Aortic Root Surgery

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R

Ross-n-97

Well friends, after almost 11 years of totally worry-free living, the time has come for more work. Sometime in March I will be having surgery to replace a dilated section of my aortic root. The root wasn't touched 11 years ago when they did the Ross on me. At the time, dilation wasn't something they normally addressed. Of course, as fate would have it, now they know better and do it all at once! Oh well. At any rate, I covet your prayers. Its better this time because I know what to expect. However, its worse this time bedcause I know what to expect. Did you catch that? I know what to tell the future "Rossers" but this is a little different. Any advice from the ones that have already done the "aortic root thing"?
 
I didn't have the Ross, so I can't address that, but I did have the combined aortic valve and root replacement. I remember, when my cardio first explained that I would need something like that, wondering to myself, "Can they actually do that?" :D Well, yes they can. I am three years in, and doing well. I guess it's frustrating to have had the original go-round when the medical technology was not where it is now on the dilation issue, but the good news is that this is quite common now. There are others here as well who had "Bentall's Procedure," as it's called. I wish you well as you go forward.
 
I have no sage advice, but wish you the best. Be sure to let us know when you have a date, so we can put you on the calendar!
 
First, sorry that you have to go through crap again. Although I know you'll be fine, its a pain to go through. Oaktree is right, there isnt any difference from your viewpoint from the operating table. There are many people here on VR that have the aortic root thing done and are doing great. I suspect you will also. Like the Ross, your surgeon needs to experienced in managing this area with expertise.
 
Limitations?

Limitations?

Does anyone know about limitations following this surgery? AFter my Ross, I had practically none and have done pretty much what i want for 11 years. Not sure about the backside of this type. Thoughts??
 
Hi there -

Something about your thread reminded me of something I had read here some time ago and I just remembered what it was. There is a member here, Bill Hall, and you may want to search some threads he started when he was in a slightly similar situation as you are finding yourself in. You can go up to Members List and find his name and click on it and then click on finding the threads he started. There are at least three of his threads that I think you may find helpful, between his experience and other members' posts also. Take care and let us know what you find out. Hoping things go well for you.
 
I don't think there is anything about having your root replaced that puts any special restrictions on you over a pure valve replacement or ross.

I had my root replaced as part of my avr/aneurysm by bentalls.

From what was explained to me the root is where the arteries to the heart are connected to so this is an extra step that some surgeons do not want to do as they need to cut the arteries and a little ring of root tissue from their place and then stich the tissue to the new root.

There is a risk relating to the skill of the surgeon to do this properly and there is a risk post surger with scar tissue blocking these newly created 'tubes'.

But post surgery i don't think it places any additional restrictions on you.

Not sure what your new 'root' will be made of and wether it will have an impact on your medication re warfarin....do you get a cow/pig/human root or a dacron type root?

Sorry you have to go through this but it makes me glad i found this site and asked/pushed further as the first surgeon i spoke to did not want to replace my root either and that was only 1 1/2 years ago.

Regards.
 
Root material

Root material

Well, the surgeon is the same guy that did my Ross. He is an excellent surgeon at University Cardiothoracic Surgical Associates in Louisville, Ky. Taking care of the root was not something they did much back 11 yers ago. Anyway, they are planning on using a Dacron graft to replace the bad part. Thoughts?
 
I think Dacron is widely used. Also, I know of no extra restrictions I had beyond those for folks who had standard valve replacements. I hesitate to say too much, though, because I'm not coming off a previous Ross procedure as you are. As suggested here earlier, you might want to look up Bill Hall's posts.
 
Thanks

Thanks

Sounds like you and I have similar issues, minus my Ross. My surgeon is excellent and I trust him totally. I was just curious if anyone had the Dacron and you do. Information is really hard to come by about these heart topics. Thank goodness for this site! Thanks again. I will keep everyone informed.
 
I am looking "forward" to a similar situation as you.... I have had a new aneurysm develop post RP and will most likely at some point have to have it fixed via OHS.
My RP is fantastic and there are ZERO issues with the valves, yet the new aneurysm has got me wondering how this will all turn out...... As you said about the root. They didn't do much with the rest of the aorta for bicuspid patients when I had mine RP done. It has become a very well known fact concerning bicuspi aortic valve patients that they can very easily develop aneurysm's following their valve replacement surgery. When I spoke to my surgeo a couple years ago, he said he now replaces the entire acsendign aorta and arch in almost all of his BAV patients.....I wish I was one of those that had it replaced!!!!!!!

As long as you have a good surgeon and you are comfident in their abilities....you will turn out just fine!

