What factors enhance surgical outcome and recovery

[elMIguel]

I guess I'm trying to gird myself (and maybe boost my confidence) for my AVR surgery on 2/17.

I'm 55, I used to be very athletic (weights & rowing) up until my diagnosis of severe stenosis last month. Since, I've been walking at least 3 miles per day along with reading posts on this forum. I'm also watching videos and reading about people who have made it through the other side, dealt successfully with setbacks, and are now managing well. I also have done a ton or research on the procedure itself and picked a surgeon with a solid track record.

Anything else to be done?

 

[dick0236]

I guess I'm trying to gird myself (and maybe boost my confidence) for my AVR surgery on 2/17........
........Anything else to be done?

Sounds like you are doing what you need to do. Education is the key to living with AVR. I think you will find you can still "walk and chew gum at the same time". Mostly everything I've worried about over the years never came true.....and now I'm looking at things most OLD people will go thru.....and my old valve is not one of them.

 

[Brokenhip]

Being as fit as possible going into surgery will assist greatly for your recovery, so keep up the walking. Motivation for recovery & rehab is also important. I was cycling about 200 kms a week leading up to surgery & back cycling on the road after 10 weeks, at age 68yrs. You will be fine.

 

[pellicle]

Being as fit as possible going into surgery will assist greatly for your recovery

seconded

 

[pellicle]

Anything else to be done?

looks like you're across it ... bodily strength and health are the best predictors of a good outcome

however:

I've been walking at least 3 miles per day along with reading posts on this forum.

as long as you're not doing the reading during the walking

 

[elMIguel]

So last night after supper my heart started racing up to 140 bpm. After being unable to get it to come down with relaxed breathing or an extra metoprolol I had my wife drive me to the ER. I’ve got a fib. I’ve been here for 8 hours with an IV drip to try to get me to convert on my own . No luck so far.

I’m scheduled for AVR next week and have been coming round to accepting it and feeling more confident but this is discouraging. Is this what I have to look forward to- constant trips to the ER? Will AVR help with a fib, make it worse, or neither? Does it put me at more risk for the surgery? Is aortic stenosis even related to this?
I’m really trying hard to stay positive.

 

[Superman]

A Fib can be part of it, but to ask, “Is this what I have to look forward to?”. Like daily? Weekly? No. I’m 48. I’ve been cardioverted twice in my life. Most have never been. Both times I was heavier and less active than I am now. Mileage varies.

That said, some members here do end up with pacemakers. They can tell you about life with that. But some end up with pacemakers with no valve issues. Sometimes it’s just age. Does no good to assign blame to something we have no control over.

 

[elMIguel]

Thanks Superman. I’m guessing that I will be cardioverted once the cardiologist makes rounds. This is my second episode, the first before bf in December 2020 which lead to my diagnosis. I was hoping the valve replacement would “fix” all of this but it may be more complicated than I’d hoped.

 

[Daniel758]

So last night after supper my heart started racing up to 140 bpm. After being unable to get it to come down with relaxed breathing or an extra metoprolol I had my wife drive me to the ER. I’ve got a fib. I’ve been here for 8 hours with an IV drip to try to get me to convert on my own . No luck so far.

I’m scheduled for AVR next week and have been coming round to accepting it and feeling more confident but this is discouraging. Is this what I have to look forward to- constant trips to the ER? Will AVR help with a fib, make it worse, or neither? Does it put me at more risk for the surgery? Is aortic stenosis even related to this?
I’m really trying hard to stay positive.

elMiguel,

Before my AVR and aneurysm repair in April, 2018, I had daily bouts of Afib after eating that would last about an hour. It was debilitating and I hated eating knowing what was to come.

In nearly 3 years after surgery, I’ve had 1 episode of Afib around a month and a half after surgery that lasted around 2-3 hours and corrected on it’s own. And it did not happen after eating.

So, yeah, surgery for me did correct Afib I suffered after meals.

Fingers crossed that surgery will do the same for you.

 

[elMIguel]

That’s great to hear Daniel. I hope I can follow your lead! I’ve had 2 bouts and both have come shortly after eating (only supper but not breakfast or lunch, oddly enough...not that I’m complaining about that ;-)

 

[tom in MO]

I don't know anybody with an artificial valve but me. I know 3 people with Afib all of whom have it under control. Don't worry, it will work out.

