Tee

[BECKY]

Hello everyone,

I had my TEE on Monday. I don't like that test much. My throat is much better today though.
The test confirmed what they had already told us. the tricuspid valve(natural) is leaking alot and can't be repaired it must be replaced. The aortic valve is not closing right and no longer clicks and has high pressure across the valve(mechanical)...so they want to replace that. Now the next question still is do we take more risk and replace the mitral valve(mechanical) now (working okay but not perfect) or risk having to do it in another surgery later? It all sounds like too much to me. I have to decide when. When I feel bad enough and just want to take the risk of this all. At this point they can't guarantee I'll feel 100% better because I have pulmonary hypertension and I guess I'm stuck with that forever. My cardio did the TEE and he will talk to the surgeon before I see him next week. I guess he will give me more information to help me with this difficult decision.
I am so glad I found this site and I really appreciate all the support and comfort I have received since I signed up. Thank you all very much!
Any ideas on where I should go from here? I apperciate any directions I can get.
Best regards,
BECKY

 

[Kevin M]

It's easier said than done, but I think once you are able to speak to the surgeon you will be better able to put your mind at ease because the choices will be laid out for you.

Fear stems from the unknown, but once you can get a better grasp of the risks, the choices and the future benefits, you may find this process less terrifying.

He or she will likely discuss what sort of valve to replace your aortic one with, as well as how serious your mitral problem is.

Once you have that information, the decision may become a little easier because you'll be better able to gauge necessity versus risk.

You may wish to also ask the surgeon on how your pulmonary hypertension affects this process and the choice of valve type(s) they would recommend.

Welcome to the forum. I'm sure you'll find this place a great source of comfort and information. There is almost always someone who has gone through similar problems and it's great to talk to these individuals to see how they dealt with these questions and concerns.

I HATED my TEE too, but it is one of the better tests they have to understand your situation, so take comfort in that it was probably worth the discomfort.

You do not have to face this alone. There are people here who will support you through every step of the way, so try your best to relax and take this one step at a time.

Take care and feel free to email me if you need to talk.
Kev

 

[gary]

Multiple surgeries in the right hands will

Multiple surgeries in the right hands will

likely give you better results. It's very difficult for surgeons to determine the extent your heart will 'remodel' itself subsequent to one surgery, let alone the 'forces' and future changes they will exert on the shape and musculature of the heart with 2 or 3.

Most of us who have not had a mechanical valve implanted have likely resigned ourselves to two surgeries (unless some deity decides on another disease or accident to overtake us).

I'd think no surgeon would tackle three valves, knowing that one or two can dramatically change heart action.

If you resign yourself to two of these ordeals, you have the prospect of being surprised if they do it in one and won't be too overcome if they decide on two.

A lady I know has had ALL four valves replaced, over the last 30 years in 4 open heart surgeries, and two of them were explanted and replaced again. She leads a relatively normal active life at age 66, but for the 'zippers' which today can be minimized, an advantage too late for her.

 

[BECKY]

TEE

TEE

Thanks for the infor Gary. It is great to hear you can stand up to 4 surgeries. The human body is amazing. I don't think I mentioned, my aortic and mitral valves are already mechanicals (Omniscience) and were done in one surgery 18 years ago. I will probably have to stay with mechanicals, but I will discuss it with the surgeon. Thanks for the confidence!
BECKY

 

[Bill Hall]

Hi Becky,

Thanks for sharing your story with us. You asked some difficult questions, but I will take a shot. I think you should make your surgeon or cardiologist decide, but I think you should ask questions to enhance your confidence in his plans. First question, is how much risk is caused by doing the second valve. I had two valves done and never thought about risks involved with doing two. Try to get him to quantify the risk in relation to time on the heart/lung machine and overall probability of the second valve having a new problem. Second question is whether the mitral valve will be stable or get worse with time. Since it is a mechanical, I would guess it should stay stable, I would ask anyway. Third question is whether they can make a better judgement when they are doing the actual surgery. Maybe your surgeon will see things more clearly at that point and have more information to make a better judgement. That's all I can think of, but will repost if I think of anything else. Hope this helps a little.

 

[JenniferO]

Becky:

I've only had mitral valve repair so am not knowledgeable about multiple valve surgeries. The one thing I would think would be important, though, is to have a surgeon who does multiple repairs often, and preferably one who has done triple repairs often.

 

[John & Joann]

Hi Becky,

Hi Becky,

You may wish to raise the question of scar tissue with the surgeon. Repeat surgeries are much more difficult and longer due to the scar tissue. Never heard of 3 valves at one time, but I had 2 valves (repeat) and 3 bypass done at the same time. It was a very difficult surgery, but I am still ticking away.

Make a list of your questions to ask the surgeon.

