Anyone had 3 valve replacement surgeries?

[TomM]

Did the aneurysm drive the reoperation?

In January 2020 I had a regular appointment with my cardiologist who noted my ascending aorta was close to the limit for requiring surgery but not needed yet. In late October 2020, at night when all was quiet I could hear an unusual swishing with each heart beat. I asked my wife to put her ear to my chest and we figured it was best to go to the GP (local doctor). I was admitted to hospital that day. I was treated for an infection for a week or so until a trans osopheagal echo was done. One of the leaflets of my heart was pretty much flapping around. There was no infection.

I was personally worried that I'd wake up with a pacemaker

When I woke up in 2004 after surgery I got upset seeing two leads coming from my chest. I thought it was a permanent pacemaker. That would have meant for me the risk of going for a homograft was not worth it as I would have been limited in my lifestyle at that age.

I hope neither of us need reoperation

Out of interest to the group I'll share the following. After the mechanical valve was installed in 2020 I started taking warfarin. When I was discharged from hospital I was discharging blood when I went to poo. It turns out I had a large polyp in my colon, that turned out to be cancerous. If I did not take warfarin I would surely not have known anything about this. I don't think I'm lucky in fact I think I'm blessed. I needed a section of my colon removed. That surgery went well and fingers crossed that will be that with surgeries.

I'm sure I paint a picture of a very sickly guy. I'm doing alright considering and to demonstrate some bit here's a photo of me taken this summer just gone.

 

[pellicle]

That surgery went well and fingers crossed that will be that with surgeries.

Thanks for sharing that with me (and us).

It was a story of good luck as well as a testimony to your resilience.

I wish you well for the future.

(and no, I don't consider you sound any more sickly sounding than me.)

Best Wishes

 

[Chuck C]

It was basically a lifestyle choice. I was 22 at the time and wanted for playing contact sports and to socialize without impediment. I played Gaelic games and though not at a high level I really enjoyed playing. I was given the option of a Ross procedure, homograft or mechanical valve. Information on these was not as readily available to me back in 2004 as it is now. I had no internet at home when making the decision. I ruled out the Ross procedure though this is what the cardiac team was pushing for and for the lifestyle reasons above I chose another homograft. I guess to put it another way I was young and had great intentions of "sowing my wild oats" though with relatively only minor success as it turned out . I was aware of the consequences of the decision. I guess if the cardiac team had put more emphasis on a mechanical valve rather than the Ross procedure I would have considered this option and went with the mechanical valve. In fact, now that I think back on it, I was left to make the decision up until the morning of the procedure. When I didn't choose the Ross procedure the surgery was postponed until later that month. The reasoning they gave was another patient was in need of surgery.

@pellicle I'm 40 years old now.

Thanks for sharing your story TomM.

I guess to put it another way I was young and had great intentions of "sowing my wild oats"

And I thought that I had already heard every warfarin myth under the sun.

"Young man, now that you are on warfarin, your days of sowing your wild oats are over."

In my view, you made the right decision in choosing the homograft over the Ross. They both have about the same track record, in terms of how long the valve lasts in the aortic position, but with the Ross you end up with a 2 valve problem instead of one, typically 20 years down the road. It's unfortunate that your first homograft only lasted 5 years, which is not typical. But, you have a great attitude in how you are accepting the hand that you've been dealt and it sounds like you live your life to the fullest.

 

[carolinemc]

100% agree, anyone can find a study that validates their viewpoint (Which I see over and over on this forum).

TO ANYONE READING THIS FORUM LOOKING FOR ADVICE ON WHICH VALVE TO CHOOSE:

A surgeon (and/or cardiologist) with years of real world experience combined with years and years of education, the ability to evaluate your entire medical history, your unique medical situation (maybe you have other conditions or family history that would complicate a receiving a mechanical or tissue valve), your personal preferences and desired lifestyle after surgery, your desire or ability to follow anticoagulation routines now or in the future, knowledge of cutting edge medicine and how it could benefit you... and then backed up by a world class support system/facility... will be much better able to advise you on which valve is best for you and your unique situation than some random guy/gal on an internet forum who, no matter how many old studies they drag up on Google, is in no way qualified or equipped to do any of the above.

It's your life people, be smart about it.


My advice:

1. Find the best cardiologist and surgeon you can find and listen to their advice.

2. Prepare for surgery the best you can (for both before and after and what to expect). THIS FORUM IS EXCELLENT FOR THIS!