 

[elMIguel]

Thanks Tom.
I have been converted without cardioverson. I’m supposed to get discharged in 2 hours. They added amiodarone to help me avoid a reoccurrence until my surgery next week. It’s been a long past 18 hours.

 

[epstns]

I had afib immediately after surgery, and was taking amiodarone for about a month or three (it was 10 years ago). IIRC, afib is one of the symptoms that AVR is imminent. The heart just goes wonky because of the extra effort needed to pump blood to the body and tires out.

Because of not only my post-op afib, but also a number of other post-op heart rhythm issues, I did end up with a pacemaker a few days post-op. Since you probably will not need a pacemaker (only some single-digit percentage of valve patients end up needing them), I won't go into all the particulars (if you get there, I'll certainly share, but you don't need all that to think about yet). I will summarize my pacemaker life with a repeat of a statement I often make to new pacemaker patients here. . . "The only time I really realize that I have a pacemaker is when I look at myself in a mirror with my shirt off." Seriously, mine has been a non-issue over the past 10 years (other than a couple of setting glitches, and one lead and device replacement). Don't sweat it, even if you need one.

What I will mention, though, is that you want to be taken off that amiodarone as soon as it is safe. The drug has some serious side effects if taken long-term. My cardio said that if I needed a drug like amiodarone long-term, he would prescribe multaq, which is a similar drug but without the onerous side effects.

 

[vitdoc]

Nobody really understands A Fib very well. People with normal hearts can get it people with abnormal hearts can get it. Interestingly it seems that people like pro bicycle riders get it later in life. It can be handled in a variety of ways depending on the rate of ventricular contractions and the frequency of the A Fib.
Drugs to slow the heart or stabilize the heart like amiodarone . This is probably the most effective drug to stabilize the rhythm but it can have some nasty side effects if used for an extended period at moderate dosing. Multaq is a derivative of amiodarone with significantly fewer side effects and significantly less efficacy also. Ablation of parts of the left atrium via a catheter can be effective in reducing A. Fib.. A somewhat similar approach can be done by the cardio vascular surgeon at the time of heart surgery where the atrial tissue is sort of scored externally. These lines heal and alter the electrical conduction and reduce A. Fib.. So if someone has A. Fib sometimes this procedure call a Maze procedure can be thrown in at the time of heart surgery. As far as I am aware it adds little risk and seems reasonably useful. I personally have had three ablations via catheter which for several years were successful. Now I have reverted to A. Fib and I just may live with it. One needs to be anticoagulated with chronic A. Fib due to the risk of stroke from emboli that form in the fibrillating atrium. Since I am on warfarin anyway for the valve this is not a big deal for me. If I had a tissue valve and chronic A. Fib I might be more aggressive in trying to be in normal rhythm to avoid anti coagulation.

 

[Amy]

Yesterday I randomly came upon information about low magnesium level contributing to a-fib. Makes me wonder what other 'heart supplements' are out there that I haven't heard of, that'd be better than more pharmaceuticals. Magnesium shouldn't affect warfarin, should it? I better do a search. Sigh. I'm never gonna make it to the park.

 

[pellicle]

Magnesium shouldn't affect warfarin, should it?

nope becase its not a toxin and not disposed of by P450. I have been taking chelated magnesium for a little while and my heart "arrhythmias" (palpitations) have become undetectable to me (when they previously were not.

I have not observed any change in my INR behaviour.

 

[Unicusp]

Yesterday I randomly came upon information about low magnesium level contributing to a-fib. Makes me wonder what other 'heart supplements' are out there that I haven't heard of, that'd be better than more pharmaceuticals. Magnesium shouldn't affect warfarin, should it? I better do a search. Sigh. I'm never gonna make it to the park.

I've been taking Magnesium for awhile. Potassium and Iron since surgery to build levels back up. No issues.

 

[almost_hectic]

I take magnesium daily. It’s seemed to help calm irregular beats pvc/pac but things “for me” drastically improved when I started taking B12. Thought maybe it was a fluke and stopped taking it. Irregular beats came back. Went back on and have ever since. Now I swear by the B12. Very regular rhythm and much calmer bpm too.

 

[Unicusp]

Agreed. I also take B complex multivitamin. Good stuff and no Vit K.

 

[Amy]

Thank you, thank you. I'm gonna do a search and see if there's any other good threads about supplements, too. I have so much to learn.