Tissue? What are the implications?

[Steve B]

Thanks Larry - your experience seems to fit with what I'd view as the 'ideal' outcome, but I fully appreciate your comment on the lack of certainties in life.

Re bacterial infections - is there a school of thought that says any infection should be hit with antibiotics asap? Maybe it's more than 'a school of thought' - perhaps it's the accepted norm? I've gone through life so far shunning antibiotics as far as possible and relying on my own immune response systems to cope, so a move to more reliance on antibiotics would be a bit of a shift in behaviour. Of course, if it turns out to be part of the territory then so be it - as several people have posted on this thread, popping a few pills is probably a reasonable price to pay to continue with a full and active life ...

Cheers - Steve

 

[JeffM]

Tissue - so far, no meds

Tissue - so far, no meds

Steve - For me, the first year: beta blocker 3 mths, Warfarin 3 mths, Amiodarone 2 mths and Cozaar for almost a year. September will be 3 years since my surgery. Heart has completely reached normal measurements. I do get a few runs of tach every now and then (weeks apart) and lately, I've had a lot of PVCs or PACs. I hope to know more after my cardio visit on Friday when we'll go over my 24 hr Holter, Nuclear Stress Test and Echo results.

Good luck with your surgery and enjoy a speedy recovery!

 

[bdryer]

At 55 I did not want to go through the pain and frustration of another deteriorating AV, with an inevitable surgery after about 10 years, so I went mechanical. I opted to manage ACT rather then worry over another pending surgery. I did my home work and found the On-X to be my valve of choice.

Sounds like you've done your research and chose a reop over ACT. Go fwd with confidence now that you have laid the course for your future.

 

[normofthenorth]

Larry/Mentu, do you have any evidence that Bacterial Endocarditis is a significantly bigger threat -- either more likely or more damaging -- for tissue-valve recipients than for mech-valve recipients? I was under the impression that we're all at risk of getting it, and all at serious risk if we do.

Steve, the consensus guidelines on pre-dosing antibiotics before dental work is pretty consistent (though actually based on virtually no solid evidence). As for the rest of the ways one can get BE -- or what to do to prevent it -- I'm not aware of anything like consensus guidelines. Just that it's good to be on the alert, because it can be tricky to diagnose (lots of things cause flu-like symptoms, etc.), and diagnosing it is very important for us HVR types. We definitely get more blood cultures and the like. Maybe more antibiotics, too, even apart from dental work.

 

[Steve B]

Norm - it seems like this whole adventure is just throwing up more and more to read up on ... ! I was aware of the dental work aspect but hadn't given much thought to the 1001 other times when the immune system may get challenged and need some help. Thanks for the input.

JeffM - thanks for that. Best of luck with the tests.

 

[bdryer]

Steve

Starting now, get pre medicated prior to dental work. No you do not have an implant but.....you have heart disease. My dentist did this for me prior to my implant. Four 500mg Amoxicillan 1 hr pre dental.

 

[bdryer]

Normo

Ironic you would pose the tissue/MHV endocarditis comparison question. I work with a guy who in his early 40's received a MHV, got endocarditis during the SARS outbreak. This prolonged his lab tests. To late.... it was so bad they removed the MHV and gave him a tissue valve!

He knows he requires a reop but at least his heart was saved from the endocarditis.

 

[LeakyUK]

I bought my first ever thermometer to check whether my temperature was infection, or my body being in shock during a rare spell of unseasonably warm weather. (It has been normal so far). With either valve you will need to watch for a raised temp, and you will probably be a candidate for the annual flu jab.

 

[Lynlw]

Norm - it seems like this whole adventure is just throwing up more and more to read up on ... ! I was aware of the dental work aspect but hadn't given much thought to the 1001 other times when the immune system may get challenged and need some help. Thanks for the input.

JeffM - thanks for that. Best of luck with the tests.

Premedicating before most dental procedure not for all people at most risk for getting BE, but the ones (like valve patients), that would have the worst outcomes if they DID get BE --in the US and many other countries, the UK I believe NICE guidelines, stopped automatatically giving prophylactic antibiotics, but do say they should discuss it with the patient and if the patient wants to pre medicate, give them,
and BE (Bacterial Endocarditis) are concerns for ALL types of replaced valves and some repairs (that use rings etc) The risk and seriousness of BE is for ALL valves, mechanical AND tissue.
We've had members who've had BE with tissue valves, mechanical valves and even their native valves. Actually one of our members was just admitted for BE on his I believe, St.Jude mech valve he got a few monhs ago.

Yes, you have to consider the possibility BE, anytime you have a fever or other symptons, which can be confusing since the symptons can be very different for everyone, but wether to start antibiotics, depends on a couple things, usually it is a good idea to have blood cultures drawn before starting any antibiotics when they want to rule out BE. FWIW Justin is 23 and has had to watch for BE since he was born, but only had blood cultures drawn 2-3 times because of concerns about BE, one time they were negative, once he had BE but the other time it was neg blood cultures but ended up being mono, if that gives you any idea of what BE can feel like.

One of the reason's it is good to stay on top of any fevers, or symptons that might be BE, is often IF caught early, they can wipe out the infection with heavy duty antibiotics before there is perm damage to your heart/valves so you might be able to avoid surgery.

 

[Gail in Ca]

After my 1st OHS at age 34, I was only on meds for a couple of months. After my full recovery, I went back to doing everything I did before. I water and snow skied, did major exercise classes, step class on 2 risers, weight machines (not crazy heavy because I had an aneurysm). If you are healthy going into it and don't have any complications after surgery, you really feel like you've never had the surgery. Only the scar reminds you of it. And that's the good thing about going with tissue. Hopefully, they last longer now than they did then...

 

[Simon Booker]

Steve

Welcome to the VR community and to a fellow Brit! My father had an AVR at the John Radcliffe hospital in Oxford 24 months ago and this site was an enormous help. We went with a tissue (Edwards Perimount bovine) - Dad was 62 at the time but very active and continues now to work in property maintenance and building.

He takes Beta blockers, low-dose aspirin and blood pressure medication, but other than that we have had a good 18 months or so following recovery and are pretty much back to normal and certainly not restricted.

Happy to talk or hook you up with him if helpful.

Well done on getting the mini AVR - sounds good. Dad had the full sternomoty - and the funny thing is he does not have a scar. He had no stitches - everything was glued, and now you would need to look very, very hard to see any sign of a scar at all. Funnily enough, the sternotomy did not seem to cause him much discomfort but I know everyone is different.