AVR w/ Dr. Smedira Cleveland Clinic Aug 9

[pat45750]

Hi

I am new to this group. Found out I had a heart murmur 6 years ago when I was in Belgium to get a hip resurfacing. They told me it would be 20 years before it would bother me. I am now 65, will be 66 in July.

Guess they were wrong. Had a heart echogram 2 weeks ago and found out I had severe aortic valve stenosis. I have been getting short of breath and almost fainting after doing much work lately. I got in contact with a surgeon friend at Cleveland Clinic who refered me to Dr. Smedira.

I talked with Dr. Smedira's office and they called me today saying they have me scheduled for surgery Aug 9. I am going to have minimally invasive surgery with a tissue valve - if at all possible. I go in for tests the week before surgery for a heart cath and other tests. I have never had any of those done. They hope that all will go as planned since I am in good health and never had any problems before. I have arthritis and would like to be able to take NSAIDS and other meds when needed so I did not want to be on coumadin for the rest of my life if I had a mechanical valve.

I wonder if anyone else has used Dr. Smedira? How did things go?

I have a large website about hip resurfacing and great discussion group. Being able to talk to others that have had the same surgery and problems is very helpful to perspective patients. I am very grateful to those that help each other on my website and I am sure I am going to be very grateful for those that will talk to me here about valve replacement.

AVR looks a lot more serious to me than a hip replacement. I helped my ex thru his last bypass surgery, so I know it is not a walk in the park to go thru heart surgery.

Any information that you would share with me would be very much appreciated. I am surpirsed to have to be posting here and learning more about valve replacement. Not something I had ever thought of before. Thank Goodness for the internet and the many kind people that are willing to talk to others. Thank You for any information or help you can share.

Pat in Ohio

 

[hall]

Hi Pat and Welcome. I do not know anything about Dr. Smedira but I know the clinic is a great place to go for AVR. Sorry you had to find the forum for this reason, but glad to hear from you. I am sure you have many questions and this forum is a wealth of information. Ask away.

 

[Mentu]

Pat, welcome to VR. I can't help you with questions about Cleveland but there are plenty of people who can. If you have had hip surgery, however, you are quite likely to find that valve replacement is less troublesome. You can expect to be up and walking around a day or two after surgery and walking easily soon after that. When you get home, there are some restrictions with respect to lifting and motion because the chest muscles must be allowed healing time. Recovery goes pretty quickly. Many of us do encounter minor issues during recovery but those seem pretty insignificant next to being able to walk without loosing ones breath or getting dizzy. On the whole, most of us feel a lot better from the first time we wake up in recovery. For now, take care.

Larry

 

[Ross]

Hi Pat and welcome to the insane asylum.

I can testify to the fact that hip replacement/repair is much more painful then OHS. OHS is not near as bad as your imagining and actually, you may wonder what all the hubbub is about once you've done it.

I'm sure someone will be along about Dr. Smedira, though I can tell you if you have anyone at CCF, your in the best possible place you can be. While I agree with your choice of tissue, I would highly recommend learning the truths of Coumadin while in the waiting process. Far too much myth is propagated by the medical community and others about the drug. Reason I say this is, you'll need a backup plan incase your first choice is a no go and also, should you develop chronic Afib as a result of surgery, your going to be on Coumadin anyhow.

 

[pat45750]

Thank You to everyone that has taken time to reply to my post. I appreciate the kind words.

It is nice to see posts from people in Akron and Canton - I assume you must be close to those cities since that is in your signature. I live in Marietta OH. Moved to Marietta from Cleveland in 1981. I figure that it is a good idea to go to the big city where the doctors have a lot of experince and specialize in heart problems.

I am happy to hear that this will be easier than a hip replacement! LOL That's good news. Some of my fears are based on helping my ex thru his heart attacks and then triple bypass. He had a very diffiuclt recovery with his chest being opened. I am lucky, I hope, to not have any other problems going into the valve replacement. I won't know for sure until I get all my tests at the end of July. I will keep my fingers crossed.

