Cognitive Impairment after Aortic Valve Replacement

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Maria

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I am new to this forum. I need some support. My husband had aortic valve replacement (pig valve) in October 2006. For about the last year he has shown signs of memory lapse, paranoia, anger. It has adversely affected our marriage and we have been seeing a therapist for severyal months. The therapist seems to think his issues might be due to oxygen deprivation during the heart surgery and should see a neurologist. He does not know about this and I am afraid to tell him about this. Is this possible, to be a result of the heart surgery?

Thanks for much for listening,
Maria
 

escargome

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Maria, I cannot quote any article specifically, but I have heard that the time spent on the heart-lung machine can cause some memory lapse. I don't know about the anger. My husband had triple by-pass surgery in Aug. 2004 and his memory is still a little impaired. So afraid of this I read lots of books both before and after my MVR surgery. So be try to be patient and maybe you will be able to work all this out without wrecking your marriage.
 

ALCapshaw2

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See the Blue Line at the top of the page, click on Search, and look for Keywords "cognitive" and "memory" and you will find links to MANY discussions on this topic.

Studies have been made with some recommendations for minimizing such effects such as using only the Best Filters, raising the body temperature back to normal more slowly (adding only 5 or 10 minutes to the 'warm up' time) to minimize gas bubbles in the blood and overheating the brain.

Anger, Short Temper, Moodiness, and other personality issues are NOT uncommon following OHS, although they usually clear up after some time.

A neurological consult is probably a good idea since these problems have lingered so long.
 

RobNDenver

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Maria,

It may be oxygen related, but I wonder if it might be Post Traumatic Stress Disorder instead. Has the therapist you are speaking with considered that the memory loss, paranoia and anger could be symptoms caused by something other than an oxygenation problem? Is there anything else going on in your lives that would trigger these behaviors? I am not sure that there are good ways to rule out the oxygen deprivation, but a visit with his doctor by the two of you seems to be a good idea.

Good luck to you.
 
M

Maria

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Stress - Yes

Stress - Yes

Thank you for your reply. Many of these issues began when my husband retired after working for the same company for 39 years. We have also been married for 39 years. He also suffers from crohns disease our entire married life. I was going to retire about four months after he did, that was our plan, but I am still working 6 months later. The things the therapist has heard and seen during their one on one sessions makes her believe it might be the oxygen deprivation.

Thanks for listening
 

Ross

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Just thinking out loud, wonder if you shouldn't consult another therapist? To me, it sounds like many issues are circling around in his mind and he's taking them all out on you.
 

Roger Frank

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I'm just five weeks out from my AVR. It was a rough surgery which required three reopens for various reasons. I have to tell ya, I'm not hitt'n on all cylinders mentally but each day it's a little bit better. This is a major traumatic assault on a body and healing will take quite some time...

My 2 cents,
 

Duff Man

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was he given any benzodiazapenes like ativan, valium, klonopin, xanax during his stay? Just a guess, but it could be a withdrawal thing. The three symptoms you mention are pretty broad, but protracted withdrawal could be a cause.
 

skeptic49

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YIKES!:eek: You HAVE to specify to the surgeon not to warm you up too fast? Don't they know that already? Side effects to drugs...aren't they known? Silly me...I expect the medical pros to be ahead of the curve on this stuff but I guess I expect too much.:(

Jim
 

tobagotwo

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The warming up too fast is a big deal.

What happens is that the brain has very low demands at a lower temperature. When it reaches a certain temperature range, it begins to wake up, and require oxygen replenishment at a high rate. If it passes through its critical, "wake up" temperature range too quickly, the oxygen flow from the blood simply can't keep up with the brain's sudden, enormous demands, leading to temporary oxygen deprivation.

Warming the person up more slowly allows the blood supply to keep up with the demand, as not so many cells wake up at once.

In the early days, it was felt that heating you up again quickly was the right thing to do, so you can see where this was an issue. I suppose you can't know what a junior surgeon or attending might do in a given wake-up situation. That is a little scary. The best thing is to discuss your concerns with the surgeon beforehand.

I believe Duke was the source for this concept.

