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Complications in surgery

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  • Complications in surgery

    Dear All,

    Please share the parameters which can affect the smoothness of valve replacement surgery . e.g : age, other health issues, double valve replacement, no. of OHS, etc.

    I am gathering this information to prepare myself for AVR and MVR.

    Please share information and experiances about the success of Valve replacement with mechanical Valves, also the causes that can lead to complications in the surgery.

    What are the parameters that leads re-operation??

    Regards,
    Sharad.
    Sharad,
    Nashik, Maharashtra, India.
    Diagnosed : Moderately severe Aortic Regurgitation & Moderate Mitral stenosis.

  • #2
    Sharad,

    Your question about complications can lead to a "slippery slope" of negative thinking.

    My recommendation is to look on the Bright Side that Heart Valve Replacement Surgery is a Highly Refined Art that extends lives to a Normal Life Expectancy with a Very High Success Rate.

    First time surgeries in patients under age 65 have a 1% morbidity and 1% mortality rate versus almost certain demise within a few years if left untreated. I'm thinking those numbers are in the USA, BUT are probably applicable to most hospitals that perform a high volume of Heart Surgeries. I have come to know a Valve Company representative who was a former surgical nurse. She has been to India several times and tells me that the hospitals / Surgeons she has seen in India are Very Good. Bottom Line: Heart Surgery is performed pretty much the same all over the world.

    I will address one complication that can lead to repeat surgery. This is found most often in patients with a Bicuspid Aortic Valve who also have a Connective Tissue Disorder that is not recognized or properly assessed at the time of their Valve Replacement Surgery. This is why I encourage ALL newcomers who report having BAV to get their Aorta checked for signs of aneurisms and to find surgeons who have a lot of experience doing surgery of the aorta which is more complex than 'mere' valve replacement surgery.

    It is known that Tissue Valves will wear out, typically in 10 to 20 years, especially in younger patients. Advancements in the technology and treatment of Tissue Valves are hoped to extend their durability beyond 20 years but we won't know how well that works out until they have been in use for that length of time.

    Bottom Line: Find a Surgeon and Hospital who do a lot of the type procedure YOU will need and you should do fine.

    One other comment and VR.com slogan is: Sooner is Better.
    This is because the sooner you get your Valve / Heart Fixed, the less damage is done to the heart and the better the recovery.

    I hope this helps you in your struggle to get comfortable with your condition and options.

    'AL Capshaw'

    Comment


    • #3
      Yup, Al is right. You should be thinking "what will happen if I don't have this surgery?" It is a life saver. My husband is a prime example. He lived a normal lifespan in spite of terrible, long standing medical problems (not all valve problems). He passed away at age 75 with both of his mechanical valves in good working order until the last moment. One of them was over 30 years old.

      If you are in otherwise good shape, with perhaps a few problems, you should do just fine, and it will fix your problem.

      Comment


      • #4
        I agree with Al. If you focus on what might happen badly you are really wasting your energy. Look around this community here and all the people that have had valve surgeries of many types, some very high risk, and very very very few that did not survive.
        Tom F.

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        • #5
          I agree with Al. Don't think about the negatives. Obviously, the more fragile you are, the greater the risk of complications. However, most people come out of surgery better than before.

          Comment


          • #6
            Originally posted by ALCapshaw2 View Post
            Sharad,
            First time surgeries in patients under age 65 have a 1% morbidity and 1% mortality rate versus almost certain demise within a few years if left untreated. 'AL Capshaw'
            What are the rates among 2nd time surgeries under age 65? Any data?

            Thanks.
            pickaback

            Comment


            • #7
              When my husband had this second, we asked the same question. The odds are about the same as the first. It was when he had to have a third one that the odds jumped, but still overwhelming in his favor.

              Comment


              • #8
                Originally posted by pickaback View Post
                What are the rates among 2nd time surgeries under age 65? Any data?

                Thanks.
                pickaback
                I *think* I was told 5 to 10% risk for second surgery.
                It depends a LOT on the skill of the surgeon and how much experience he has doing "re-do's" and dealing with scar tissue.

                I've heard numbers all over the place for 3rd surgeries (10 to 25%). Again, I suspect it depends highly on the skill and experience of the surgeon along with patient issues such as age, co-existing risk factors, etc.

                Comment


                • #9
                  I'm with everyone else - you just can't think about the risks... for me, it would make me shut down. I've had the scary thoughts creep in a couple times and I have to shake it off and focus on preparation and recovery... skip the procedure itself. I'm a firm believer that we all have our scheduled "time" to go... and I'll leave it to our Maker to decide when mine is.

                  (I'm also with everyone else in that the healthier you are going in, the stronger you will be during it and your recovery will go much more smoothly as well).