31 years and still counting and clicking.

 

[ILoVeNY25]

Although, I did not have a repeat surgery. I did indeed have 3 valves taken care of at once. I had my aortic and mitral valve replaced with St. Judes and I had my tricuspid repaired all in under 3 hours I might add. I know it's a bit of a different situation with scar tissue but I'm sure they can do it. Please let us know what your surgeon says and keep us posted. Take Care!

 

[Lorraine]

Hi Becky,

I had 3 valves taken care of at once too. I had my Aortic and Mitral Valve Replaced with St. Jude Mechanical and my Tricuspid Valve was repaired.

If they are going in there to repair or replace your Triscuspid Valve and you are having problems with your Aortic Valve and or Mitral I would definitely have them do it all at once. If the Mitral Valve is working good then of course leave it alone, but if its iffy, you don't want to have to be opened back up down the road. The more times your opened up, the more scar tissue there will possibly be. Keep us informed with what you and the surgeon decide. Take care!

 

[Sierra Bob]

Excuse my ignorance, but what is a TEE?

 

[ALCapshaw]

TEE = TransEsophagael Echogram

An ultrasonic transduced is placed down your throat into your
esophagus. It produces better resolution pictures than echograms taken externally through your chest.

'AL'

 

[gary]

Sierra bob:

Sierra bob:

Don't try this at home. nft

 

[Sierra Bob]

Al---Thanks for the info on a TEE. Since my throat is partially closed wirh scar tissue due to 35 days of radiation for neck cancer, I guess I'll have to relie on the standard echogram to continue to check on the leakage around my St. Jude Silzone impregnated Aortic Valve.

 

[ALCapshaw]

RADIATION EFFECTS to the Chest

RADIATION EFFECTS to the Chest

VERY interesting Bob...

Was your chest irradiated as part of your cancer treatment?

Johnny Stephens and I were both treated for Hodgkins Disease years ago, including radiation to the chest. Another Hodgkins patient reported a 4X CABG on the Bypass Surgery Support Forum on Yahoo. I suspect the cancer Doc's weren't fully aware of the long term effects of radiation such as Premature Coronarly Artery Disease,
Premature Calcification of the Heart Valves, and Gastro Esophageal Reflux Disease (GERD) !

'AL'

 

[Sierra Bob]

No the chest was not specificaly included. However the upper lobes were in the field of radiation when I was radiated from the front.. I did show an abnomally on a CT scan in the right upper lobe. They continue to follow it with scans. It hasn't changed in two years and my oncologist has concluded it is scar tissue, either from the radiation or from pneumonia. My main problem is the neck radiation kills the salivary glands, so I have no saliva. Unless one has experienced this problem, it is impossible to explain how dibilitating no saliva can be, from eating to talking to saving your teeth.

 

[Johnny Stephens]

Hi Bob, yes, I can relate to the lack of saliva. This was quite severe during my treatments and they told me it would never come back, but it did to a limited extent. My primary Hodgkin's tumor was on my right neck. I had to use fluoride trays on my teeth every night. I'm very lucky in that it doesn't hinder me now, but has caused some minor dental problems over the years.

I still sometimes wake up with my mouth glued shut.

I believe a TEE is in the future for me as a followup to my pulmonary hypertension, and I don't relish the thought of that. My first one they did while I was knocked out for surgery.

 

[Sierra Bob]

I can certainly relate to the mouth glued shut!!! But mine happens during the day when I'm working or frustrated. Then, I unconsciously breathe through my mouth and everything dries out. At night, I use Oral Balance, an artificial saliva gel. I use a tube per week at seven bucks per tube-----but it is well worth the cost. I also used trays during radiation. Now I use Prevident 5000, a prescription tooth paste high in fluoride. So far I've had NO problems.

Sierra Bob

4/99 AVR
9/99 MRND 6400 cGy

 

[mimmidoe]

Ticktock here

Ticktock here

Becky
Numerous surgeries are no fun. no fun.

I have had 4, and they get a little more difficult each time. They never expected to have to do a 4th, since a Bjork Shiley aortic was put in, during the 3rd. You never know what might come up, to cause a repeat surgery.

There are excellent answers here. I've been away awhile, but i see the board hasn't changed much. Lots of compassion, advice and support. Keep it up gang.
ticktock

 

[Gail in Ca]

Bob,
Not to worry, I've had 2 surgeries 12 years apart and have never had a TEE. Only echos and the last time a cat scan as well before the surgery only.
My docs seem to think echos do the trick for checking the valves yearly, and then when it started to leak I got the scan.
You live in a beautiful place. Have traveled there often in winter to ski ( okay,before coumadin) and in summer to Bass Lake where my lucky brother in law has a 2nd home and a boat!
Welcome fellow Californian!
Gail