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T

tphillips

Member
Joined
May 13, 2009
Messages
16
Location
springfield, mo
Hello everyone. I have been lurking in the background for a while now, reading and learning from everyone. Thank you so much for the valuable information. I have a bicuspid aortic valve, with stenosis and regurg, 4.6 ascending thoracic aneurysm, pulmonary hypertension, and mitral valve prolapse. I went in for my routine echo and they noticed that the aortic valve is leaking severely. Was not a surprise to me because I am having a lot more shortness of breath, swelling in feet and legs, light headedness, and exercise intolerance. I have now been scheduled for a cardiac cath on Thursday and a referral is being made to the surgeon.

I have a few questions: what should I expect during and after the cardiac cath, and what are some questions that I need to ask my cardio in regards to the findings of the cath?

Any help would be greatly appreciated. I always knew that this day was coming but I thought it would be later instead of sooner. Makes me nervous thinking about all this.

Tammy
 
Hi Tammy - welcome.

Caths are not particularly comfortable but they do not hurt. They numb the area where the cath is inserted and usually give you something to relax you. Actually, if you ask them to place a monitor in view, it is pretty cool to see. The only "unpleasant" thing for me is when they insert the dye. It gives you a very warm feeling throughout your body and makes you feel like you are peeing (but you're not). However, it only lasts a few seconds.

When the cath is over, they will make you lie still for awhile. The amount of time depends on whether they "plug" the cath insertion site or use pressue to stop the bleeding. The last time I had a cath, they inserted a foley cath for urine output and I found that to be much easier than using a bedpan. However, I was fully anticoagulated for my cath and movement was not allowed at all - hence the foley. I do not think it is a common thing.

You should get results pretty quickly afterwards. Each cardio is different. Sometimes they visit you before you leave the hospital and sometimes they schedule a follow up visit.

Best of luck.
 
THE KEY element for someone with BAV and an Ascending Aneurism is to find a Surgeon with LOTS of Experience dealing with those issues and a keen eye for being able to recognize the signs of 'Connective Tissue Disorder' in the Aorta.

THE TOP Aorta Surgeon in Missouri is Dr. Kouchoukos.
He is a World Renowned Aorta Surgeon who has taught some of the other Top Aorta Surgeons, such as Dr. Sundt at the Mayo Clinic. FYI, Surgery of the Aorta is considered to be another step above Valve Replacement Surgery.

You will also want to be at a Top Heart Hospital so that you will have experienced Nurses and other staff who 'know what to watch for'. Personally, I would NOT have a surgery like yours at a Local ByPass Center where they rarely see these types of conditions.

'AL C'

EDIT -

Here is his background and contact information.

...I believe UAB has been ranked as high as the #10 Heart Hospital. That is where your esteemed Dr. Kouchoukos did his residency :) (UAB Residency 1967 to 1970, UAB CT Surgeon 1970-1984 )

YEP - here it is:

Nicholas T. Kouchoukos, M.D.
3009 N. Ballas Road
Suite 266C
St. Louis, MO 63131
United States

Institutional Affiliation
Missouri Baptist Medical Center

Specialty
Adult Cardiac Surgery
General Thoracic Surgery
Peripheral Vascular Surgery

Background
University of Michigan (1954-1957)
Washington University School of Medicine (M.D. 1961)
Barnes Hospital-Washington University Geneal Surgery Residency (1961-1967)
University of Alabama Cardiothoracic Surgical Residency (1967-1970)
Thoracic and Cardiovascular Surgeon, University of Alabama, (1970-1984)
Cardiovascular and Thoracic Surgeon-in-Chief, Jewish Hospital of St. Louis, (1984-1996)
Professor of Surgery, Washington University School of Medicine (1984-1996)
Attending Thoracic and Cardiovascular Surgeon, Missouri Baptist Medical Center, St. Louis, MO (1996
I
Excerpted from www.CTSnet.org

If your Local Cardio won't refer you to him, you can Self Refer.
All you need to do is tell his office that you have BAV and an Aortic Aneurism and all they will want in the way of a referal is for you to send in copies of your Echo Report and Tape plus Cath Report and Tape or CD. You will have to get those records directly from the facilities that performed those tests.
 
I wish I had had a Foley catheter for urine output like Geebee (that's the first time I ever heard of it being done for a cath, and I realize that they don't like to do it for just anything because there is always a risk of infection). I am simply not able to use a bedpan, so for me that was the worst part of the whole thing. The actual procedure was nothing. They sedate you in any case.
 
geebee said:
Hi Tammy - welcome.

The last time I had a cath, they inserted a foley cath for urine output and I found that to be much easier than using a bedpan. However, I was fully anticoagulated for my cath and movement was not allowed at all - hence the foley. I do not think it is a common thing.
Click to expand...

Actually, for my last two ablations, which are basically caths (but can last much longer), I had a foley for each one. They make the whole thing much more comfortable, for me anyway. I wouldn't do one without a foley. Trying to pee in a bed pan while you are lying flat on your back with a room full of people is not a fun thing.
 
Hi Tammy, Welcome to the VR.com family! Don't be nervous - this is the nicest and most knowledgeable group of people anywhere! Read through the forums and/or do a search and you will find tons of info on what to expect and questions to ask. I'm sure lots of other will be along too to offer up their experiences. I found this group 10 days before my husband had OHS and we have gotten so much support and learned so much in these last 6 weeks. You will do great too!

