Introduction / Unexpected Aortic Regurgitation/Insufficiency

[BillyG2]

I've been lurking around since early August 2015 when I started to self-diagnose my problem of aortic regurgitation/insufficiency (without any previous indications or signs of valve issues). This will probably be long, but hopefully it will help someone as many of the posts here have already helped me.

I figured it's well past time for me to introduce myself for 3 reasons: (1) there have been several times I almost replied to various threads but then thought, "I should introduce myself somewhere first . . ." (2) The people here helped me so much a month before my problem was even formally diagnosed, I hope I can similarly help others. When an echo in late August confirmed my suspicions of aortic regurgitation, I didn't even flinch; I was like, "Okay, so let's get to the next steps so we can schedule surgery and fix the problem." I was ready for the diagnosis, was as comfortable as could be with it, and was ready to fix the problem, mostly because of all of the posts within this site (and watching open heart surgeries and valve repairs online helped as well). And (3) although I don't think I have too many questions right now, that may well change, especially after surgery.

MY STORY

I am 34 years old and athletic. I was a collegiate swimmer and have been swimming lifetime bests in my 30s, including 3 lifetime bests in April of 2015 despite looking back and now knowing I had aortic regurgitation at the time.

I have been borderline high blood pressure most of my life, at least since college. Knowing about my pre-hypertension and family history with heart issues, I've obsessively eaten cleanly and worked out regularly.

I had a radiofrequency catheter ablation for atrial flutter in February 2013. Valves and everything else were allegedly very healthy at the time, but then I started noticing a wide pulse pressure (that got wider and wider) starting around April 2014. This concerned me because my diastolic blood pressure kept getting lower and lower - it was a sudden and significant change from my past, and I had been tracking blood pressure regularly for years. The doctors kind of blew off my concern, but I started feeling a thrill in December 2014 and started experiencing fatigue, especially when working out, starting around July 2015. I self-diagnosed myself as having aortic regurgitation in early August 2015, which I confirmed with my cardiologist via an echocardiogram on August 27, 2015.

I pretty much knew my options before being diagnosed and was ready to get my valve replaced as soon as possible. After my TEE on September 4, 2015 showed a trileaflet valve with no signs of stenosis, calcification, disease, or aorta/aortic root dilation, I started investigating repair as an option.

I'm ready to have surgery as soon as possible so I can start recovery and get back to working out regularly, but I am currently searching for the right surgeon. I know repair is difficult and may not be an option. I am at peace with an aortic valve replacement, but since my valve appears healthy but for the right-coronary leaflet prolapsing, I am currently exploring the possibility of aortic valve repair with some of the best surgeons in the country to make sure I explore all options for treatment.

As a final note, my CT angiogram on September 8, 2015 showed no additional problems, i.e., my arteries are all clear, the aorta appears normal, etc.

WHAT'S NEXT?

I live in Las Vegas, and the local surgeons I met with either say a repair is not an option or if it is an option, I won't find a surgeon in Vegas that will have the skills to successfully perform a repair. I am by no means expecting a repair, but I'd rather choose a surgeon that says he can sometimes repair aortic valves and there is a chance he can repair mine rather than one that says there is no chance he would even try a repair of any aortic valve. I am probably looking at two primary areas: LA (or maybe Stanford) or Cleveland Clinic. Since I started looking into the possibility of repair, some other top surgeons started to pop out as well, though.

As for now, I currently have a surgery date of November 4 set with Dr. Trento at Cedars-Sinai. In the meantime, I'm still talking to surgeons and getting more opinions. In the very beginning, I thought, "I must go to Cleveland," but I think if I can find a surgeon closer to me that is capable of a repair, it will be better to be closer to home in case I need to go back."

POSSIBLE QUESTIONS

I know I said I don't really have any questions, and that's mostly true. If I had one question, I guess it be whether anyone has any thoughts regarding aortic valve repair, especially with respect to Dr. Trento's skills and other recommended surgeons.

