TAVR Forum

[rich01]

Hi Rich.
How old were you when you went with TAVR. What were the factors that led you to choose TAVR over SAVR?
Thanks

I was 70. I was scared to death of having SAVR. Since I was young, I have had a fear that if I was ever put under for surgery, I would not wake up again. Silly, but it stuck with me my entire life.

When I had mine (Sep 2019), studies were recently out showing TAVR to be equal or better than SAVR on most criteria. For 1st generation valves that wasn't the case, but for 2nd generation, it was. I am single and living alone, so the amount of time I needed to have someone stay with me was also an issue. I got them to let me out of the hospital after just 1 1/2 days, so I was home before my sister arrived to stay with me. The cardiologist OK'd me spending the night alone much to the amazement of the nursing staff. My neighbor was on standby if I needed anything.

So for me, it came down to I thought TAVR was at least equal to SAVR, it didn't require that I be put under and on a heart/lung machine, recovery time was much shorter, I only needed a few days of support instead of weeks, I could drive after a week, and because of my age, it was thought that I would probably only need 1 TAVR in TAVR in the future.

 

[rich01]

All went well on April Fools morning. Guess they give you heparin to thin your blood and when they were finished they used a drug to reverse the Heparin and that gave me a pretty good reaction. I had tremors big time for a while. My wife has tremors so now I know what she goes through. I got good care at Long Beach Memorial and was released the next evening. I know this is nothing compared to full open surgery but I tell people its not like driving through McDonalds for a sandwich either.
I see the cardio for follow up next week and told to do two walks a day, not to lift over 10pounds but other than that just let my body be the judge. Last words were that valve is firmly in place and you are not going to hurt it. You just have to let your body adjust.
I feel much better, people have remarked at how my voice is much stronger and what good color I have. At 88 I am a happy camper.
Ready for cardio rehab program, probably at VA.

The main problem I had was the wound where they inserted the catheter started bleeding into the groin. I probably caused it by lifting more than I should have the 1st few days. Make sure you take it easy for the 1st couple of weeks. If your groin area starts turning dark purple, let the cardiologist know.

 

[pellicle]

So for me, it came down to I thought TAVR was at least equal to SAVR,

at 70 I believe I understand that view

 

[tom in MO]

I wish I had read this before my SAVR, which was 2 weeks ago. The catheter was one of the worst parts for me. I was bleeding and it was very painful the night after surgery. I begged the nurse to remove it, but she did not care. It was bleeding and my entire penis was bruised, as well as the surrounding tissue.
The day shift nurse arrived at 7am and he was my hero. He acted as my advocate. He got permission from the ICU doc to remove the catheter, with the caveat that if my bladder got to 300cc, as measured by ultrasound, that he would have to reinsert briefly to relieve me. It was such a game changer once it was out!
Well, I was able to urinate without the catheter some, but by the evening he did have to insert it briefly to release the urine that had built up, as it was over 300cc at that point. He was very gentle, and it was no big deal and out of me again after just a couple of minutes.
In addition to getting permission to remove the catheter, I was in extreme pain and he got permission from the doc to give me a PCA(patient controlled administration) with dilaudid. This was also a game changer and I did not abuse it- in fact I used it less than 2x per hour, and they had set a limit of 6x per hour.
We got along so well that the next day was supposed to be his day off, but he requested to work and requested that he work with me again. He made such a difference in making my ICU experience much more tolerable. Except for my first night with Nurse Betty, who kept me in pain for no reason, with the catheter and also by refusing to give me enough pain killers, my ICU stay was not too bad at all. Well, insomnia of course, but that is to be expected.

Your hero pushed the envelope. You can be injured by a catheter, that's why they put it in and keep it in until it is time to remove it. I have permanent pain from a catheter induced nerve injury. PCA dilaudid leaves you constipated (I know from experience) and shouldn't be needed for a relatively low pain operation like OHS. Nurse Betty was more on the road called "standards of care."

 

[Chuck C]

Your hero pushed the envelope. You can be injured by a catheter, that's why they put it in and keep it in until it is time to remove it.

I disagree.
The catheter that was in me was doing damage, hence the bleeding and the bruising. After having it out for 10 hours the bleeding stopped as well as the pain. When he reinserted it briefly to relieve me it did not hurt at all, as he was careful. He was able to remove it right away and I never needed one again the rest of my stay.