3. Go to the best high volume valve surgery center/hospital you can.

4. Spend time with people that matter to you.


What not to do:

1. Waste time going down internet rabbit holes that will stress you out when you could be doing something productive, like preparing for surgery or spending time with loved ones.

2. Take advice from unqualified internet people over the advice of your doctors and surgeons.

3. Let unqualified internet people sow distrust between yourself and your doctors and surgeons.

I HATE TO BURST YOUR BUBBLE, BUT MANY HERE TALK FROM MANY YEARS OF EXEPRIECNE OF TALKING TO SURGEONS, NOT UNSOUND POLLS TO GET MEDICAL ADVICE. I never give unsound advice, since I was born with Aortic valve defect and had it replaced with a ST. Jude's' aortic valve. I would rather people here talk to the professionals than just looking it up from unreliable sources from internet. I got great advice of how to deal with after surgery here on this site. And when all possible, talk to the cardio and surgeon. Do not knock down us that have been here advising others for years. We always say to go reliable sources.

 

[TGM]

My son, aged 20, has 2 prosthetic valves (one tissue and one mechanical). He has had 4 OHS (1) Septal defect closure and pulmonary valvotomy in 2003 (2) placement of St Jude’s mechanical in the mitral position and homograft in the pulmonary in 2007 (3) failure of homograft which was replaced by a Hancock II porcine valve in 2009 (4) double valve replacement with another set of St Jude’s and Hancock II in (2018). That last surgery was extremely challenging with numerous complications and some extremely scary moments for this traumatized parent but thankfully he is on the other side of it and managing his INR pretty well on his own while away at college.

 

[pellicle]

and some extremely scary moments for this traumatized parent

Hugs

 

[Earthsciencerocks]

In January 2020 I had a regular appointment with my cardiologist who noted my ascending aorta was close to the limit for requiring surgery but not needed yet. In late October 2020, at night when all was quiet I could hear an unusual swishing with each heart beat. I asked my wife to put her ear to my chest and we figured it was best to go to the GP (local doctor). I was admitted to hospital that day. I was treated for an infection for a week or so until a trans osopheagal echo was done. One of the leaflets of my heart was pretty much flapping around. There was no infection.

When I woke up in 2004 after surgery I got upset seeing two leads coming from my chest. I thought it was a permanent pacemaker. That would have meant for me the risk of going for a homograft was not worth it as I would have been limited in my lifestyle at that age.


Out of interest to the group I'll share the following. After the mechanical valve was installed in 2020 I started taking warfarin. When I was discharged from hospital I was discharging blood when I went to poo. It turns out I had a large polyp in my colon, that turned out to be cancerous. If I did not take warfarin I would surely not have known anything about this. I don't think I'm lucky in fact I think I'm blessed. I needed a section of my colon removed. That surgery went well and fingers crossed that will be that with surgeries.

I'm sure I paint a picture of a very sickly guy. I'm doing alright considering and to demonstrate some bit here's a photo of me taken this summer just gone.

Love it! So good to hear of similar stories of decisions made and reasoning for surgical choices! Surviving 4 puts my perspective back on life and less focus on meeting my maker "prematurely." God must still have plans for us.

 

[Mr V]

I have only had 2 but they were only 4 days apart. The first one was a mitral valve repair. I had hoped to avoid the lifetime of warfarin by having the repair done. Repair has probably advanced a lot since 1996. I had made it out of the ICU and was in a regular room on the heart floor when I woke up with what I thought was heartburn. When it got worse the did an echo and I believe one of the flaps was blocking something else causing fluid to back up into my lungs. Cardiologist turned up the temporary pacemaker thinking maybe it wouldn't block if the heart was beating faster. That has to be one of the strangest things I have ever experienced. I was breathing fast for hours and it felt like I wouldn't be able to keep breathing with my chest muscles wearing out. So back to the ICU and a TEE while the cardiologist tried all the things that would usually get this to stop. When none of that worked they intubated me and waited for a operating room to open up. The surgeon thought he knew how to fix what was going on with another repair but they decided not to chance it with my oxygen levels dropping to around 10% before I got into the OR. Guess GOD was not ready for me yet. After what my wife went through she did not need to hear them tell her they were surprised my organs hadn't started shutting down. They didn't find any brain damage although my wife disagrees with that . I never hear my valve unless I listen for it. Probably helps that I use a CPAP so background noise anyway. It's my restless legs that keep me awake now. My ST Jude valve has been working great for 26 years now and GOD willing, hopefully can another 20 years out of it.