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oscar1113

Member
Joined
Jun 14, 2008
Messages
14
Location
Columbus, OH
Hello All-
I am new to the forum and have been reading everything I can over the last week. Great resource!

I am 38 yo male and diagnosed in March with BAV with severe regurgitation. I am asymptomatic. Experiencing the same feelings others have documented and now ready to get things moving.

I've been to two cardios with similar reco - AVR in the next 6 months or sooner. My aorta measured 4.2 in March via TEE - I'm having my first surgical consult on 7/3. Very familiar with the questions to ask surgeon regarding experience with various procedures etc. Would like to stay local but may check out Cleveland Clinic.

Can anyone help with questions I should ask the surgeon regarding the aorta situation? One cardio says he would not do anything now at about 4.2, the other cardio suggested speaking to the surgeon given the mild anueryism. Had a CT yesterday and will have the results at the surgical consult. I am leaning to a mechanical valve and obviously not interested in a reop.
 
Welcome to our family.

I am not too familar with AVR and anuerysms but, from what I have read here, 4.2 is not all that small. In addition, I do not really understand why they would not repair it if they are going in anyway. I am sure others will chime in who know more than I do.

I just do not know how fast anuerysms grow but I would guess everyone is different. If you indeed go mechanical to avoid a reop, it makes no sense to me to ignore the anuerysm while they are in there.
 
Welcome,

I'm 39 and just have my OHS on May 12th to replace a bad aortic valve.

I went mechanical. The coumadin isn't that bad at all. I didn't have any anuerisms.

I didn't have any symptoms when I found out, but my valve was at .7 before my operation. I didn't want to risk anything. BEsides, now that I had the surgery, I'm glad I did while I was relatively healthy and younger. My recovery has had its up and downs, but right now, about 6 weeks out, I'm feeling so much better than I did 3 weeks ago.

What I did was keep a small pocket notebook with me at all time. In there I would write any questions that would pop into my head, or saw on this site. That way when you go to your doctor, you won't forget anything.

Feel free to email me if you have questions.
 
Hello Oscar and welcome!
About 10 days before my AVR my surgeon wanted a heart cath done.
My aorta was enlarged, and he said he would "deal with it" if necessary when he had me open. Nothing else was needed.
Just make sure your surgeon is very comfortable dealing with a possible aorta issue.
 
Welcome to VR, Oscar. Sorry for the circumstances but glad you found us. I don't have any advice on AVR and or anuerysms as I haven't experience with either. I just wantd to welcome you. Best wishes and good luck.
 
Hey Oscar...

I had a BAV with severe stenosis, no regurg or anuerisms. I see your in Columbus, Im just up the road in Worthington. We are similar in age as well, I've got 5 years on you. I can't help you with the anuerism related questions but I can tell you that it will be very worth your while to take the 2 1/2 drive up to Cleveland Clinic. My cardiologist was a member of the McConnell Heart Hospital which Im sure is a wonderful institution but when I started researching surgeons all roads point north to C.C. One of the first things that jumped out at me when I talked to my cardio is he told me that I would have an 8 inch incision, standard protocol at McConnell for OHS. My surgeon was/is extremely experienced with complex procedures and did all his OHS with a mini-incision, 4 inches. My motivation was to get the best possible surgeon, no matter what hospital it was. The small incision aspect was a great residual because I do think I recovered quicker than what I've read from others. I will be 4 months post-op in a few days and have felt pretty much back to normal for about 1 month now. And Im also able to jog now and not have SOB and chest pains :D

You don't necessarily need to go to C.C. to have a surgical consult. Once I finished my research I contacted the surgeons office directly and asked for a consult. I shipped my echo and EKG which he reviewed and let me know he would perform the surgery. I also went mechanical with an On-X. Seems there are 3 or 4 top mechanical valves and the On-X is the supposable latest and greatest regarding flow dynamics. My surgeon told me that if I hadn't asked for it specifically it is the valve he would have used. One item regarding this valve that I read is that it is a bit more complex to get properly seated due to its higher profile. If you choose this valve make sure to pose that question to your surgeon, how many On-X valves have you installed ? My surgeon told me he had done 50 of them and was very comfortable with the procedure.