QUOTE="tom in MO, post: 904893, member: 10927"]
PCA dilaudid leaves you constipated (I know from experience) and shouldn't be needed for a relatively low pain operation like OHS.
[/QUOTE]
Everyone experiences different levels of pain from OHS. Mine was severe the first two days following it. I was told by the doctor and several of the nurses that younger patients tend to have more severe pain from OHS because they have more nerve endings that are still active in their chest. That is why they have available heavy pain killers like dilaudin. The constipation was easily solved by a suppository for me. In any case, the patient should have the right to relieve the pain with the pain killersand take the risk of being constipated if that is the trade off. The constipation was easily resolved for me, and was well worth not suffering for those two days.

 

[rich01]

I disagree.
The catheter that was in me was doing damage, hence the bleeding and the bruising. After having it out for 10 hours the bleeding stopped as well as the pain. When he reinserted it briefly to relieve me it did not hurt at all, as he was careful. He was able to remove it right away and I never needed one again the rest of my stay.

Chuck, I think what is happening is the heparin makes us prone to bruise and bleed easily. The catheter caused some bruising of the bladder which then started bleeding. It took me about 12 hours for the bleeding to stop after the catheter was removed.

After my cardiac cath, I couldn't pee for several hours. After the 2 stents were put in, I had a bleeding problem similar to yours. When discussing this with the nurse practitioner, she suggested I ask for a condom catheter for the TAVR procedure. I also took a Flomax just before the procedure and was supposed to take one right after, but they didn't get the pill to me for over 6 hours. This seemed to solve the problem for me. I still had a little trouble peeing, and I think if I would have received the other Flomax I would have been fine. The next time, I will have my own stashed in my bag.

 

[Chuck C]

I also took a Flomax just before the procedure

Yes, they gave me Flomax as well and continued to do so. After that things got flowing just fine.

 

[ncmimi]

My sister (in NC) had a TAVR 3 years ago at age 81. She’s been doing well.

Eva - I have a consult with surgeon for TAVR. I am in NC also and am considering Duke Medical for the procedure. Do you mind disclosing where your sister had her surgery?

 

[Eva]

Eva - I have a consult with surgeon for TAVR. I am in NC also and am considering Duke Medical for the procedure. Do you mind disclosing where your sister had her surgery?

I’ll ask her tomorrow and let you know. Best of luck.

 

[ncmimi]

I’ll ask her tomorrow and let you know. Best of luck.

Thank you so much.

 

[Eva]

Hello, my sister had her surgery at UNC REX Hospital in Raleigh.
The surgeon‘s name is: Deepak Pasi, MD, FRCP, FACC
https://findadoc.unchealthcare.org/...igh?Affiliations=16,8&FreeText:Last+name=PasiThe more surgeons you can interview, the better! write down all the questions you need answers to.

Wish you best of luck.

 

[ncmimi]

Hello, my sister had her surgery at UNC REX Hospital in Raleigh.
The surgeon‘s name is: Deepak Pasi, MD, FRCP, FACC
https://findadoc.unchealthcare.org/...igh?Affiliations=16,8&FreeText:Last+name=PasiThe more surgeons you can interview, the better! write down all the questions you need answers to.

Wish you best of luck.

Thank you so much for this information. I am glad your sister is doing well. Rex is an excellent hospital. I was hoping she had been at Duke and could give me evaluation of those doctors. I am going to be evaluated there (Duke) this week to ensure TAVR is an option for me. If so, I will have it done at Duke. Blessings to you and your sister.

 

[Eva]

Thank you so much for this information. I am glad your sister is doing well. Rex is an excellent hospital. I was hoping she had been at Duke and could give me evaluation of those doctors. I am going to be evaluated there (Duke) this week to ensure TAVR is an option for me. If so, I will have it done at Duke. Blessings to you and your sister.

My sister had not much choice at the time! It was kind of emergency then.
My 2-cents advice: let your decision be based on the surgeon’s choice more than on the distance to your home!
Blessings. Keep us posted.

 

[ncmimi]

My TAVR is scheduled for 10/12 at Duke Medical Center. Since, I believe, a little apprehension is normal for any heart surgery, I do find solace in hearing others positive experiences after TAVR.

Thanks for sharing.

 

[tom in MO]

My TAVR is scheduled for 10/12 at Duke Medical Center. Since, I believe, a little apprehension is normal for any heart surgery, I do find solace in hearing others positive experiences after TAVR.

Thanks for sharing.

Duke Medical Center is an excellent hospital. They saved my father's life when he had an abdominal aneurysm that was minutes away from bursting. He got excellent care there both in the ICU and for a few weeks afterwards.

 

[rich01]

Just an update. I am at 4+ years on TAVR and all is fine. At last doc appt, he said the valve is working fine. He also thought I would get at least 15 years from the valve.

 

[pellicle]

Just an update

love the updates (bet I'm not the lone ranger)!

here's to more for you

 

[skeptic49]

Wow...15 years from a TAVR...let's hope so!!