Cath pre surgery

[big_L]

One item that the cardiologist mentioned to me this week, which was a surprise is that he can tell from the echo that part of the back side of the heart wall isn't moving like it should. He started talking about doing a bypass here, depending on the cath results. I will have a cath done the day before surgery to look at the valve and also any other heart issues, including this one. If they do the bypass also, then they must do the full sternotomy.

I'm really struggling with this. No heart disease other than hypertension in my family. My lipid profile the past ten years has been quite good. I really want the mini-sternotomy for the valve only. Obviously, I don't want to do anything stupid or short-sided; however, I also feel that the Drs can be a bit too aggressive, especially with the very good diagnostic tools available. Whether some of these conditions would truly ever cause a problem is the question. You know the old example - check me into a mental hospital and before you know it, they've found me to be nutty as a fruitcake.

Point is - I'm going to ask if we can do the cath earlier than the day before surgery. We're planning to meet with the surgeon approximately one month pre-surgery and could hopefully do it then. This way we're not trying to digest the cath results with all the stress of the pending surgery the next day. Doing it earlier gives us more time to truly understand the results and make a better decision.

Comments?

 

[SuzanneSLO]

I was told by my Cardio on Mar 28 that I needed AVR. My Cardio did the cath on Apr 9. Mine showed nothing more than what was already known. It was stressful preparing mentally for the cath, but it went better than expected because he was able to do it through the radial artery.

I saw it as a mini trial run for the AVR. I know it's common to do it day before, but I liked getting out of the way. If it had shown something new, I would also have had time to digest it.

By the way, I still don't have a surgery date scheduled. I'd talk to your Cardio about going ahead and scheduling the cath. -- Suzanne

 

[Jkm7]

By all means speak with your cardio about moving up the date of the cath so you have time to digest whatever information is learned and make your decisions. We often read here of people who have their cath done weeks in advance of the scheduled surgery. Mine was. If I recall correctly, I think my cath was about two weeks prior and actually was scheduled a week earlier but had to be rescheduled.

Cath gives very valuable information and is the major test they use to see if there are any blocked arteries that need to be addressed during surgery. If they have to do a bypass, it is likely they would open your chest.

Best wishes. Let us know how it is going for you.

 

[Racquetshopper]

I, too, had my cath 3 weeks before my valve surgery and was glad to have it out of the way. Having it done before gave me more time to prepare for and focus on the surgery. The day before surgery is such a whirlwind.

 

[Bryan B]

I had the cath before my first surgery 2 weeks ahead of time. I was living in Nashville, TN at the time and my surgeon at Duke was fine with it. I didn't meet my surgeon in person until the pre-op visit so I think he liked the fact that he could review the cath results ahead of time. For my 2nd surgery they did the cath the day before the surgery. Personally I liked having the cath the day before because I preferred already being in the hospital on the morning of the surgery. That was just a personal thing...I felt I has less anxiety by already being there.

 

[kimcdougc]

I had my cath done 2 months before my scheduled surgery. That is when they found out my AV was worse than they thought. The cath was really a breeze. No blocked arteries or anything else wrong..just the valve. They will schedule it before your surgery if you ask them to. It took a couple of days to heal from that. Not bad though.

 

[Gail in Ca]

I've had my caths done more than one day ahead of my surgeries as well. The first time it went very well. The 2nd time, however, the nurses were on strike and I had stand- in nurses that gave me a fluid overload after my procedure and I went into congestive heart failure. I had to spend a night in the hospital, was sent home, and ended up going to the ER 4 days later with feelings of dread, like I would die if I didn't go to the ER.
My BP was 90/19, I needed OHS soon. Luckily, the surgeon I had picked was available, even though I hadn't met him, yet, ( I was to meet him a couple weeks after the cath), and I had my 2nd surgery as a sick patient instead of one that was just going to need a valve replaced and otherwise was normal. So, I would agree that you would want the cath more than one day ahead of time. Don't mean to scare you off the procedure, but in my case, stuff happened!
I am fine now, had no lasting effects from my ordeal.

 

[iheart]

Big L.,
I agree you will probably feel much better scheduling the cath for a couple weeks ahead of the surgery. No reason to wait.

I just had my AVR surgery a little over three weeks ago and I had to travel 9 hours by car for my surgery. I wanted the hospital I traveled to do everything. They did the cath 2 days before surgery as is customary for patients like me from out of town. I was VERY uptight about the cath, especially about having it so close to surgery. It turned out to not be a big deal at all, and it was kinda nice getting everything done at one time. But, had I had it done locally I probably would've scheduled it for a couple weeks ahead of time. I also figured my arteries would be in good shape (no narrowing) and they were. They also used less contrast dye on me than normal, cause my kidneys are slightly compromised and they didn't want to possibly make them worse. The dye can sometimes have a bad effect on kidneys, although it's very rare.