God Bless.

Ben
 
Hi there,
I recently had an aortic valve repair and an aneurysm resection replaced with a dacron graft. I believe my root was "remodeled" but I still have the dacron replacing my entire ascending aorta. I was told, in terms of restrictions, that I would never be able to lift weights, basically anything over 40 pounds, for the rest of my life. I guess because of the graft coming loose? I am not sure...anyone else with aortic aneurysm and dacron graft that received similar restrictions? My husband and I were talking about this.....having these restrictions "for life" can be really overwhelming because even my nephew weighs over 40 lbs and I used to pick him up all the time....not to mention that my harley weighs over 800 lbs! Oh well, guess the object is to keep the Harley upright and NOT have to pick it up!
Can anyone clarify the weight lifting restrictions on those of us with dacron grafts/aneurysm repairs?
 
My Dacron graft is in the descending aorta, different from the other descriptions here I believe, and pre-valve replacement my doctors all displayed various degrees of pleasant surprise that it was all still in good condition, from its repair about 25 years previously.

I didn't know whether to be happy with them, or to wonder why they were so surprised.
 
Got weight restrictions for a while after surgery but at my last cardio checkup got a qualified all clear.

I can lift whatever i want as long as i don't have to hold my breath for a period of time to do so....as long as i can breath while lifting its ok. No purple face straining.

So lifting my son's, household furniture, computers etc all fine.....holding the car up while someone changes the wheel is not a good idea :)
 
Oaktree said:
But that's not the fault of the graft, nor does it mean that we shouldn't have gotten the graft. It's the fault of the funky aortic tissue that we have. That dacron graft is our only option if we want to go on living instead of keeling over from a rupture or dissection.

So now we're back to realizing that we have limited choices. Dacron is not as good as healthy aortic tissue, but healthy aortic tissue isn't one of our options. Our options are either to stick with our OEM funky tissue or switch to dacron.

The problem is that only the funkiest part of the funky tissue gets removed in an aneurysm resection, and the cut end of the aorta that the dacron sleeve gets sewn to may not be all that strong, either. We have to be protective of what aortic tissue we have left. I've been through aneurysm surgery twice, I don't want to go through it again.
Click to expand...

Interesting oaktree. This post actually ties in nicely with my 10/12 week review that i am just back from. My ascending aorta was 4.5cm when my valve was being replaced for my AVR re-do 10/12 weeks ago. My surgeon had me prepared for either a Bentalls or an asending aorta replacement.

But when he went in, he discovered very "normal" strong aortic walls (thus aneurysm being caused by the re-gurgiataion and not the the BAVD itself), and no dilatation anywhere else.

He felt the best option for me was to conserve my own tissue and do a "reduction" aortoplasty" (used for small-moderate aneurysms) which reduced the size of my ascending aorta to less than 4cm. He explained to me today, that he felt this was the better option. He said that he would be very very surprised if it were ever to dilate again - particularly given the fact that the walls are strong and a new mechanical valve functioning normally.

When i asked, "why even take the chance"?, he exlained of the greater risk of getting an infection with a sleeve/graft....and the importance of maintaing one's own tissue if it is safe to do so. Bottom line...I didn't need it.

BTW he this guy has been operating since the 1970's and is an aortic specialist who does alot of Bentalls very successfully.....plus with my surgery being filmed it wouldn't have been good for his street cred to take the easy option :D well that's the story i'm sticking to anyway!! :p

There are very few threads/posts on VR about this procedure, probably because it is not a good option for larger aneurysm's, thus we don't see a lot of it. I think "Bac Doc" had this done recently also.
 
My graft is Gortex.:) I have lifting limitations because they're worried I'll tear the rest of my aorta (like others have mentioned). But that's because I have some type of connective tissue disease like Marfan's that makes another tear more likely. I guess it all depends on what caused the aneurysm in the first place.
 
Magic8Ball said:
I can lift whatever i want as long as i don't have to hold my breath for a period of time to do so....as long as i can breath while lifting its ok. No purple face straining.
Click to expand...
I think this is the main item they are speaking of when giving the advice of no lifting weights post op.
Obviously, when you still have an aneurysm they mean it directly and specifically. But I wouldn't be too worked up over being told to not lift. Just be sure to breathe and not over strain.
 
Lifting

Lifting

Well, i don't have any tissue issues that I am aware of. This dilation came about because when the valve was corrected, it was affected by the greater pressures over time. At any rate, thanks for all the advice! The only concern I have is that I won't be able to lift my children! Other than that, I don't really care. Heart cath March 3rd. I will keep you posted. Thanks again!
 
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