How bout them Buckeyes ?
 
Buckeyes

Buckeyes

Thanks to all for the great information and support.

ctyguy - Glad to hear you are doing well after your surgery. I live just down the road in Dublin. I have a lot of questions for the surgeon on Thursday and will evaluate further once I speak with him. Go Bucks.
 
SIZE alone is not an adequate indicator of problems with the Aorta. Recent studies show a high correlation between BAV and Connective Tissue Disorders (CTD).

One result of CTD is WEAK tissue in the Aorta which can lead to aneurism(s) and the potential for Rupture or Disection.

The Common Theme I read in the Bicuspid Aorta Valve and Connective Tissue Disorder Forum is to find a Surgeon who has Considerable Experience with Surgery of the Aorta. This generally means going to a Major Heart Hospital. Local Surgeons who primarily do Bypass Surgery and a few Valve Replacements generally DO NOT have much experience dealing with Weak Tissue issues. Be SURE that the Surgeon you select is a Skilled Aorta Surgeon and not just a Bypass/Valve Replacement surgeon.

Note also that leaving an aneurism of 4.2 cm untreated, just sets you up for ANOTHER OHS when it becomes larger and in even greater danger of Rupture or Disection.

'AL Capshaw'
 
Hi Oscar, I'm 36 and a bit over three weeks post op and learning as I go. I had the Ross procedure and my ascending aorta was 4.9cm.
The tissue was fine so the surgeon simply cut the excess and sewed in a dart down to the correct size.
I have my surgery on DVD, the dart was very simple and didn't take long; about 10 minutes. I think the dacron graft adds another 30 minutes onto the surgery.
I've been back at work a week and feel fine. The hardest part for me right now is learning to hold back.
 
Hi Oscar -

Welcome! I'm a mitral repair person so no words of wisdom here other than welcome and enjoy the camaraderie and support of this wonderful group of folks.

I wish you all the best for a successful surgery and uneventful recovery!

Peace,
Ruth
 
Visit with surgeon

Visit with surgeon

Had an informative visit yesterday with a local surgeon about my situation.

The surgeon had my latest CT which shows my aortic root size at 4.5cm. He feels there is a chance to spare the aortic valve assuming the valve tissue is in good condition. I will also require an aortic graft to repair the aneurysm. If the valve tissue is faulty, I would need a new valve. I believe this procedure is called the "modified David reimplantation procedure". (I found this on the Cleveland Clinic website) The surgeon said this procedure has only been done for the past 18 months and is promising thus far.

It appears on the CC website that Dr. Lars Svenson is the man to see regarding this procedure. My wife and I decided last night its time to go up the road to Cleveland. The CC website says they've done 120 of these procedures so far with 0 mortality rate. I am interested in this course of action since it would mean saving the current valve, thus not requiring LT coumadin therapy. (Although I know from vr.com that this is not all that bad)

Is anyone familiar with this procedure or perhaps had it done?
 
Dr. Svensson is a World Class Heart Surgeon.

Getting his opinion is definitely a Wise Move on your part.

'AL Capshaw'
 
Hi Oscar,

On April 11 of this year I had my bicuspid aortic valve repaired, a 4.5 cm ascending aortic aneurysm repaired and a PFO closed by Dr. Svensson at the Cleveland Clinic. I am doing very well since the operation. The current thought on repair is that the patient is better off with their own natural valve, if possible. This is not always possible, however. The surgeon needs to determine that when inside.

I would highly recommend the Cleveland Clinic. It is a huge place but the staff and facilities are excellent and the surgeons are some of the best in the world. For a surgery like this you need to listen to the people on this forum, as I did, and go to the experts.
 
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