Bypass with Valve Replacement?

[Anne-Marie]

I met with my surgeon yesterday and he told me that it appears that one of my arteries was also damaged by the radiation (or possibly chemotherapy) that damaged my aortic valve. He said the angiogram will give them a clearer picture, but he will probably do a bypass using an artery from my left arm. He said my mitral valve also shows a mild regurge.

I know there are a few people here who have also had radiation to the chest, were your arteries affected? Has anyone else had bypass surgery?

 

[jackc]

Bypass with Valve Replacement?

Hi Anne-Marie,

I had a triple bypass but went into surgery looking at an AVR plus bypass. The surgeon did some tests while I was opened and determined the valve replacement was not necessary AT THIS TIME.

My problem however was a bivalve AV and it has worked OK for 60 plus years...your problem I am not familiar with. The bypass was pretty normal for me and the recovery has gone well. The usual sternum stuff and rehab but I feel great now. Surgery was done June 2002.

Best of luck for you..we'll be supporting you all the way.

Jackc (Welland)

 

[Johnny Stephens]

Hi Anne-Marie...my aortic and mitral valve disease was also caused by radiation to the chest for Hodgkin's disease in 1980. I expected to also have bypass surgery when my valves were done, but the catheterization revealed that I had no blockages. Totally surprised me.

 

[ALCapshaw2]

Hello Anne-Marie,

I was treated with Radical Radiation Therapy for Hodgkins Disease 30 some years ago.

I had a triple bypass 3 years ago and Aortic Valve Replacement 1 year ago.

I'd really like to know more about the relationship between my radion therapy and my heart issues. My surgeon has been rather 'vague' on that issue.

'AL Capshaw'

 

[Anne-Marie]

Thank you Jack, I hope your valve doesn't need replacing anytime soon! When they did the bypass, what part of the body did they get the arteries from?

Johnny and Al,

I had radiation treatments above the diaphragm in 1974 for stage I A hodgkin's and chemotherapy in 1977 (MOPP) for stage III A. I've found a lot of information on the net regarding the link between radiation treatments and early development of heart disease. No one has mentioned the link with chemotherapy, but I have found a site that mentions "certain chemotherapies" as having an adverse effect on the heart. I'm still digging for more information.

The surgeon also told me that there is a scar on the anterior wall of my heart that would be consistent with a radiation injury.
I ran this into the search engines at yahoo and got back a fair bit of information:

Hodgkins Disease + Heart Disease

The idea of using the artery from my wrist for bypass gives me the willies! I haven't heard of that before, but the surgeon said they wouldn't use the arteries from the chest because of the radiation. The inside of my wrist hurts just thinking about it

A-M

 

[ccrawford]

Source of CABG grafts

Source of CABG grafts

I think a more typical source of the artery bypass is a vein in your leg called the (spelling) sapheous vein. This is apparently a fairly redundant vein, and about the right size for a bypass. While you have to wear the gorgeous support hose for awhile after they harvest the vein, most people don't seem to have much trouble. Hope this helps. Chris

 

[jackc]

Bypass with Valve Replacement?

Anne-Marie,

As stated one of the veins used was the saphenous vein ( from the ankle up to the groin ) there is still a slight scar and constant nerve tingles as the nerve is still regenerating , especially arounf the ankle.

The other used was the interior mammary artery where only one end was cut and then used as a bypass. I notice nothing from this one.

There is no impediment of any type from the missing leg vein and I do everything I did before the operation, including a 4-5 mile walk daily and carrying my clubs for 18 holes of golf (when this damn cold weather leaves us ).

jackc (Welland)

 

[Anne-Marie]

Jack and Chris,

Thanks for the information. I think I'll ask about the saphenous vein. For some reason, the wrist really bothers me. I wonder if he is considering the artery in the arm because only one bypass might be necessary. He did say he would take a vein and an artery, but my arm veins are shot from chemo drugs.

Jack, I just noticed that you're from Welland! "Hi" from the Nation's bitter cold Capital. My husband is looking forward to golf season too.

 

[maxximom]

Hi Ann Marie..I don't post to often..but I do try and read as often as possible. I had a Triple By Pass and aortic Valve replacement 11/2 years ago down here at Duke Hospital..I have a St Jude's Toronro Porcine valve.I had a pretty standard recovery. They used the mammary arteries (always the better choice than the veins if possible) and a saphanous vein from my leg. This vein was harvested with Minumally invasive surgery from my thigh right near the bend of my knee. The scar is so tiny that you can't even find it..a big difference from when my husband had his bypass 15 years ago and has 2 large scars on his leg. I also had my surgeon start my sternum incision between my breasts..so I can wear a low cut neckline..if I wish. Hey I may be 71 years old..but I still have some vanity left
If I can answer any other questions for you..please email me and I will be happy to answer what I can for you. When I posted here a year and a half ago..No-one had had both bypass and Valve replacement..since then..there are a few of us. This is a wonderful website and terrific people. Good Luck!!
Joan

 

[ALCapshaw2]

More information on Bypass Grafts...

In spite of my radiation treatments, my triple bypass surgery 3 years ago included using one of my Mamory Arteries to the Left Anterior Descending Heart Artery which is the most important one.

Mamory Arteries are prefered (when possible) because the LAST FOREVER. This is because they only reroute the END, leaving the source connected in it's original position and, since it is already an artery, is conditioned to the higher pressures that exist in arteries.

Regarding the harvesting of leg arteries, they now have surgical procedures that only require a couple of small incisions and robotic instruments so leg problems are much less common. I haven't heard of anyone wearing leg stockings for a LONG time. I never had them and my leg vein was harvested in the old fashioned way.

Thanks for the Hodgkins-Heart Disease Link!

Best wishes,

'AL Capshaw'

 

[Anne-Marie]

Maxximon and AL, thanks for the information. That's so reassuring to hear that the procedure is not as invasive as I thought. The surgeon traced his finger down my arm along my radial artery and told me they'd get the artery from there. I just envisioned a scar all along where he touched

 

[Anne-Marie]

Some good news, I guess. I had my angiogram Monday and my arteries were nice and healthy.

One thing is worrying me though. My left ventricle EF was 35% back in December. One doctor told me that once they do the AVR the heart muscle can recover. Another doctor told me he didn't think it will recover. He said I will feel relief, but there's a scar on the heart wall that will prevent complete recovery.

I guess I'm a little worried going into surgery knowing that my heart muscle is weak. Anyone else with a similar experience?

 

[Georgia]

Hi, Anne-Marie! Yup - went in with weak heart muscle. It got that way from the bad valves; surgery wasn't optional and heart wasn't going to improve without surgery, SO-O-O, if you can't control it, there's no point in worrying about it. My left ventricle operates at @70%. I've done fine in surgery and recovery.

 

[Anne-Marie]

Hi Georgia,

I'm wondering if the scar (which they think is an old radiation injury) combined with the worsening valve is what led to my ventricle dysfunction. Anyhow, your attitude is the best. If the scar is from past radiation, it's been there for decades and I've had a very active healthy life up until now. I'll take it slow and steady.

Thanks Georgia, you're such a great support!!

 

[jackc]

Bypass with Valve Replacement?

Anne Marie

re; entering surgery with a weakened heart muscle....

Fear not..I had my surgery following two major heart attacks,
the second was just about the ball game..
ended up with severe damage to the left ventricular wall.

but fortunately I recovered well, had my operation successfully, and recovered with no problems from that.

Won't say it was all a breeze but not to worry about a weakened heart muscle.

jackc ( Welland )