I have read some of the posts here about coumadin. I have arthritis in much of my body, sigh, and sometimes take NSAIDS or Celebrex. I assume as I get older, I will have more problems and read that most of those meds are not compatible with coumadin. I don't like the thought of having another valve replacement at 15 or 20 years, but that makes me 80 or 85 - so I am not going to worry about it now. Want to be as active as I can while I can. Dr. Smedira is suggesting a tissue valve.

I can see a lot of questions going thru my mind during the next 2 months. The doctor was going to be gone in July, so they said they thought I could wait until Aug. So that gives me lots of time to read and learn more.

Again, I appreciate the time the posters took to reply to me.

Pat

 

[Ross]

It's not that Coumadin isn't compatible, everything can be adjusted for, but they worry so much about bleeding and give little consideration to stroking. You can replace blood cells, but you cannot replace brain cells. NSAIDS and other stomach erroding medications (What doesn't anymore?) are something to watch out for and should be introduced with either a Proton Pump Inhibitor or some other stomach protection agent like Carafate. I won't go on and on about it, just wanted you to know in case something happens that you end up on Coumadin. I've seen a few people choose tissue to avoid Coumadin and ended up on it anyhow. Again, given your age, I'd go tissue myself.

 

[nngbwh]

Welcome aboard the VR family. I can't help you with questions about Cleveland but there are plenty of people who had surgery there.

Hopefully you should get the answer you needed.

 

[barbwil]

Hi Pat, I want to give you another welcome from Ohio (Warren) and say what beautiful friends with whom you are pictured in your avatar!! I had a mitral valve repair at CCF in 2005 at age 75 (wow what a slip of the finger-- first put 25--lol) and did very well. Last week I had my 8 year old pacemaker replaced by one with more "bells and whistles"; tomorrow I will go to get my stitches out. As others have said the initial apprehension when you are told they are going to mess with your heart is by far worse than the actual experience. I'm also on warfarin for A-fib and it's really no big deal except to the doctors who make it one!

 

[pat45750]

Hi Barb

Thank You for the welcome. It is great to hear how well you did at 75 years young! I will already sleep better tonight after reading everyone's comments.

I use to do websites for our local shelters and did a lot of dog rescue. I still have 10 dogs left from my work. Haven't done that for over 5 years now. It gets more diffiuclt to take care of so many as you get older. I shopped and bought 1 month of food and a neighbor friend brought it all in the house for me since I am not suppose to lift more than 10 pounds until after my surgery. So I am making plans so I will be ready. Still have 2 months to prepare - Thank Goodness.

Thanks again for your encouraging words.

Pat

 

[daveguy14]

How did this thread end up being about Coumadin?

You have what appears to be isolated aortic valve disease, and I have not heard of any widespread happenings where people go in for tissue and end up with mechanical. And at CCF no less. At 65+, tissue valves are the standard treatment.

 

[Lily]

Hi Pat - Welcome to the site. FWIW, I had a lot of various joint aches, here there and yonder, that must have been contributed to by my insufficient blood flow; a lot of strange little things, pains and some vision issues and such, resolved after I got the new valve. I know that's not the arthritis that you are dealing with but possibly some of your pain may resolve with a properly-functioning valve also? And I kind of think that, since most of us don't end up dealing with that enormous leg vein bypass issue such as with Coronary Artery Disease issues (like your ex-husband), our kind of OHS doesn't usually cause as much pain, for the most part anyway, and the recovery can be less-complicated. Just my opinion. And we all seem to have them around here. Anyway, hoping all goes well for you

 

[pat45750]

Thanks Lily

Every post is making me feel better about the upcoming surgery. I have had some vision issues - blurry and strange double vision and weird things that you just put off trying to analize or think about. Maybe I will feel a lot better after getting my valve replaced. At least I will be able to walk fast again and run up the stairs without breathing hard. It is strange how long things can start to go bad and eventually you accept them as normal. Happens with bad hips all the time until you are just sitting in a chair and doing nothing.

Yes, my ex had 2 heart attacks with much damage before his triple bypass. He was not in very good shape going into his surgery. I, on the other hand, am in pretty good shape and haven't had any heart problems up to now. I am very lucky and blessed.

Thanks again. I will dream about being energetic and really active again. I didn't think I should be slowing down this much at my age since I have been very active most of my life but you just start to accept things.

