Magic8Ball
Well-known member
Ok, this is going to be a long one so grab a coffee and read on, i need to make a decision in the next 24 hours and would appreciate feedback.....
I have the choice of two surgeons to fix my bicuspid aortic valve and aortic anurism of 5.6cm's, the following is a summary of both.
Surgeon 1 suggests fixing the valve and anurism as two separate units keeping my aortic root so the arteries don't need to be moved. The surgery would be done under cooling but NOT DHCA.
Surgeon 2 suggests doing a one unit bentalls procedure under DHCA.(deep hypothermic circulatory arrest)
Both Surgeons suggest the St Jude Valve.
Both Surgeons are lovely to talk to and seem very compitent.
Now i was initially taken aback because i thought all work on the aorta needed DHCA so was slightly unsure of surgeon 1, i was also a little unsure of keeping my aortic root but the reasoning behind it for surgeon 1 was if its ok don't mess with it as you can't control scar tissue....
Surgeon 2's reasoning behind full bentals is that i have a connective tissue dissorder so why keep anything in there that could go pear shaped in the future, he also says that without DHCA there is no way that all of the ascending aorta can be replaced and so you leave a little bit there that could start to dilate in the future also.
Surgeon 2 also says the full bentalls is a one hit surgery that should last a lifetime and is no more of a recovery period so 6-12 weeks ok and i should be absolutely normal after 12 months with no restrictions at all. He also says an inr of 2-2.5 would be ok for me. he also says doing the full bentals only adds minimal risk to the surgery although it is a more difficult procedure for the surgeon (wonder if this is why surgeon 1 did not suggest it), its still 98% success rate in his hands.
Just some background also, surgeon 1 was recommended by my cardio, surgeon 2 was recommended by a friend of a friend who has just had exactly the same surgery done by surgeon2 and was recommended to surgeon 2 by a highly placed person in the cardio thorasic arena as she has connections in those circles....
Surgeon 2 has done 34 bentalls and done 3 in the last 2 weeks, surgeon 1 never gave me figures on how many surgerys he had done but he had worked on severy aortic emergency disections over the weeks prior to me meeting and told me he was one of the few that published his results. None of this is really a consideration for me as i think they are both great surgeons.
Probably my only worry of surgeon 1 is that he goes on holidays for a week 10 days after my surgery so if something goes weird i'd be getting his surgical cover and not him...
I have to choose between them in the next 24 hours.
I'm leaning towards surgeon 2 and his get it all in one shot approach, i feel that i understand his unwillingness to keep my aortic root and i think i'm happier with the DHCA approach even though it has a slightly higher risk associated with it due to the brain being on pause for 15 minutes or so.....
Although surgeon 2 is slightly less charismatic i spend nearly an hour in surgeon 2's rooms talking through my conditions, the risk, the options and i never felt rushed or hurried in any way. He injected humour in the right places and i was very happy with him, plus he was on time. Surgeon 1 was late for my appointment and i felt rushed, we were only in there for 20 minutes or so.
Whadaya think people?
yeh i know hard one to answer but has anyone with my condition gone/not gone with a full bentalls for any reason? also what are everyones thoughts on DHCA...all my reading up until seeing surgeon 1 was that it was the way to go as you didn't need to clamp etc....
Anyway i'll stop rambling....i realise i have probably answered my own question above....surgeon 2 is also a kids heart surgeon and has done heart flips on hearts less that an inch big and reattached arteries less than 1mm in diameter...
Yeh i know, surgeon 2 but you gotta ask..
I have the choice of two surgeons to fix my bicuspid aortic valve and aortic anurism of 5.6cm's, the following is a summary of both.
Surgeon 1 suggests fixing the valve and anurism as two separate units keeping my aortic root so the arteries don't need to be moved. The surgery would be done under cooling but NOT DHCA.
Surgeon 2 suggests doing a one unit bentalls procedure under DHCA.(deep hypothermic circulatory arrest)
Both Surgeons suggest the St Jude Valve.
Both Surgeons are lovely to talk to and seem very compitent.
Now i was initially taken aback because i thought all work on the aorta needed DHCA so was slightly unsure of surgeon 1, i was also a little unsure of keeping my aortic root but the reasoning behind it for surgeon 1 was if its ok don't mess with it as you can't control scar tissue....
Surgeon 2's reasoning behind full bentals is that i have a connective tissue dissorder so why keep anything in there that could go pear shaped in the future, he also says that without DHCA there is no way that all of the ascending aorta can be replaced and so you leave a little bit there that could start to dilate in the future also.
Surgeon 2 also says the full bentalls is a one hit surgery that should last a lifetime and is no more of a recovery period so 6-12 weeks ok and i should be absolutely normal after 12 months with no restrictions at all. He also says an inr of 2-2.5 would be ok for me. he also says doing the full bentals only adds minimal risk to the surgery although it is a more difficult procedure for the surgeon (wonder if this is why surgeon 1 did not suggest it), its still 98% success rate in his hands.
Just some background also, surgeon 1 was recommended by my cardio, surgeon 2 was recommended by a friend of a friend who has just had exactly the same surgery done by surgeon2 and was recommended to surgeon 2 by a highly placed person in the cardio thorasic arena as she has connections in those circles....
Surgeon 2 has done 34 bentalls and done 3 in the last 2 weeks, surgeon 1 never gave me figures on how many surgerys he had done but he had worked on severy aortic emergency disections over the weeks prior to me meeting and told me he was one of the few that published his results. None of this is really a consideration for me as i think they are both great surgeons.
Probably my only worry of surgeon 1 is that he goes on holidays for a week 10 days after my surgery so if something goes weird i'd be getting his surgical cover and not him...
I have to choose between them in the next 24 hours.
I'm leaning towards surgeon 2 and his get it all in one shot approach, i feel that i understand his unwillingness to keep my aortic root and i think i'm happier with the DHCA approach even though it has a slightly higher risk associated with it due to the brain being on pause for 15 minutes or so.....
Although surgeon 2 is slightly less charismatic i spend nearly an hour in surgeon 2's rooms talking through my conditions, the risk, the options and i never felt rushed or hurried in any way. He injected humour in the right places and i was very happy with him, plus he was on time. Surgeon 1 was late for my appointment and i felt rushed, we were only in there for 20 minutes or so.
Whadaya think people?
yeh i know hard one to answer but has anyone with my condition gone/not gone with a full bentalls for any reason? also what are everyones thoughts on DHCA...all my reading up until seeing surgeon 1 was that it was the way to go as you didn't need to clamp etc....Anyway i'll stop rambling....i realise i have probably answered my own question above....surgeon 2 is also a kids heart surgeon and has done heart flips on hearts less that an inch big and reattached arteries less than 1mm in diameter...
Yeh i know, surgeon 2 but you gotta ask..