Nadine
 
They used a collagen plug on me after the cath. I never had a Foley catheter or was offered a bedpan after either of my cardiac caths. I guess they assume that males have larger bladders and should just tough it out...

I did have to use a weird, bottle-type device to pee in after the actual heart surgery (they track liquid input and output intently after surgery). I had drainage vaccuums on both sides for the four chest tubes, and that totally wrecked any hopes of mobility. That was a bit tricky to use lying down.

Fortunately, after the heart surgery, between the anesthesia and the morphine, most people's intestines go on strike for several days, so you likely won't have to worry about the other, as long as you're relatively mobile in three or four days.

Best wishes,
 
I too was Foley cathed for the heart cath. I was well sedated, but remember my cardio saying "see, this is where you're leaking" after he added the contrast dye.

For me, the recovery was a bit more than I expected. Since I was already on Lovenox and being bridged to warfarin, I had a bit more bleeding. They didn't tell me I'd have a "goose egg" between my legs for a couple of weeks. I was bruised clear to my ankle, and it was a bit tender to say the least.

It's now been just over 2 months and my "lump" from the collagen plug is the size of a pea, and nearly all the bruising is gone, just a stripe at my boot line and ankle.
 
Also a hello from me.

I had the collagen plug after my cath and had absolutely no pain or discomfort, no lump and was able to drive and go about my usual routine the next day.

Hope things go smoothly for you.
 
Tammy, the cath is not a biggie...more fear of what's going to happen and once it's going on it interesting. I asked for a Foley because I have OAB and knew I would not make it without. That was a huge sense of peace of mind for me.

The room they do it in is really chilly but I got covered with warm blankets and the only thing I felt were a few finger tips on the top of my leg where they went in. The doctor doing it didn't say much except for, "Yep, it's time" but there were three or four monitors that I could watch and that was really interesting. Not too often you get a tour of your heart.

After the cath, went into a room with other people who had had caths that AM and we all laid there for a few hours with these clampy things on the incision site. Some type of weird looking plastic contraption that held it closed. After maybe 2 or 3 hours like that then they brought in these sandbags, undid the clamp and put the sandbags on. After about an hour they said it was okay to leave....just in time for L.A. afternoon rush hour traffic. Had them leave the Foley in until just before time to leave and that worked well.

I was awake the whole time and no pain or discomfort. The "heat rush" you feel when they put the dye in is so quick it's almost over before it starts.

But it is boring....just laying on an uncomfortable guerney so some music would be nice to take. It's hard to do reading because you are totally flt.

Good luck.

Midge
 
Hello Tammy & welcome to the forum. Try not to be too nervous about the cath. It is really easier to get thru then most people think.

I too had a foley when I had my last cath a few months back & thank goodness for that because I had to lay immobile for at least 5 to 6 hrs & I could not have held my bladder for that long nor been allowed to make the effort to get on a bedpan.

You will be groggy with a mild sedative that is administered thru an IV & the groin area is numb so you will not feel much of anything except perhaps a weird sensation when the dye is injected. But it's not painful!

If you have a weak back, when you are wheeled down to the cath lab, ask them if they can insert a small pillow or roll underneath the small of your back to relieve the ache from the hardness of the guerney.

Good luck to you & don't worry. You'll do just fine!
 
Tammy welcome! We sound very similar...except I had my OHS for BVD and aneurysm a year ago in August. Glad you found us.

Q's for your cardio who does the cath...
1. How big is my (insert problem here).
2. Who is the best surgeon for this in my area.

Also, do your own research on the internet.
 
Thanks for all the great information!!!! I am checking now to see if I my insurance will allow the referral to Dr. Kouchoukos....My cardio will make the referral where I want it...thanks again for all of the great info!
 
Don't let your insurance company try to push you into using a "Local Heart Surgeon" under the misguided impression that "a heart surgeon is a heart surgeon".

As I stated before, Surgery of the Aorta can be among the most complex Heart Surgeries, especially if there are 'connective tissue disorder' issues. Some of our members have had to have Botched Valve Replacements re-done by World Class Surgeons when the "local surgeon" botched the job.

This is not intened to scare you, just to have you and your Cardio push for the Best and Most Experience Specialist you can find do your surgery. In the hands of these kinds of surgeons, the risks are not much greater than 'simple' valve replacement surgery.
 
Welcome Tammy,
You will find a wealth of knowledge from so many nice people here....
PS...I did not let my cardiologist pick my surgeon...I researched and pick the best that could handle complex thoracic surgery for my aneurysm .
Welcome again and good luck!
 
Hi Tammy. Well, you've got plenty of answers about the heart cath and even better advice about surgeons... Just wanted to welcome you aboard! Here is wishing you the best possible outcome! You have quite a list of issues bless your heart I am still waiting around to see what/when things will happen with me - trying to lose some weight while I'm at it. I've been led to believe that if I can lose 40 lbs they'll do me the honor of cracking me open and getting this over with. They better not be pulling my leg...

Good Luck!

Rhena
 
Hey everyone! I found out that my insurance will not cover Dr. Kouchoukos (He's not in-network). So my cardio and myself are researching the cardiothoracic surgeons at Barnes-Jewsih in St Louis. If anyone has had any experince with one of these surgeons, please let me know. Have a great day!
 
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