New member valve damaged by reactive arthritis/Ankylosing spondylitis

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T

terence

Hi there,

My name is Terence, I'm 34 years old and live in Wellington, New Zealand.
In 1999 I developed Reactive Arthritis (ReA), which may or may not have turned into ankylosing spondylitis.

While I've finally shaken most of the more regular symptoms of ReA (i.e my joints are mostly fine) at some stage in the past the same inflammatory process which left me immobile has damaged by aortic valve and ascending aorta.

The result: valve replacement surgery, possibly accompanied by replacement of part of my ascending aorta, probably occurring mid-late August 2008.

It has been a comfort to read some of the really positive posts on this forum, as well as to learn that - as remarkable as it may seem - valve replacement is practically routine surgery. :)

In my case there are a few complications. The first being that Reactive Arthritis is a relatively rare cause of aortic valve damage. So there aren't many surgeons out there who have operated on people in situations like mine. Which shouldn't matter too much except that we are currently uncertain whether there is still active inflammation in the vicinity of my aorta. If there is, it isn't the end of the world, although it does present something of a conundrum. It isn't a great thing to be operating on inflamed tissue, nor is a great thing to be operating on someone who has been taking medication (like steroids) to dampen inflammation.

The second complication is the possible need to have part of my ascending aorta replaced. If it's a small part it's no big thing, but my understanding is that if they have to replace a larger strip, surgery becomes much more complicated and the heart lung machine less easily operated. Even taking this into account replacing a large section of my ascending aorta, hopefuly, isn't the end of the world. The odds of survival are still strongly in my favour. But I would be lying if I said I wasn't worried.

So, if anyone out there has had a valve replacement accompanied by a large chunk of aorta being replaced too, I'd love to hear from you. I'd also love to hear from anyone who has had valve replacement as a result of Reactive Arthritis or Ankylosing Spondylitis.

Thanks and thanks for such a great forum.
 
Welcome! I'm sure many will be along to help you with your concerns. Please let us know when you have a definite date for surgery so we can add you to our calendar and in the meantime, read as much as you can in the valve choice and pre-surgery threads.
 
I can't offer any insights or experience on your situation, but welcome to the VR community. I'm glad you found us. I'm sure others will be along shortly with some experience or insights to share. Best wishes and good luck.
 
Hi Terrence and a big Welcome!...

I only had the standard "Ascending Aorta" replaced with my dodgy valve...have you been told exactly how far along they are looking to replace your Aorta? I had the Bentalls procedure and have recovered perfectly after a bit of a hiccup.

Another thing that will probably be of interest to you is the great debate between mechanical and tissue valves....as you have Arthritis I am assuming you take various drugs to combat the pain...Mechanical valves and NSAIDS do not mix well together so that would be something for you to discuss in detail with your Docs.

Its great to have another member from this side of the world...I hope you find lots of new friends and useful info here.
 
Thanks Netmiff, Cooker and Wayne :)

and thanks too Aussigal,

I think I will go the mechanical valve route (aged 34, so it seems to make sense). I can't take NSAID's anymore as it is (and don't need them at present either, thankfully). So that's not a huge issue.

As for how far up the aorta - that's the big question. Maybe just the root; maybe they'll need to get at the arch too. And my understanding is that will make a big difference. I'm really hoping that I'll only need the valve done; or the valve and the root...

I'm definitely enjoying meeting you all.
 
If you are only looking at the beginning of the Aorta ie: the root , then that is a good thing...The ascending aorta is the bit between the root and the arch and there are lots of us on here who have had this done. There are those here who have work done all the way up to and including the arch ...if you do a "search" some posts should pop up.

I had an aneurysm in the ascending aorta which is why mine was replaced. Mind you it was a helluva shock to find out it was there. Have you been scanned to see if you have an aneurysm ?...its quite common around here (@vr.com) .

PS.I'm so pleased you arent reliant on NSAIDS.
 