 

[Mom2izzy]

Cath pre surgery

I had my cath about a month before surgery. It was done in a local hospital. I worried about it, but it was really a breeze. I'm glad it was done in advance because, the "hole" in my groin area would have been just one more thing to be concerned with post surgery. However, I can think of one reason it would have been better to get it all done at once...it added an extra week of not being able to pick up my daughter (she was 3 at the time).

If they do find something, it would definitely be best to get it all taken care of at once. I had a "mini" sternotomy...Turns out all it meant for me was about one or two inches less than a full. It's still a good six inches long (not very "mini" in my opinion). The great part is that a year later, I can hardly see the scar...people who don't know it's there don't even notice it.

I hope they let you have it done sooner rather than later, but if not, just try to remember that all of our concerns leading up to "the big event" are pretty much forgotten as soon as you wake up on the other side.

 

[Guyswell]

Big L.

For both of my surgeries, the heart cath. was done the week before. If you're traveling to K.C. to meet the surgeon, try to have it done during that trip. There's no reason to wait and do it the day before your valve replacement. Don't stress out over the difference between a mini and a full sternotomy. Both of my surgeries were full sternotomies. I told my surgeon I was happy to give him as much room as he needed to do the best procedure possible. I suspect we're both well past the age where we should be worried about the length of the scar and how it will look at the swimming pool. If you also need a bypass during your valve replacement, look upon it as an ideal opportunity to take care of another problem that could present a problem later if not treated now.

 

[big_L]

I spoke with the med center today and they're fine with doing the cath early. Believe me - guyswell - the last thing that I'm worried about at this point is my poolside appearance. Most probably won't even notice the scar and would focus on the bird-legs and general nerd appearance, especially next to my fine Kansas sunflower mate.

 

[epstns]

Big L,

Guyswell hit it on the head. If you can get the cath done early, I would do so. I had mine about a month before valve surgery. Cath was done at my local hospital, where my cardio is. I had the valve done at another hospital downtown, where my chosen surgeon practices. In the cath, we found that I had a major artery that was 50% blocked. The surgeon told the cardio to just send him the video and report, and that he would do a bypass while he was doing the valve. The bypass didn't add more than a few minutes to the procedure time, and knowing about it in advance gave me time to get used to the fact that it was coming.

As for mini versus full sternotomy, my surgeon said he really didn't want to do mini's, and that needing to do a bypass while in there precluded any choice. Seriously, it didn't make any difference. They tied my sternum up so tightly with the wires that I never felt any movement or weakness at the repair site. In fact, the bone cutting and healing was hardly noticeable all along. I guess maybe it delayed my getting back to doing pushups, but other than that it wasn't much of an issue. It probably didn't affect my scar much, either. Mine is only about 4 inches long and runs on a slight angle so that if I wear an open-collared shirt, it doesn't show. Of course, once I remove my shirt, people run away screaming about monsters. (I have scars from the sternotomy, surgical drains, pacemaker and lately a hernia.) Actually, I find that in the gym locker room people get a glimpse of it all, then look away. . .

 

[tom in MO]

Don't sweat mini versus full. In the long run, the outcomes are generally the same. The biggest effect the sternomoty has on most people is the 6 month wait before full physical exertion. If you do physical activity for a living, this can be a significant loss of money compared to the 1.5 months for those w/o physical jobs.

I was told the preferred timing for cathertization is at least 2 weeks before surgery. This is to make sure the drugs are out of your system and you've got no secondary infection at the cathertization site. They can and will do it right before surgery, usually to accomodate out of town patients or in the case of an emergency.

In my case the results were kind of funny in a weird way. I was told to drop cholesterol and beware of arterial plaque for years due to my BAV. However, the catheritization showed I had great pipes with just "normal" calcification. Some good news for a change.


If your team is like mine, there is one more test. They do a scope exam down your throat to look at another part of the heart. If they find problems there, you may have a change in direction. I didn't. In my case, with my BAV, there is also a history of abdominable anuerisms in my family. With me open, he felt around to make sure there was not anything dramatic.

With the hood up, might as well get fixed anything that is broken or about to break It will put extra miles on your frame.

 

[carolinemc]

Big-L, at least you are not freaking out about the cath thing anyway. Just don't sweat it on the scar, it is a attention getter. Most people, when they see a bypass scar, they get curious and ask questions. Go with it, the ladies love it. I have watched this on the sideline, being a lady with my badge of courage myself. Good luck and keep us posted on everything. Hugs for today.