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priley

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I'm not looking at TAVR, I was looking at what they are doing at WVU Dr Badwar. Apparently he has done 50 Aortic valve replacements with 100% success. I watched a video on it, he was being interviewed by Adam Pick on heartvalvesurgery.com
Looks good--Is it?
 

pellicle

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Looks good--Is it?
well we don't know ... << that's the point

I *know* you aren't contemplating TAVR, but (assuming you're replying to my comments) but I furnished that another example of something new that was introduced to satisfy a specific need that's been taken up by the general public as being gold because it seems to involve less risk.

So my comments were a metaphor of something we are still gathering data on to this which is "something we have almost no data on"

Apparently he has done 50 Aortic valve replacements with 100% success.

this is a pretty meaningless stat (and that site you quoted if from is to me an unashamed shill) without knowing a lot more.

when I was 10 having OHS was new, but there were no alternatives other than known early death. Now we have a slew of good well known well tested methods and you seem to be fascinated by the one which has no history.

It might be better, it might even be "nearly as good" ... how do you feel about going to Vegas with everything you own.

 

Lucker

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What's here to win? Easier and faster recovery, probably lesser chance for surgical infection, probably easier future reoperation due to less scarring. What's to lose? Having a prompt open reoperation or worse if the robotic surgery fails.
The method appears to be good, but is also new and uncommon.
 

pellicle

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Good analysis angle

What's here to win?
Easier and faster recovery
probably

, probably lesser chance for surgical infection

perhaps ... but that's low anyway right?

, probably easier future reoperation due to less scarring.

what's your basis for this? Scar tissue isn't just the stuff at the wound, its where the valve gets taken off and put back on again too ...


What's to lose? Having a prompt open reoperation or worse if the robotic surgery fails.

so basically the risk is you have two operations instead of one (and increased risk of infection on the second surgery) for the benefit of a faint possibility of an easier recovery.

This has to be dancing bears risk analysis.
 

Lucker

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@pellicle
"perhaps ... but that's low anyway right?" - Differs from place to place, and if present can be very unpleasant, as you know, or deadly.

Also IMO scarring makes harder to access and distinguish the needed parts, not to cut them off. Since reoperations are likely more invasive procedures, having a "virgin" sternum and what's under should help.
 
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pellicle

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Also IMO scarring makes harder to access and distinguish the needed parts, not to cut them off. Since reoperations are likely more invasive procedures, having a "virgin"
Exactly

Like critical things such as the nerves on the heart that govern its beating. These are exactly where the incisions are placed for valve replacement.
The robot incisions will perhaps even scar more...j
 

priley

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Do these numbers mean anything to anyone?
Aortic Valve bicuspid aortic valve with calcific sclerotic changes.
Aortic Stenosis peak velocity 5.59 m/s with gradient of 125.4 mmHg. Valve planimetry 0.58 cm2.
Aortic Regurgitation regurgitant jet with regurgitant fraction of 30%.
 

Chuck C

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Do these numbers mean anything to anyone?
Aortic Valve bicuspid aortic valve with calcific sclerotic changes.
Aortic Stenosis peak velocity 5.59 m/s with gradient of 125.4 mmHg. Valve planimetry 0.58 cm2.
Aortic Regurgitation regurgitant jet with regurgitant fraction of 30%.

Aortic Stenosis peak velocity 5.59 m/s with gradient of 125.4 mmHg

5.59 m/s is high. A peak jet velocity across the aortic valve over 4 m/s is considered severe.

As far as gradient, they usually will specify peak and mean pressure gradient. Mean is the one used to grade severity. If the 125.4 mmHg is the mean, that is very high and severe, if not critical. But, without clarity on whether it is the peak or mean I can't say.
Valve planimetry 0.58 cm2.

This is your aortic valve area. A normal valve area is 2.5 to 3.5cm2. Once it drops below 1.0cm2 it is considered severe aortic stenosis. Once the valve area drops below .70cm2 it is considered critical.

I expect that your surgeon is going to want to operate right away once he evaluates these numbers. When is your follow up consultation?
 

Timmay

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In my opinion, those numbers are bad. Get surgery sooner rather than later. Chuck pointed out everything above so I won't repeat ... except to say that 125 is super duper high. Not saying this to scare you ... but to increase urgency in your mind.

You're actually not too far from me (geographically). I had my aortic valve replacement done at Washington DC hospital, MedStar by Dr. Christian Shults. Dr. Shults did a good job (at least that's what my life is showing). That said, I cannot recommend that hospital. Although they have good success rates, I was more of a number there rather than a human being. My experience with that hospital was not a good one (and that was a little over 3 months ago).
 

priley

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I'm trying to get a response from the cardiologist. I've been trying since the test. His nurse says it doesn't seem critical. I have been in touch with the Cleveland Clinic and am trying to get a cd of the ECHO from the cardiologist. They told me it would be $25 and 2 days to get it. Unbelievable but I paid them their much needed $25 up front as requested. Waiting on them to tell me the CD is ready. I have the one from the MRI. When I get everything together CC wants them. I have also contacted Dr Badwar's office at WVU. I have an appointment at the local valve specialist on the 21st but I don't see me getting them to do this. I think I've narrowed it to Dr Badwar at WVU or the Cleveland Clinic. I'm not waiting for anything except for Dr's to get back with me so I can get this thing behind me. Not looking forward to it but am not procrastinating either, Just want to make the right choice. I thought I was heathy as a Bull a few weeks ago. Timmay, You are right up the road from me, I just finished the new Northgate Fire Station in Frederick.
 

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