Pat

 

[ALCapshaw2]

Welcome to our World Pat !

You can't get any better than the Cleveland Clinic. It is rated as the #1 Heart Hospital.

They like the Bovine Pericardial Tissue Valves which do well in older patients.
Many early recipients who were in their 60's at the time of their surgery are approaching 20 years of service.
Porcine Tissue Valves have lower pressure gradients but tend to wear out faster.

As Ross mentioned, it would be wise to have a Plan B "just in case" your first choice is not viable for some reason once they 'get in there'. They won't be able to 'wake you up' in the middle of surgery to ask what would you like for your second choice!

'AL C'

 

[Bill B]

I lived in Cleveland for 13 years after getting out of school and worked at Case Western Reserve/University Hospitals of Cleveland. Great place. But as everyone recognizes, The Clinic is THE place for cardiac surgery. Yes, you absolutely should go to the big city for this operation.

And the prediction the doctors in Belgium made about how long you would go without needing surgery was a total guess. It's just way too variable, but it's important to get this fixed while you are still in good shape before any serious damage is done to your heart.

Good luck, but you should know you are going to do just fine. The odds are overwhelming in favor of a good result, especially at The Clinic.

Bill

 

[Luckyguy17]

Welcome Pat,

Am 2 1/2 weeks post OHS and recovery is well underway.

At 56 years, I chose tissue valve for AVR.

OHS is serious as you witnessed with your spouse, but as many have said, you are likely walking 2 days post op from OHS

all the best

Gil

 

[Ross]

How did this thread end up being about Coumadin?

If you'll read my posts, you'll see that I said she should make it a part of her education because there is always the chance that she may end up on it anyhow. Everyone should learn the real deal. It's not about Coumadin. Just a fair warning to possibilities.

 

[Sandi]

Welcome, I am having minimal invasive surgery on June 8th at Mount Sinai in Miami Beach. I am having the TEE and cardio cath day before, also getting the porky AVR. If all goes well with testing, the surgery will be minimal invasive. I felt soooo much better to know that this can be done and with all my symptoms, I know that this is my blessing. Anxiety is at a high level right now, but I want to be able to take a shower without feeling like I worked all day at it. I have only heard the very best of everything about the Cleveland Clinic. Good Luck!

Sandi

 

[pat45750]

Sandi - Good Luck with your upcoming surgery. I will be interested to read about your post op experience. I will keep you in my thoughts and prayers.

Gill - Thanks for the welcome. Glad to hear your recovery is going well. Hope everything continues smoothly for you.

Thanks to everyone for their messages.

Pat

 

[heartman77]

HI Pat....i have my AVR surgery this coming Wednesday June 9th and ill let you know how it goes...i have no worries...i chose the ST Jude Regent mechanical valve as i am 55.....dont have a problem with taking coumadin and dont want to need another replacement in my lifetime.....I have severe degenerative disk disease and arthritis and have had hip surgery. But because of GERD and a sensitive stomach i cant take NSAIDS. I take Lortab 10/500s and they help take the edge off the pain. I am near Buffalo ny and have a well known and respected cardiac surgeon and trust his skills implicitly. The hospital has WIFI so i may let you know how it went as soon as i am awake and can use my ITOUCH ....it so great to have the web to connect with others and share and learn from each others experiences. Stay in touch and keep smiling... Michael

 

[pat45750]

Hi Michael

Thank You for your note. Sounds like we have similar problems. I have degenerative disks too, but am getting along pretty well with that if I am careful. Guess it comes with the territory as you mature! LOL I don't take many NSAIDS since I know they are bad. Can take other meds that I have when needed that aren't NSAIDS.

I will follow your story. It is great to have the internet to talk with each other. I talk with a lot of people coming out of hip surgery when they are on wifi at the hospitals. Some of them are still pretty loopy - but it is good to know everything went well. It really helps to know how people are doing as they progress after surgery. I will do the same thing in Aug. Although family support is wonderful - it is also so great to talk to others that have been there and done that with valve replacement. They know exactly what you are going thru.

I want to wish you good luck! I will keep you in my thoughts and prayers next week. Thanks for sharing. Pat