I've Transitioned From The Waiiting Room To Pre-Surgery - Some Thoughts

[cldlhd]

Hi Jim,

I had an aortoplasty - IIRC, it was referred to as an S-plasty in the surgical report, where they cut an S-curve in the ascending aorta and stitch it back up to reduce its overall diameter. Mine was only 4cm, so I figured they do that for a small reduction in diameter, and use a graft for "real" aneurysms. I don't know at what size they would switch from one to the other. Here's a study I found that compares the two methods and concludes they are somewhat interchangeable when the aorta isn't "too big.".

http://www.ncbi.nlm.nih.gov/pubmed/11899172

Well at 4.7 cm for the ascending and 4.8 for the root mine must qualify as a "real " aneurysm because there hasn't been any discussion other than replacing with a graft.

 

[skeptic49]

Let us know when you get a surgeon and a surgery date, Jim.

Thanks, Mary...I have two consultations scheduled for next week...hopefully one of them will work out.

> Well at 4.7 cm for the ascending and 4.8 for the root mine must qualify as a "real " aneurysm because there hasn't been any discussion other than replacing with a graft.

Question for you and Michele: is or was surgery by full sternotomy or mini-sternotomy? Generally, is combination AVR with aneurysm repair/replacement doen with minimally invssive surgery or does it require the usual full cut?

 

[cldlhd]

Thanks, Mary...I have two consultations scheduled for next week...hopefully one of them will work out.

> Well at 4.7 cm for the ascending and 4.8 for the root mine must qualify as a "real " aneurysm because there hasn't been any discussion other than replacing with a graft.

Question for you and Michele: is or was surgery by full sternotomy or mini-sternotomy? Generally, is combination AVR with aneurysm repair/replacement doen with minimally invssive surgery or does it require the usual full cut?

I haven't had my surgery yet-it's scheduled for Feb. 6th at HUP with Dr. Bavaria ( same surgeon as Michele) . I was told it will be the usual full cut and he doesn't want to replace my valve - it's barely leaking and has no signs of stenosis , he said if it wasn't for the aneurysm he wouldn't even consider operating on me. So basically he wants to get my valve leakage to zero and replace the aneurysm with a graft. Just a little plumbing work from his perspective I guess, he seems very confident so I assume that's a good thing.

 

[skeptic49]

I haven't had my surgery yet-it's scheduled for Feb. 6th at HUP with Dr. Bavaria ( same surgeon as Michele) . I was told it will be the usual full cut and he doesn't want to replace my valve - it's barely leaking and has no signs of stenosis , he said if it wasn't for the aneurysm he wouldn't even consider operating on me. So basically he wants to get my valve leakage to zero and replace the aneurysm with a graft. Just a little plumbing work from his perspective I guess, he seems very confident so I assume that's a good thing.

Interesting. Are you symptomatic at all? Normally there are none with aneurysms until it's too late. I guess Bavaria will be doing some work on your valve in addition to the aortic graft? Bavaria is always confident, I'm sure.

 

[charles g]

I'm transitioning to pre-op on feb 3 then surgery the 5th. I finally settled for my experienced AVR mechanic whom I'd found via a very roundabout way and the advantages of getting it done closer to home certainly made sense. I got a call from UWMC head cardiothorascic surgeon Dr.Aldea on Xmas eve (he must have had a slow day ..it was a welcome call. skeptic: That Cat therapy works..they love low-stress surroundings and a warm spot near us. Pete checks on me by putting his ice cold nose against mine at 03:30am almost everyday

 

[skeptic49]

I'm transitioning to pre-op on feb 3 then surgery the 5th. I finally settled for my experienced AVR mechanic whom I'd found via a very roundabout way and the advantages of getting it done closer to home certainly made sense. I got a call from UWMC head cardiothorascic surgeon Dr.Aldea on Xmas eve (he must have had a slow day ..it was a welcome call. skeptic: That Cat therapy works..they love low-stress surroundings and a warm spot near us. Pete checks on me by putting his ice cold nose against mine at 03:30am almost everyday

great on kitty...so what is your story...avr plus???

 

[cldlhd]

Interesting. Are you symptomatic at all? Normally there are none with aneurysms until it's too late. I guess Bavaria will be doing some work on your valve in addition to the aortic graft? Bavaria is always confident, I'm sure.

Ha, ya he's definitely confident but as long as the work warrants it that's fine with me. I am symptom free and he says I could take the wait and watch approach and it could be years before I NEED the operation. He says he won't have to do much with the valve.

 

[river-wear]

Bavaria may be a little cocky, but I think it's earned. He took the time to answer my email (as a complete stranger who dug up his address on the Penn site) and even called me once before I flew out from California to see him. I'd say he clearly cares about his patients.

He was supposed to do a mini-sternotomy for me, but ended up doing the full thing. Honestly I'm not sure what difference it would have made for recovery - I had very little pain and the only discomfort was having to sleep on my back for about seven weeks. It would have been nice to wear a v-neck without the scar showing, but once it fades I really won't care about showing it. Now I dab a little make-up on it to blend it in.

 

[river-wear]

Chris, I didn't consider my case a "real" aneurysm because no doctor ever told me I had one. After doing some research post-op, it appears that at 4cm mine was at the upper limit of normal (or perhaps over the limit for my body size).

Jim, Bavaria may be a little cocky, but I think it's earned. He took the time to answer my email (as a complete stranger who dug up his address on the Penn site) and even called me once before I flew out from California to see him. I'd say he clearly cares about his patients.

He was supposed to do a mini-sternotomy for me, but ended up doing the full thing. Honestly I'm not sure what difference it would have made for recovery - I had very little pain and the only discomfort was having to sleep on my back for about seven weeks. It would have been nice to wear a v-neck without the scar showing, but once it fades I really won't care about showing it. Now I dab a little make-up on it to blend it in.

 

[Paleowoman]

Hi Michele - I had "minimal invasive" but my scar is nearly full length of sternum - my scar certainly shows even without v-neck unless I wear something right up to my neck - and my recovery was very slow - I don't mind my scar though - war trophy !

 

[cldlhd]

Chris, I didn't consider my case a "real" aneurysm because no doctor ever told me I had one. After doing some research post-op, it appears that at 4cm mine was at the upper limit of normal (or perhaps over the limit for my body size).
I hope you didn't take my comment in a negative way because it wasn't meant that way ,sometimes tone gets lost in postings.
Jim, Bavaria may be a little cocky, but I think it's earned. He took the time to answer my email (as a complete stranger who dug up his address on the Penn site) and even called me once before I flew out from California to see him. I'd say he clearly cares about his patients.

He was supposed to do a mini-sternotomy for me, but ended up doing the full thing. Honestly I'm not sure what difference it would have made for recovery - I had very little pain and the only discomfort was having to sleep on my back for about seven weeks. It would have been nice to wear a v-neck without the scar showing, but once it fades I really won't care about showing it. Now I dab a little make-up on it to blend it in.[/QUOTE

 

[river-wear]

No offense taken, Chris.

Anne, I was curious enough that I asked my cardiologist if my surgery was "minimal" (which truly is a silly term). He agreed that it was not; my scar is 6 inches. However, I have an inch or two of unmarred skin below the notch at the top of my sternum. The original plan was for the scar to start a couple more inches below that. I find it a little weird though that I have two lumps from the wires, and the top lump is about an inch above the end of my scar. Like you said - war trophy! Or conversation piece - lol.