Most of my other thoughts, questions, or concerns fall into that category of "things I probably can't really control other than choosing a capable surgeon with a good team." For example, I am fearful about how long it will take me to get back to my recent level of training and continue to put up lifetime best times in the pool. I do not dwell on those type of fears, however, because the most important thing is I have no choice but to have surgery to prevent heart damage and failure, so whatever recovery looks like on the other side is just something I'll have to deal with. I know life will never be completely the same, but I'm determined to get through surgery and fight to be better and stronger than I ever was if at all possible.

 

[yotphix]

I think a lot of us here will find your story particularly interesting since you have a valve problem which manifests symptoms in a very familiar way, but which is kind of unusual. To have an otherwise perfectly health valve and aorta, with one naughty leaflet is certainly new to me. I wonder if anyone has considered whether there is a correlation between having had a catheter passed through the healthy valve, and the eventual prolapse? Not that it particularly matters, unless there is something to be learned from it.
It sounds as though you've done a great job learning about your condition, and the possible treatments and their likely outcomes. I'll be curious to follow your story as it develops.
Welcome.

 

[BillyG2]

You're probably right in saying, "Not that it particularly matters, unless there is something to be learned from it." That's almost exactly what I said to my cardiologist. The engineer/lawyer/inquisitive nature in me wants to know the "why," but I recognize I may never know. My family has always joked about how heart problems run in the family, which has always been part of my drive to eat extremely healthy and to keep myself in great shape. The irony is that I'm probably by far the most fit of anyone in my close and extended family, yet I'm the one that is now having problems earlier in life. I have to wonder at least a little if the level I push myself athletically may not have caused a weak valve to give out earlier, but I have no regrets if that was the case.

I wonder if anyone has considered whether there is a correlation between having had a catheter passed through the healthy valve, and the eventual prolapse?

That was definitely one of the first questions I had for my cardiologist - could they have damaged my valve during my ablation? She said unless there was something out of the ordinary during my ablation, they should have never been near my aortic valve. My cardiologist said she was going to read through the report for the ablation and see if they did anythign out of the ordinary. I'm not sure she ever did that, though. She did look at the TEE report from immediately prior to the ablation (as soon as they put me under for it), and she said the report said everything looked good and healthy. The followup echos after the ablation reported the same. You did just remind me, however, that I do want to try to get my hands on the actual TEE done just before the ablation. Both my cardiologist and Dr. Trento said they'd be interested to see the pre-ablation TEE to see if something was overlooked. I'm not sure it helps with anything other than curing curiosity.

One general note that is probably worth making to others is that when I first started reading about aortic regurgitation, I thought aortic valve repair was rare and replacement was the only real option. Once I started researching aortic valve repair, however, I started learning it can be an option in some cases. I have come across statements/videos by Dr. Svensson (Cleveland Clinic) in which he says that he can successfully repair 70% of the bicuspid aortic valves (without stenosis) and 90% of the tri-leaflet aortic valves that are insufficient. Furthermore, he said the durability of such repairs is 96% at the 10-year mark.

 

[pellicle]

Hi Billy

Just wanted to say that I applaud your attitude and wish you all the best for your surgery.

You seem to have a great grasp not only of yr own health but of the medical options. So you seem to be in excellent hands - your own. Your summary about choices is perfect.

Like yotphix I will be interested to follow your story over the years

 

[BillyG2]

Thanks pellicle! Your story and posts have definitely played a huge role in giving me comfort with what the future holds, even before that echo confirmed my suspicions. I did not even talk about valve choice because despite me occasionally wondering if I should consider a tissue valve, I feel deep down that I would be more comfortable with a mechanical valve if a repair is not an option. Some of your thoughts have definitely helped me be comfortable with that decision. Please stick around and continue doing what you are doing!

