Worried sick

[Jimmyk]

while visiting my heart dr. Last week, I was told I was very fortunate to be able to have non invasive surgery to replace my aortic valve.
After doing research on the Internet , I'm reading that this surgery is for people who might not survive typical open heart surgery .
As in low to intermediate risk. Usually people in the 80 year old range.
I was led to believe, that I was very lucky to have this chance to get this surgery.
I'm 52 years old , I eat healthy, don't smoke, im an active person, construction for 30 years plus....my father had this same diagnosis at age 62, he opted to not do anything about it and died 4 years later.
From what I remember , they offered him an artificial valve replacement . For me they say it's to risky.... Can I please get some input? From what I'm reading a non evasive procedure May last 12 years for an older person, I have another 10 years that I was planning to work to support my family. Any advice?:Face-Worried:

 

[Nocturne]

I can appreciate being worried sick.

Do you know WHY you would not qualify for regular OHS? Surely there must be some known complication that you have?

 

[pellicle]

Hi and welcome

I confess i'm a littl confused about your doctors wording. Does he mean minimal invasive (which is still an open heart surgery) or does he mean trans catheter (or TAVI)

Given what youve said I would say that a proper open heart surgery would be the better choice.

It's a well known surgery with good outcomes. Solid history and to be hinest the gold standard.

Definitely get the surgery done because as with thr example you gave you will die without it.

With that surgery you can expect to be able to return to work and live a relatively normal life. Thats the usual outcome

Best wishes

PS
Don't be worried, it's a good well known procedure, with very high success rates.
​​​​​

 

[Jimmyk]

Thanks,
I'm not really sure why they elected the non envasivive surgery .
but I sure will have a lot of questions.
Does anyone know if this non invasive surgery can be done more than once? Not that I'd like that, But would like to just know. Thanks

 

[Jimmyk]

They are recommending a TAVR. But from what I'm reading, this surgery is usually done on patients , being elderly 80+ or low risk recovery patients.
Thanks for this forum, I learn a lot and am able to question the doctors.

 

[pellicle]

Hi

They are recommending a TAVR. But from what I'm reading, this surgery is usually done on patients , being elderly 80+ or low risk recovery patients.

that's certainly the origins of the procedure; the elderly and the infirm.

There seems to be a bent towards making it more main stream. I'm going out on a limb here and will express that my view is that this is profit motive driven not data driven. The data on the TAVI for the moment is an order of magnitude worse than "regular" OHS.

To my understanding the trans catheter holds a lot of obvious promise as to being a more simple intervention, but the issue is that once in place the valve is not (at this point) easy to replace. When the valve decays there can be a "valve in valve" replacement and there are even some designs where new leaflets are pinned in to the framework.

With the valve in valve as I understand it the effective aperture (the diameter of the valve opening) will shrink. Also (as I understand it) this can only be done once more and then a normal OHS is required to replace that entire chunk.

At your age and with your activity levels I would be hesitant to recommend a TAVI as the good option.

A few years back I wrote this blog post on the topic of valve choices (yes, its my blog)
http://cjeastwd.blogspot.com/2014/01...r-choices.html

There is a discussion in that about a few papers and a great presentation by a Mayo Clinic surgeon.

Thanks for this forum, I learn a lot and am able to question the doctors.

this is the perfect approach. Use the experiences and thoughts here to form your next line of questions to your Dr. I strongly recommend that you record the meetings so that you can go back and listen again to what has been said. You can then take that to form the next step for asking the next "generation" of questions.

About me (if you haven't gone to the about me on the forum is that I've had 3 surgeries over my life (I'm 54 now) and now rest with a mechanical valve and am managing my own "blood thinners" quite well my self.

Lastly, don't worry if you can help it. I personally believe that worry is a negatve and corrosive reaction which brings no benefits and just harms you. The outcomes of OHS are excellent and its the single most effective medical intervention in the medical repertoire as far as I know.

Seek Knowledge, for knowledge brings confidence and calm.

Best Wishes

 

[dick0236]

Have you talked with a heart surgeon yet? The advice you have been given about "being lucky to get TAVR at age 52" seems strange unless there is some overriding fact that your doc knows. I would get a second opinion from another cardio and/or a heart surgeon. Valve replacement may be indicated and replacement is not that big of a deal.......but I would want a "fix" at your age......not just a "bandaide",.

 

[epstns]

Jimmy - What I think we are trying to ask is whether you have any other medical conditions that would make you a risky candidate for traditional open-heart surgery. If you do not, I would ask that doc just why they are recommending TAVI. If it is just "because they can" then you owe it to yourself to get another opinion. Absent other medical risks, I would think that traditional open-heart surgery with a prosthetic valve (either mechanical or tissue) would be the superior choice for you.

You do not have to take the first surgery offered. You are allowed to shop around for alternatives and choose another. Please do your homework before you agree to any procedure like this.

 

[AZ Don]

Seems to me like it's time for a 2nd opinion.