TAVR procedure

[docsmith]

I just discovered this forum and registered today. I am scheduled to have TAVR next week to replace my aortic valve and I see that most here have had open procedures. I am not a stranger to heart issues. I am 70 and had 6 vein CABG many years ago and seven stents between then and now. I am hopeful that the procedure will provide symptomatic relief and was hoping to see if anyone here has had the procedure and was willing to share their experience. My research shows a high success rate and relatively low incidence of complications. Until two weeks ago, it was only approved in the US for high risk and hence patients even old than me. My medical team will be using the Sapien 3. I would love to get input from anyone who has experienced TAVR with particular interest in post surgical recovery . Thanks everyone in advance.

 

[pellicle]

Hi DocSmith

you're right that its only recently made available to intermediate risk patients. There is one fellow here who is in his 40's who managed to get a TAVI by pushing hard and having himself classified as intermediate (so that his insurance would pay).

He was engaged in asking questions, but since he's had his surgery he's kept to himself. I don't thinks this says much worrying, as he did the same 12 or so years ago when he had a tissue prosthetic.

I wish you all the best with your procedure and if nothing else emerges to inform you, I hope you do pop back here with your experiences cos its a question on many peoples minds.

 

[docsmith]

Thanks for responding.When I get out of the hospital I will be sure to report my experience. I had done a fair amount of investigation before agreeing to this adventure. Everyone here knows the feelings associated with committing to having any procedure. I feel good about the decision since I don't have to have my chest cracked again and I know that without it the slope of my life would be in the wrong direction. 70 year olds have to take these kind of chances. Maybe in some small way my experience can be informative here for the next person confronted with this decision.

 

[pellicle]

Hi

...When I get out of the hospital I will be sure to report my experience.

I'm sure there will be a bunch of interested readers, both registered and unofficial lurkers ;-)

...I feel good about the decision since I don't have to have my chest cracked again and I know that without it the slope of my life would be in the wrong direction. 70 year olds have to take these kind of chances. Maybe in some small way my experience can be informative here for the next person confronted with this decision.

from where I sit I think your decision process seems quite sound. I've seen my neighbour (80's) take a drop in quality of life just over a torn achilles tendon that simply prevented her from walking ... A year later the tendon is better, but her health has dropped due to a hiatus in activity. So I think your process is prudent.

Knowing nothing at all about your general health and activity levels, I would wager that at your age you are quite likely to get the maximum estimated life from the valve and be then up for a valve in valve later.

Look forward to hearing your post recovery stories and information

Best Wishes

 

[Twobike]

I have signed up for the TAVR procedure in a study for 65 and older, low risk. It's been nine weeks now and still no answers on when it will be done. In this study I have a 50/50 chance of having the TAVR. So much red tape to go through. I was given the choice of dropping out and having SAVR, but I'm trying to avoid that. I'm wondering how long I can wait. I think they are getting tired of me calling to check up on how the review is going. Last time I called, I was told that some tests would have to be done over to be in the time limit given. It would also be a Sapien 3, if I get the TAVR. I need approval from three different places. I thought, when I signed up the 1st of September, that it would be this month. Now with all the delays, I really doubt it.

 

[docsmith]

Twobike. I would hang in there and not let them scare you away from this study. I am located in Dallas and it took me from June 1st to get on the schedule. My surgery is at the Heart Valve Institute at Medical City. This clinic was involved in the original TAVR studies and has done more than anyone else in North Texas. It was really important to me that I have this done by a cardiologist with many cases since these procedures are always technically challenging. The alternative is to seek out other cardiologists at major institutions in your area since they may be more accommodating. Just for information purposes it took almost 5 years from the first trials to get intermediate risk patients qualified. They have been doing these procedures longer in Europe with very good results. The most important criteria in selecting a center is the case experience of the team including the number of patients, complication rate and long term survival. Good luck to you and I think it is outstanding that you are actively participating in your care..I for one have changed cardiologists 5 times since my bypass almost 20 years ago...always seeking the best person I could find for my then current condition. With one exception I have had genuine confidence in my cardiologist..one doc did not make the cut despite a big reputation.. DocSmith

 

[Agian]

I for one have changed cardiologists 5 times since my bypass almost 20 years ago...always seeking the best person I could find for my then current condition. With one exception I have had genuine confidence in my cardiologist..one doc did not make the cut despite a big reputation.. DocSmith

Good for you! I got accused of 'doctor shopping' for seeking alternative opinions.

 

[Agian]

I have signed up for the TAVR procedure in a study for 65 and older, low risk. It's been nine weeks now and still no answers on when it will be done. In this study I have a 50/50 chance of having the TAVR. So much red tape to go through. I was given the choice of dropping out and having SAVR, but I'm trying to avoid that. I'm wondering how long I can wait. I think they are getting tired of me calling to check up on how the review is going. Last time I called, I was told that some tests would have to be done over to be in the time limit given. It would also be a Sapien 3, if I get the TAVR. I need approval from three different places. I thought, when I signed up the 1st of September, that it would be this month. Now with all the delays, I really doubt it.