To elaborate a little on my decision, I think I am willing to risk a second surgery if they think a repair can last at least 10 years (and hopefully longer), but I do not think I am willing to risk an all but guaranteed second surgery (pending technology advancements) by choosing a tissue valve if repair is not an option. Although it seems there is not a clear reason tissue valves calcify/deteriorate faster in younger and more active people, I'm especially concerned about the lifespan of a tissue valve in view of how active I am (and plan to be after surgery).

Dr. Trento did say he would not be comfortable telling me to expect a tissue valve to even last 10 years for me. His recommendation, if repair is not feasible, is to go with an On-X valve, which is fine by me.

 

[AZ Don]

I had OHS for an aortic aneurysm. Since my BAV was well functioning I had the option of sparing the valve, which I did. With this option it was estimated I had something like a 50% chance of never having to have another OHS again, and if so, at least 15 years away. Since the surgery my valve has started leaking and so I'm told it is no longer a question of if, but of when I will need surgery, and probably sooner than 15 years. Still, I had a reasonable chance for no future surgeries or blood thinners, and so I took that chance and have no regrets. As it is, I've bought some time and if my valve holds out several more years who knows what options will be available. They are working on mechanical valves that won't require blood thinners and even tissue valves grown in the lab. Just sharing my experience and thought process on this in case it is of any help to you.

Regarding the hospital. Generally I suggest a very good regional hospital and you certainly have some good choices in LA, including Cedars Sinai. I would ask the Dr. at Cedars Sinai what he thinks the durability of repair would be. You could also have your test results sent to Cleveland Clinic to see what they think of the chances for a successful repair in your case. If there is a big difference, you want to try for a repair, and Cleveland Clinic works out for you cost/insurance wise, then that may justify the trip.

 

[honeybunny]

Welcome, Billy, and ditto to what everyone else has said. It appears you are self-advocating your healthcare just fine. I suspect that you will become a constant on this site as some others have, helping others through similar journeys. Best to you and you move forward in this process.

 

[cldlhd]

The fact that there are no signs of stenosis or calcification means repair is much more likely , especially since the valve is trileaflet. I know the Cleveland clinic is top shelf but there are great surgeons all over . The success rate at 10 yrs is impressive, the surgeon I used has been doing his current repair technique since 2004 and has had no reops for repair failure. He told me he wouldn't know if the valve could take a stitch until he was in there. My valve was a BAV with no stenosis and only trace leakage. I told him I only wanted it repaired if it was a clear cut robust repair if not my backup was mechanical.

 

[BillyG2]

Welcome, Billy, and ditto to what everyone else has said. It appears you are self-advocating your healthcare just fine. I suspect that you will become a constant on this site as some others have, helping others through similar journeys. Best to you and you move forward in this process.

One of my goals is to be here for a while to give back and help others. I'm not one to usually post a lot on social media or elsewhere. I am pretty humble, and I think it makes me feel like I'm bragging. However, I can't emphasize enough how much this site helped me feel prepared to tackle the problem head-on before the cardiologist even formally confirmed my suspicions, so I hope to be able to help others in the future.

 

[BillyG2]

cldlhd - I've been trying to reply to the private messages we had going but none of them seem to be getting through. There's nothing that needs to be kept private, though, and maybe others will be interested in my questions to you anyway.

Did you by chance ask Dr. Bavaria how many successful repairs he does (e.g., per year)?

I think that Dr. Trento is a great surgeon with a lot of experience, and it sounds like what he told me was similar to what Dr. Bavaria told you, namely that a repair is his first choice but he will not repair it unless he feels it will last at least 10 years. He told me that he successfully repairs 1-2 aortic valves per month. That doesn't sound like much, but if you look at how many aortic valves even have a chance of repair, I feel like that number is pretty good.

I talked to Dr. Trento about it a little more 2 days ago, and he told me that he'd give me an 80% chance of a successful repair. His main concern is that my right-coronary leaflet is prolapsing so significantly, he seems concerned.

