Guess it's time to join the group

[Philip B]

I've been visiting the forum for the last several weeks. Like many of you, I was blessed at birth with that nifty little bicuspid aortic valve. The murmur it created caught the attention of Doc Johnson when I decided to play high school sports and he decided that I needed to visit a team of cardiologists. The team checked me out, gave me the green light to do whatever I wanted, and I never looked back.

My mid-twenties and dealing with an alcoholic fiancée took me to ole Doc Johnson's office again with stomach problems. Doc gave me some good advice; dump the drunk and make another trip to a cardiologist to have the murmur checked again. The cardiologist informed me I needed to have immediate valve replacement or I wouldn't last until I was thirty. I thought about this for a short moment and improved on ole Doc Johnson's advice. I dumped my fiancée and the cardiologist. I felt great and I could eat donuts again.

My life has been incredibly active. Twenty-eight years as a secondary educator and building level administrator, a fourteen year seasonal stint with the National Park Service which included work on wildfire management and suppression teams, and my ticker with the murmur never missed a beat.

Unfortunately, or maybe not, a kitchen accident a few weeks ago landed me in the ER. The ER doc flipped-out when she heard my murmur and insisted I get checked by a cardio doc again. The echo was worrisome and led to an angiogram and a CT scan which indicated that the old "ghost" hadn't gone away. After fifty-one years of chugging away, my aortic valve has become rather tight and like many of you, wear and tear on my aorta has created an aneurysm.

My wife, Colleen, refers to my kitchen accident as divine intervention; I call it stupidity with a steak knife. In any case, we'll take a run at AVR surgery on March 28. Since I'm in pretty good physical shape and present no symptoms, my surgeon is confident that he can implant a mechanical valve and do a Dacron graft to fix the aneurysm. We're counting on him being right.

This is spooky stuff, and as most of you know too well, the emotional overload makes thinking about questions and decisions pretty tough. We've appreciated the information and insights posted on this forum. It helped us ask good questions (at least we think they were) and make informed decisions.

Anyway, does anyone have any insights about how well those Dacron tube grafts work? Thanks.

-Philip B.

 

[Superbob]

Hi Philip,

I don't have an answer to your specific question but I'm sure folks will come along who will. Just wanted to welcome you to this forum. I, too, plodded along with a murmur for a long time -- 40 years -- and even ran a few marathons before the time came for OHS in my 60s. Sounds like you are in great shape, well informed, and ready to have the procedure and get on with the rest of your life. All best to you. Look forward to seeing you on here regularly.

Cheers,

 

[Ross]

Dacron grafts will out last us! Nearly bullet proof.

 

[WayneGM]

I don't know anything about Dacron grafts but just wanted to welcome you to the VR.com community. Wishing you all the best.

 

[Phyllis]

Welcome, Philip. If Ross said they are bullet proof than you can count on it. I put you on the calendar for the 28th. Best Wishes.
Phyllis

 

[Arlyss]

Dacron is a very strong material that will last much longer than a human life span!

However, there are some important things about how the surgery is done. They are going to attach the Dacron to some very special tissue, and the way that is done is important. You do not want to have problems later at the sewing lines or with aortic tissue that was left behind.

I encourage you to find out how much experience the surgeon(s) that you are considering have with aortic surgery - and how long they have followed their patients after surgery (how many years?) so that you can evaluate their track record. You might ask them if they take the entire ascending aorta using circulatory arrest.

There are details about aortic surgery at the following link that might help you form some questions for your surgeon

www.cedars-sinai.edu/aorta

Best wishes,
Arlyss

 

[geebee]

Philip,

Can't help with the graft because I am a mitral valve patient but I did want to welcome you. I can and will help with any general surgery or recovery questions.

Welcome to our world - it is a great place to be if you have to be in this situation.

 

[Philip B]

Good Points Arlyss

Good Points Arlyss

Arlyss,

Thanks for the tips concerning surgical work on the aorta.

My surgeon has a good track record. My CT scan shows that the patch job won't require taking the entire aortic arch as the aneurysm is confined to the lower portion of the ascending aorta.

If memory serves me correctly (I may be wrong because I'm a newbie with this stuff-I may need more education), the total circulatory arrest technique involves dropping the body temperature significantly. The surgeon felt this technique would be necessary only if my anneurysm involved more of my aorta than indicated on the CT scan.

I'll be visiting with him again within the next two weeks to have him walk me through the entire procedure. I'll make sure to bring up some of the points you posed in your posting. When the proverbial bombshell drops on you it's difficult to think of everything that needs to be asked and discussed. Colleen and I were expecting bad news about the valve, but the aneurysm was a huge shock.

Thanks!

-Philip B

 

[Magic8Ball]

Welcome, & heres my take on the ascending aorta thing...

You have a condition that affects the strength of the tissue of your aorta and the formation of the aortic valve and root. All three bits are faulty to some degree.

Now ask yourself how confident are you/your surgeon that if they don't replace as much as possible now that the bits they leave behind won't go wrong in the future and require re-surgery.

I wasn't confident so i chose to have a 'bentalls' under DHCA, replacing the whole lot with a single piece factory made valve+root+graft.

I couldn't see the benefit of leaving an inch or so of ascending aorta as a ticking timebomb...its not like that extra inch would give me any greater a quality of life...

Likewise with leaving in the root.

The additional risk that DHCA poses above the normal cooling technique does not even add a whole extra 1% to the surgery you are having.

Have this discussion with your cardio/surgeon and make sure you are fully around the whole subject area before you proceed.

Best of luck on your journey.

 

[DeWayne]

just a little less than a year ago I found out about the whole aortic aneurysm thing myself. I had known since I was a small child I would someday need a valve replacement, but the aneurysm was a bit of a shock, but that probably had something to do with the 30+ years I didn't bother to go see a cardiologist. Back then it was not known about the corolation between bicupid valves and potential aneurysms. The last time I was at a cardiologist prior to this they didn't have such a thing as a echocardiogram. My cardiologist jokes about it now, that my first one was in 2006.
My aneurysm was big, 5.8 at the largest part of it. so a bit over 6 months ago I had my valve replaced and a dacron graft, the root and a new tissue valve. The graft was in the ascending aorta up to and including the bottom of the arch, it gets more complicated when it includes the whole arch and even more so when the descending needs replacement too. Much better if you don't need any part of the arch replaced.
At 6 months now I have no limitations put on me as to what I can do, and don't find much I can't that I used to do.

 

[MrP]

Sounds familiar...the Dacron graft will work fine. It does represent more prosthetic material, and cooling time for DHCA adds considerably to overall pump time. Get the best surgeon...period.