Exciting developments! All the best!

 

[Nocturne]

Docsmith,

I have not even had my procedure done, as I just found out I have very mild AS a few months ago, so these other folks know a lot more than I do.

However, I can tell you a piece of good news, and that is this. Several studies have shown that at your age (68+), life expectancy does not seem to be affected by AVR. In other words, assuming you pull through the procedure OK, you should enjoy the same number of years you would have had if you had never developed AS in the first place! That is good to know.

 

[epstns]

Hi, Doc! I'll certainly be watching your story. I had my aortic valve replaced via median sternotomy 5 1/2 years ago at age 63. I have an Edwards tissue valve, and watch the TAVR story unfold in case I live long enough to need another valve replacement. If TAVR is viable when I need it, that would be neat.

 

[docsmith]

Well it is Thursday September 22 and I got out of the hospital ICU last night I was told by my Cardio that I was the first person ever discharged directly from the ICU..I feel pretty good but I am very sore in my groin and neck (not to mention my genitals from the Foley catheter in my urethra.) I put on 18 pounds in 30 hours from the saline drip and that will restrict my breathing till I get that off. The procedure apparently went well and my ejection fraction is now almost 60 from a presurgical 45. I am told that it may increase more after I can move about. For those who have struggled with the choice between a femoral approach and open ( and I have had both) this is certainly easier so far. I can begin exercising in a week and will start cardio rehab the week after. My surgery was done at Medical City in Dallas by Bruce Bowers and I have been impressed with the whole team. I have had 7 stents and 6 way CABG and this group was remarkable. They have been participants in both Partners studies and have almost 1000 case histories. I would highly recommend that anyone considering TAVR go to an institution with significant experience... It reduces the risks and smoothes the process. The lines and catheters in the carotid caused the most discomfort but we all get used to these things when we are suffering. I am still tired but I will post more when I am more coherent. I know we all live with dread over having to submit to these invasive procedure and I just wanted everyone to know there is light at the end of the tunnel...I am walking and breathing better and for the first time in a year I am not dizzy every time I get vertical. Thanks to everyone for their thoughts and prayers. This website was very comforting to me preparing for this procedure

 

[pellicle]

Great news doc, glad to read it went well

I hope your recovery is smooth and your remission lengthy.

 

[neil]

brill news doc,

 

[Eva]

Very happy for you. Wish you speedy and bumpfree recovery.

 

[Agian]

Wonderful.

 

[epstns]

Now that's something! Discharged right from ICU? Heck, I was in ICU for days. . .

We will most definitely be watching your continued success, Doc. Thanks for posting.

 

[Twobike]

Glad everything went pretty smooth for you. I was also told that the stay might just be over night if I get the TAVR. Last I heard from Shands, it will be a couple of weeks yet, then getting testing up to date. I still have my fingers crossed that I will get the TAVR instead of SAVR. Thanks for keeping us informed on how your doing. I think I will be at least a month behind you.

 

[docsmith]

I'm in day 3 post surgery and still making good progress. I was told by my docs to expect to be in the hospital for at least one day in the ICU and the at least 2 says in the step down unit. Frankly, I was really surprised to get liberated so quickly. My experience was that the team treats this like an open procedure with a cardio thoracic surgeon in the theater on standby to convert to an open procedure if necessary. I was prepped like an open procedure and received a general just like my CABG. The total time in the operating room was 3 hours. I am pretty bruised in the left femoral area ( this is the side that provided access for the device ...a Edwards Sapien3). As I said earlier the only real pain so far has been at the catheter sites. Since I have been opened in the chest 3 times in my life there is no question in my mind that TAVR is superior in terms of patient recovery. Twogbikes,hope you get in as soon as possible. It is going to be exciting to see how much of a difference this makes in my ability to function. Up next for me is adding a third wire to my pacemaker but that will not be until after the new year. I am almost bionic now..it is wonderful how science keeps old guys alive and functioning...now if there was some way to wrap all of this equipment in a perpetually youthful outside life would be amazing. I hope this discussion helps others to make the decision that can restore the quality of life we all hope for.

 

[Eva]

Thanks for sharing such a positive story! Count your blessings and may you continue to feel better and bionic! Enjoy your new you, and we would love to hear more about your progress.

 

[pellicle]

Hi
Thanks for the update

Since I have been opened in the chest 3 times in my life there is no question in my mind that TAVR is superior in terms of patient recovery.

Indeed ... three times makes you a higher risk patient.

Glad it's going well