Valve Replacement & Infection

[LaniBug]

Hi. I'm new to this board. You all seem like a very supportive group with much information.

My father-in-law had a bicuspid aortic valve replaced 13 days ago. Prior to surgery my husband and I went with him to meet the surgeon, and discuss the entire procedure. Because he has been on coumadin for the past 15 years already, the surgeon told us a mechanical valve was definitely the right choice. (Dad is 70, but in pretty good health. Had a problem with blood clots many years ago, hence the need for coumadin. His only complaint recently has been some shortness of breath.) The surgeon said the mechanical valve would last longer than the tissue that would need replacing in 10 or so years. We all agreed, and surgery was set.

Two days after surgery, mom was handed a card that needs to be kept in Dad's wallet that says he received a tissue valve. Mom said, "it must be a mistake...he was supposed to get a mechanical valve." After the nurse checked with the surgeon, the surgeon said that he used a tissue valve because the mechanical valve wouldn't have fit properly.

Have any of you ever heard of this? Sounds to me like each person here chose the type of valve they received.

Now dad is 13 days post op, and really struggling. He was doing rehab on Friday, when he started running a fever. He has been placed back on the ventilator, and tests have shown an infection in both lungs, AND a test yesterday showed an infection on the new valve. The surgeon says that he is not strong enough to survive another surgery. They have placed him on Zyvox, (a strong antibiotic), but the surgeon does not sound too positive about being able to fight the infection.

Do any of you know anything about either of these problems.

I appreciate your time and prayers for dad, (Grady).

Thanks,
Lani

 

[LUVMyBirman]

Welcome to VR.com Lani. I think you will find a wealth of information.

Don't have any suggestions for you. So sorry to hear your father is struggling
. Have honeslty never heard that a mechanical could not be used? Usually it's the other way around. Someone it expecting a repair or tissue valve and they end up with a mechanical valve.

Prayers coming your way.
Take care.

 

[WayneGM]

Lani, Glad you found us but sorry it's under these circumstances. Unfortunately, I can't answer your specific questions but there's lots of knowledge and experience here so hopefully somebody will come along soon with some insights that will help you.

My thoughts are with your father-in-law and your family. Best wishes for a positive outcome.

 

[Nancy]

Lani-

I'm sorry to hear about your FIL. He is still with us, so never give up hope. Is he under the care of Infectious Disease specialists? If not you should request that they become involved. Has he had blood cultures to determine what the nature of the infecton is?

There are all kinds of antibiotics and many are specific for a particular group of bacteria. You must stand strong on this problem and get him all the best care you can get for him.

He will be in my prayers.

 

[Karlynn]

Lani, I am so sorry to read of the struggles that your father-in-law is having. It has to be very upsetting for the whole family.

At 70, unless your father has other issues, I think they were being very conservative in telling him that a tissue valve would only last 10 years. I think a tissue valve is pretty much the standard choice for someone of 70. It would most likely last the rest of their life. Tissue valves don't last as long in younger people. However, I could see them going with mechanical because he was already on Coumadin.

If he had a mechanical valve installed, I'm fairly sure that that valve would also be having infection problems right now as well, since the tissue valve does. Unless for some odd reason the tissue valve had the infection prior to installation? Do you know what type of tissue valve he received?

Many people here do make a valve choice, but some have not. And some members have gone into surgery thinking they are getting one valve and find afterwards that they got a different type. I don't understand why your MIL wasn't told about it right after surgery.

I would advise that your family continue to question, question, question the course of treatment your FIL is receiving. Have them tell you the specific reasons they are doing things. Does he need to be on more than one antibiotic. Make sure the hospital infectious disease doctor is working on the case closely.

I will remember Grady and the rest of your family in my prayers.

 

[Susan BAV]

Hi Lani -

Welcome; but so sorry your father-in-law and you all are in such a difficult situation. I'm interested that they put him back on the ventilator; is that typical with a lung infection?

Since you're new here, you wouldn't know but the member, Nancy, has a great deal of experience with and knowledge of various heart procedures. So please read her post again and consider her excellent advice closely.

It doesn't necessarily seem like a bad situation to me, that they gave him a tissue valve at this age, but it does seem odd that your family didn't have this all explained to you right away -- the fact of it and the reasons for it.

I hope all goes well. Post again when you can.

 

[Phyllis]

Welcome, Lani. You've received all excellent advice and I can't add anything but prayers and best wishes. Please be sure to report back and let us know how he is doing.

 

[PJmomrunner]

Hi Lani:

How very distressing a situation. I don't think Nancy's advice can be stated too strongly. Get an infectious disease specialist on board. It would be very hard to accept a surgeon's not being "too positive" that an otherwise healthy 70-year-old can fight off an infection. Make sure you advocate for your FIL. Someone should be with him at all times. Not only can you make sure he gets the care he needs (and doesn't get what he doesn't need), but it also sends a strong message to the medical staff that your FIL is loved and cared for and that you all believe he CAN fight off that infection. Above all, it sends the same message to your FIL and that can make all the difference.

Best of luck to you.

 

[Ross]

Get an infectious disease specialist in there right not. He might well be able to save both dad and valve..

 

[Bradley White]

I just want to strongly echo the sentiments already put forth: you need to request a infectious disease doctor immediately if one is not already handling the case. Endocarditis (bacterial infection of the heart) can be very tricky to treat; it is critical that one determine the bacteria causing the infection and prescribe a course of antbiotics aimed specifically at that species of bacteria.

I have never heard of a mechanical valve not fitting. They make them in a very wide variety of sizes to accomodate many different individual anatomies. Regardless, you and your family should have been notified immediately that a tissue valve was used instead of a mechanical valve. It is very hard to say where the infection came from, but the important thing now is to treat it aggresively and with expertise.

Good luck,

Brad

 

[tobagotwo]

In a seventy-year-old, a premium tissue valve should last more than 18 years, not ten.

If he had the infection in the lungs first, it's not surprising it spread to the valve (actually to the site of the surgery). Definitely look for the infectious disease specialist. As Ross said, they may well be able to save the valve as well.

Best wishes,