed 2000mg of Amox. 1 hour before the dental work, is that normal?

My surgeon also told me that he will be able to give me a 4'' incision (skin-wise) and open up my sternum bone through that 4'' incision, so that I don't have major scarring(not that I care, but that's how he practices). Has anyone experienced this?

He also said that my surgery should only take about an hour and a half from start to finish, assuming it is a simple AV replacement. He also said that I should expect to be hospitalized for 3-5 days.

Do they start you on Coumadin through IV immediately after surgery? Scared of forming a clot immediately after.. Do I leave the hospital with a prescription for Coumadin? How do I regulate my INR afterwards (before I see my Cardio)?

Anyhow, please pray for me! And I will keep you all updated!

 

[Bill B]

I don't know if the amoxicillin is normal for all root canals or if the dentist is showing some concern for your BAV, even though antibiotics are not called for until you get the mechanical valve.

Post-op you will be on heparin, an IV anticoagulant, for a few days while waiting for the oral warfarin to take effect. You will leave the hospital with a prescription for warfarin with instruction to go to a lab for an INR test within a certain number of days. Your cardiologist appointment should be scheduled for about a week after you get home. Someone will need to order the lab test before that, so I think you will have to ask your cardiologist's staff to do that when you get home from the hospital.

I did not have a mini incision like you're getting. Also, my operation was far longer and my hospital stay was a full 7 days. So, it sounds like your surgeon thinks you are going to be a pretty straightforward operation and are going to be out of the hospital in almost record time. All I can say is there is no reason to worry much. Your surgeon has probably done hundreds or thousands of these operations. Yes, it's open heart surgery, but it is essentially routine and overwhelmingly successful.

 

[Madsometimes]

I was always given antibiotic cover for dental work when I had a BAV. Now I have a mechanical valve, so still need AB cover. Unfortunately, the guidelines in the UK have changed, so now I have to be quite pushy to ensure that I still get cover. My surgeon doesn't like the new guidelines, but that leaves me in the position of having to explain to every doctor and dentist that I come across that I need cover.

Good luck with the operation.

 

[Bina]

Yes, taking the big dose of Amoxi before an invasive dental procedure is a very routine cautionary measure.

It's nice that your surgeon has given you all the details of your surgery, but once you are done the size of scar, etc. all becomes
totally irrelevant for most of us. I'm a small woman with a 7" scar and I was happy to flash it to everyone as my badge of courage.
Or maybe I just wanted an excuse to flash...LOL...who knows.

Regarding the anticoagulation: the post op hospital team will have you hooked up to an IV of Heparin while they start you on
Coumadin ( a slow acting drug), they will check your INR daily to make sure that it is slowly increasing until in range.
Try not to worry too much about all of this, but it is wise to understand what is going on around you.

 

[nngbwh]

Don't be nervous you will do fine. Surgery should only take about an hour and a half from start to finish ? That is nothing. My surgery took over 9 hours. Good luck and keep us posted.

 

[Greg a]

Hello all,

I have set my surgery date for June 1st at 7am. I will be having my bicuspid aortic valve replaced with an On-X valve. I will be using Dr. Dembitsky through Sharp Memorial, here in San Diego.

I am really nervous and on anxiety medicine, so I was looking for some words of encouragement for BAV'ers. I am 25, married, with two children and one on the way.

I also need a root canal and deep cleaning, so the surgeon recommended I do it before the surgery. I called my dentist and he is accomodating for me, which is awesome. I go in for an "emergency" root canal tomorrow and deep cleaning the weeks following. He prescribed 2000mg of Amox. 1 hour before the dental work, is that normal?

My surgeon also told me that he will be able to give me a 4'' incision (skin-wise) and open up my sternum bone through that 4'' incision, so that I don't have major scarring(not that I care, but that's how he practices). Has anyone experienced this?

He also said that my surgery should only take about an hour and a half from start to finish, assuming it is a simple AV replacement. He also said that I should expect to be hospitalized for 3-5 days.

Do they start you on Coumadin through IV immediately after surgery? Scared of forming a clot immediately after.. Do I leave the hospital with a prescription for Coumadin? How do I regulate my INR afterwards (before I see my Cardio)?

Anyhow, please pray for me! And I will keep you all updated!

You are on the calendar and will be in our prayers

 

[Boston Tiger]

That dental work can be nerve wracking, but at least you will follow that up with a nice easy OHS procedure.

I take the same dose of amoxacillon before all my dental trips, and had to do that even before surgery since I had torn cordae in my mitral valve. The dentist said there was some argument about whether the dosage was needed with "just" MVP, but it was absolute if the cordae were torn.

I had a lower ministern, but my scar extends a little bit below my sternum since I think some of my drain tubes were there.

Watch out for the heat when you get back from your surgery and go out for walks. Hopefully, you are near the beach area, where the outside temperatures aren't quite so high as they are just a few miles inland.

You're in the toughest part right now, because the wait can be excruciating. The majority of the people on the site will be able to let you know that the actual procedure and recovery were not nearly as bad as they had feared. Keep using us for support as you head to June 1st!

 

[valdab]

I'm in the UK; used to have Amox with dental work but no longer.
Try not to worry - far easier said than done, I know. I'm sure you'll find the worst part is the waiting. Wishing you the very best of luck.

best,
Valda

 

[bocco]

In my case they waited a few days before starting the coumadin. I think it helps the healing process if you are not on it right away. I was also told that they use other stuff during the surgery. You may leave the hopital with your numbers not right yet. It's OK. As was previously stated, it's a slow acting drug. Better to ease up to your numbers than to blow past them.

 

[DanielB]

Hi pagammo, A fellow San Diegan here (we traded a PM a while back). Antibiotics after dental surgery are not uncommon and certainly something that's a good idea ahead of surgery to make sure you your blood is clear of any infection. I had a dental check-up a couple of weeks ahead of my AVR and they were worried I had an abcess, but it turned out to be a bone pocket and all was okay. Sharp does a very thorough pre-surgery work-up of tests and things to make sure you are ready to go a few days before your date so you can be assured that you're ready when thay say you are. I had surgery from the other Heart Surgeon Director at Sharp, Dr. Adamson, assisted by Dembitski and I have the 4" incision and the On-X valve. It's nice in that it starts low enough below my collar bone so that it does not show even when I wear an open collar. I was on a number of IV's from the time I went into surgery until I left the ICU floor and I suspect one of those was an anticoagulant. I believe was started on the pill form of coumadin when I went upstairs to the recovery floor. Try not to worry too much, speaking from my experience, your with an exceptional team of doctors, an excellent cardiac PA and a really good hopital. As you probably know, Dr. Dembitski did thew first heart transplant in San Diego some 20 years ago and that person is still here and doing fine. Valve replacements, though still serious, are much simpler. Feel free to contact me about any specifics on the 'routine' for Sharp Memorial's valve surgery, I'm sure you'll be working with the same group of people I did (they are partners and share office staff, etc).

Dan

 

[greg]

I had a tooth extracted last Nov and took 1000mg of Amox before. Implant procedure for the tooth is this Thurs and that Dr wants 2000mg 1 hr before. It all sound normal to me since they are worried about infection around the heart.