Terrence, Welcome! I don't know anything about ReA/ AS, but did have several inches of my aorta replaced/repaired.I hope your inflamation is history, and you will have a "routine" surgery, and recovery. I never got a diagnosis that I felt sure of, and am always interested by the causes of valve failure, and anuerysm. I'm sorry about yours, but really glad to have you here telling your story. Brian
 
Thanks BDMc.

Thanks Aussigal,

That's the big question for me really - will the arch have to go too. I might learn more when I visit my surgeon this Thursday.

To be honest I don't know if I have an aneurysm. If the term, aneurysm, includes any dilation of the aorta, then I certainly have this. If it means more of a 'bubble', I don't know. It's hasn't been mentioned to me, but I will ask on Thursday.

cheers and I hope the weather is warmer on your side of the Tasman than mine (3 weeks of rain and counting). :)
 
Hello fellow kiwi - surely the bad weather down there is bringing in the surf.

I had the Ross procedure and had part of my aorta dissected. Sounds quite different to you - but my ascending aorta was quite large to cope with huge volume pumped out by my heart.

Who's your surgeon down there? Have you spoken to Raudkivi in Auckland? He's a top surgeon.
 
Hi there Leroy,

Nice to hear from a fellow New Zealander.

My surgeon is Barry Mahon, who I have heard good things about and who has been good to deal with thus far.

My aorta is large as well. Was yours replaced or just repaired?

Why did you go for the Ross Procedure?

cheers

Terence
 
Hi Terence,

I don't know of Barry Mahon but you have to do you research on the surgeon. NZ has some fantastic surgeons - Sir Brian Barrett-Boyes had a hand in everything important in heart surgery and there are many following in his footsteps at Greenlane.

When it comes to valve choice you need to read a lot - like Ross the administrator says on this board - follow the choice from the arguements that rings truest to you. For me at 36 and being very active and somewhat careless; I don't think I could sustain 40+ years of Coumadin management. The pig valves gaurantees further surgery at my age. The Ross was my best hope for an active life without the drugs.
The surgery is tricky and the surgical risks double. I think Peter Raudkivi is the only doctor in NZ on the Ross registry - he's done about 150 of them.

My ascending aorta was big but the tissue was hi quality. Stelz simply snipped it down and sewed it together - much like darning a sock. I have the photos and video of everything if you want to see.

Are you on the list for surgery or are you going private? I had an MRI done at Auckland University - it pretty much showed everything the surgeon needed to see.

Spot ya
 
Hi Terence ~ Welcome to the site. Sorry i'm late in my welcome, but i was in the hospital until Friday and am just now feeling good enough to reply to other people's posts. It's nice to have you here!
 
Hi Dawn-Marie,

Thanks for the welcome and happy to hear you are out of hospital and able to type :)

Thanks Leeroy,

I appreciate hearing your thoughts on valve choice. When I speak to my surgeon I'll ask about aorta snipping too. I'm definitely hoping to avoid having too much replaced (at the same time, though, I need to accept that if it needs replacing, that's what it needs).

I'm going private (Wakefield here in Wellington).

I think, at this stage, I'll pass on the video - wouldn't want to spoil any surprises ;)

Are you a cyclist? My sister used to road cycle competitively. Me, I'm just hoping to be surfing again after surgery. How do you find cycling now?
 
You'll be back surfing no worries - your sternum healing will hold you back for a while though. Your not going to be able to swim until it knits properly.

My heart rate is restricted for 6 months but I'm riding over 3 hours already.
My fathers mate does round lake taupo every year - he had a heart transplant.


Thanks Leeroy,

I appreciate hearing your thoughts on valve choice. When I speak to my surgeon I'll ask about aorta snipping too. I'm definitely hoping to avoid having too much replaced (at the same time, though, I need to accept that if it needs replacing, that's what it needs).

I'm going private (Wakefield here in Wellington).

I think, at this stage, I'll pass on the video - wouldn't want to spoil any surprises

Are you a cyclist? My sister used to road cycle competitively. Me, I'm just hoping to be surfing again after surgery. How do you find cycling now?
 
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