                  Best of luck!
                  Kerri
                  7/14/09: ASD Re-Repair, MVR(eplace) & Maze, new Pacemaker at UNMC
                  12/97: MVR & Pacemaker at UNMC
                  '74, '77 and '79: Atrial wall built and rebuilt (born with CHD)

                  Comment


                  • #10
                    This is what drives me (and I am sure others) crazy about the waiting period. It provides way too much time to ruminate on various scenarios (both good and bad). However, I agree that it is important to focus on a positive outcome (which as Dyna alluded to isn't always easy).
                    CE Perimount Aortic Bovine Valve

                    Comment


                    • #11
                      Originally posted by ALCapshaw2 View Post
                      I *think* I was told 5 to 10% risk for second surgery.
                      It depends a LOT on the skill of the surgeon and how much experience he has doing "re-do's" and dealing with scar tissue.

                      I've heard numbers all over the place for 3rd surgeries (10 to 25%). Again, I suspect it depends highly on the skill and experience of the surgeon along with patient issues such as age, co-existing risk factors, etc.
                      Having just been through my 2nd open-heart surgery and 3rd heart surgery in total (the first time they went through my ribs) I was given a 3-5% chance of something going wrong. Compared to a 100% chance of death by not going through with the surgery, they were considerably much better odds!!

                      Of course the healthier you are before surgery, the better your odds over-all, so it is important to make sure you are eating well, keeping as active as possible (this can be difficult if your exercise tolerance is lower because of your heart, but even a daily walk is better than nothing), NOT SMOKING!!, losing extra weight if you can / need to, and keeping away from anyone who may pass on a cold or virus close to surgery - regular washing of hands helps reduce your chance of catching something (I kept an anti-bacterial lotion in my bag for when I had to go to public places like supermarkets).

                      As far as surgical complications, for some people who have had multiple surgeries there may be issues with excess scar tissue, but it's hard to predict if or what complications may occur. A skilled team will be prepared for most things, but sometimes it's impossible for them to predict a potential complication. Over-all, it's probably a very minor risk and not worth needlessly worrying over.


                      A : )
                      37y/o, born with Tetralogy of Fallot, Blalock-Taussig shunt @ 18 months, corrective surgery @ 5 years, PVR Dec '08 (37th birthday pressie!)
                      Surgery blog:[url="http://abbanabba.nowblogging.net/"]My Brokendown Heart[/url]

                      Comment


                      • #12
                        [QUOTE=ALCapshaw2;389879]I *think* I was told 5 to 10% risk for second surgery.
                        It depends a LOT on the skill of the surgeon and how much experience he has doing "re-do's" and dealing with scar tissue.
                        QUOTE]

                        Thanks for the numbers. I see a cardiologist about a second surgery this week and am terrified. I had my first open heart surgery 30 years ago as a kid. Everone says things have changed so much, but it is hard to get out of kid mindset.

                        pickaback

                        Comment


                        • #13
                          Just wanted to add, I actually went much better with my second OHS than my first. Apparently when I was a kid I haemorraged after surgery and had to be rushed back into theatre to stop the bleeding before I died (clearly they were successful!). From there I developed a fever and spent almost a week in ICU before the fever broke and I was able to be transferred to the cardiac ward.

                          This time around things went very smoothly and I was home on day 6 - would have been day 5 but I was transferred out of the cardiac ward and they forgot about me until the next day!

                          Anyway, my point is that each surgery is very different - even for the same person - but you're in the hands of experts who are equipped to deal with pretty much anything that may arise.
                          37y/o, born with Tetralogy of Fallot, Blalock-Taussig shunt @ 18 months, corrective surgery @ 5 years, PVR Dec '08 (37th birthday pressie!)
                          Surgery blog:[url="http://abbanabba.nowblogging.net/"]My Brokendown Heart[/url]

                          Comment


                          • #14
                            [QUOTE=pickaback;390115]
                            Originally posted by ALCapshaw2 View Post
                            I *think* I was told 5 to 10% risk for second surgery.
                            It depends a LOT on the skill of the surgeon and how much experience he has doing "re-do's" and dealing with scar tissue.
                            QUOTE]

                            Thanks for the numbers. I see a cardiologist about a second surgery this week and am terrified. I had my first open heart surgery 30 years ago as a kid. Everone says things have changed so much, but it is hard to get out of kid mindset.

                            pickaback
                            We have many members who have survived second surgeries, several who have survived third surgeries, and a few with even more.

                            As I said before, having a surgeon who knows what to expect from scar tissue and how to handle it reduces those risks greatly. Surgeons at Major Heart Hospitals and Teaching Hospitals usually have those skills. It would be wise to explore the experience and track record of any surgeon one interviews for a repeat surgery.

                            'AL Capshaw'

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