Best wishes,
 

aussigal

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You say many of these things started when he retired. That just seems to much of a coincidence to ignore. I am thinking he is suffering from the change from a working man to a retired person. Does he have a hobby ? Its a big change to go from working to retired and some of us have difficulty with it.

I wish you both luck...
 

hensylee

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pumphead

pumphead

I just did a search on 'pumphead' and we have ten pages of it here in VR. Some of it fun, some informative, some disagreement on causes, but you might find something that will help you out if you read up on it.

seems lots of us have some memory impairment after heart surgery and I guess the discussions have gome from being on the pump and getting wee clots banged into our brain to being warmed up to quickly. Guess it will go on and on and.........

Hoping you find some help and maybe reading some of those posts will at least let you know you are not alone.
 

Marguerite53

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I hope that he has had a complete physical with a good doctor recently. It sounds like it might be a mix of everything you've mentioned. We don't know what meds he may be on which could be causing some depression, or other chemical imbalances.

I just lost a father to Alzheimer's and I truly honestly hate to mention this as a possibility, but please explore this also and get him on some Aricept soon if a doctor advises it. Don't go reading up on google about Alzheimer's until a neurologist or GP has suggested it.

I don't know how forgetful he is, but there is a thing called the Mini-mental exam which you can print up and give him. http://www.chcr.brown.edu/MMSE.PDF

I think a neurologist is a great idea. Perhaps you can start working on getting his surgery notes available for doctors to peruse should they have a question about the warming time.

Good luck. Hang in there. You sound like a very devoted wife.

Best wishes.

Marguerite
 

Eva

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Maria,

It may be oxygen related, but I wonder if it might be Post Traumatic Stress Disorder instead. Has the therapist you are speaking with considered that the memory loss, paranoia and anger could be symptoms caused by something other than an oxygenation problem? Is there anything else going on in your lives that would trigger these behaviors? I am not sure that there are good ways to rule out the oxygen deprivation, but a visit with his doctor by the two of you seems to be a good idea.

Good luck to you.
I agree with Rob, these maybe belated post traumatic signs that are triggered now due to 'maybe' other issues coming on. Do not forget, the surgery is a major one and I try not to remember the pain I felt the first few days when morphine did not work on me. When I remember, I get angry, but dismiss the feeling and look at the positive results I am experiencing now, which I hope to continue without surprises. Discuss these symptoms with your doctors and you may want to seek another therapist's advice.
Note: When I take the 'generic' vicodin, I become a different person -angry and I pick on little things that won't bother me usually. So, watch out if he is on any new meds. All the best. Eva
 

Roger Frank

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12 weeks out and I still have *holes* in my memory. However, each day a bit more history returns...now if I could just remember where I put the TV remote...:cool:
 
G

GLH729

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Cognitive Impairment

Cognitive Impairment

Hi,

My mother had aortic valve replacement surgery on October7, 2008 and just came off the Coumdin last week January 24, 2009. She had a problem last week where she was at a Dr's appointment and does not remember anything about the appointment other than arriving there and going into the exam room and then leaving the Dr's office. She is worried sick and her cardiologist recommends that she see a neurologist.

Has anyone else experienced this after valve replacement surgery?
Thank you,

Gail H.
Detroit, MI
 

ALCapshaw2

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Mar 20, 2003
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Hi,

My mother had aortic valve replacement surgery on October7, 2008 and just came off the Coumdin last week January 24, 2009. She had a problem last week where she was at a Dr's appointment and does not remember anything about the appointment other than arriving there and going into the exam room and then leaving the Dr's office. She is worried sick and her cardiologist recommends that she see a neurologist.

Has anyone else experienced this after valve replacement surgery?
Thank you,

Gail H.
Detroit, MI
Gail,

It would help to know some more information on your mother's situation.

First, I'm wondering why she was taken OFF Coumadin.
My *guess* is that she received a Tissue Valve (Bovine or Porcine) which does not require anticoagulation long term.

If that is NOT the case (i.e. if she received a Mechanical Valve) and was taken Off Coumadin, that is a prescription for STROKE as Clot Formation is a known Risk with Mechanical Valves if they are NOT receiving AntiCoagulation medication.

Please clarify.

'AL Capshaw'
 

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