After nagging my cardiologist's office for 4+ weeks, they did finally get my medical records out to Cleveland. They arrived yesterday, and Dr. Svensson's office said he will review everything and give me his opinion by early next week. Based on what I've seen Dr. Svensson say in videos and such, I'm expecting him to say he has a 90% chance of successfully repairing it. I'm not sure there is much of a difference between Trento's 80% and Svensson's anticipated 90% probabilities, as those numbers could be influenced by many factors and skewed depending on how you look at them.

I have no apprehensions to travel for the right surgeon. If I was to fly across the country and the Cleveland Clinic has surgeons that are as skilled as Dr. Bavaria, as I believe they are, I would choose Cleveland over Bavaria only because it is closer to me and especially closer to my parents that live in Indiana. I am feeling fairly comfortable with Dr. Trento, however, and I am not anxious to push surgery back just to have another highly skilled surgeon do what the already-scheduled surgeon can probably do.

In summary, do you know how many aortic valve repairs does per year (or month or whatever), and what probability did he give you of having a successful repair?

 

[cldlhd]

The only reason I saw for the private messages , which have been a problem, is specific surgeon opinions and recommendations might not interest everyone. As for how many repairs Bavaria does a year I don't know the exact number. I was told , in addition to lung transplants, he does over 200 OHS's a year and he specializes in valve repair so I imagine they're a fairly high percentage . He also told me that they have an improved repair technique that was instituted in 2004 and as of my meeting with him in November 2014 he had no reops due to repair failure. I'm not familiar with Dr Trento and I'm not an expert on surgeons anyway so I can't say anything in regard to him one way or the other. I have heard of Dr Svenson and he's obviously well known. As for the difference between the 80 and possible 90% odds of repair from Svenson and not being sure if it would be worth the travel I think it's a bit more nuanced than that because both surgeons might say after the surgery that it was a "successful" repair but that doesn't mean both repairs are equal or will last as long. One " successful " repair might last 15 yrs while the other could last a lifetime . In regards to my valve Bavaria said he couldn't say for sure whether my leaflet could take a stitch or not until he gets in there but based on my scans he said it would be as close to a guarantee he could repair it as he could make. I definitely understand the desire to be closer to family but if you're shooting for repair ,which is more complicated than replacement, if Dr Trento isn't as experienced as the surgeons at the Cleveland Clinic I'd consider the trip. If you came to Philly to see Bavaria and you don't know anyone I'd be willing to take you out for a drink or 3 if that helps. I don't think my wife could complain about that...
Funny how you wonder if your working out wore the valve out early as I've wondered if all the weight lifting I did in the past helped my aneurysm along.

 

[BillyG2]

That's interesting you say surgeon opinions and recommendations may not interest everyone - it's probably been one of the things I've been researching the most (especially once I got a pretty good general understanding of the options, how they generally replace/fix things, etc.).

I was struggling to find comfort with Dr. Trento simply because I cannot find much about him online. Compare that with surgeons at the Cleveland Clinic, for example, that crank out endless videos and other information on all kinds of things. From what I can tell, however, he definitely has experience with over 7000 heart surgeries. I forget the number, but I think about 4000 of those have been valve surgeries. He currently performs about 300 surgeries per year, 80% of which are valve surgeries. That means he does about 240 valve surgeries per year, or 20 per month (for all types of valves). When he told me he's repairing 1-2 aortic valves per month, that made me feel pretty good.

I kind of challenged him on what other surgeons are doing. I crafted questions where I was not directly asking him if his procedures were the same or as good as those at Cleveland but where I was instead still forcing him to answer that question. His response was essentially, "We all compare notes on our experiences and learn from each other." I guess that made me comfortable enough.

You're right, though: what does 80% versus 90% mean? What does "repair" mean and what is the longevity of one surgeon's repair versus another's? Hell, what is the longevity of Dr. Svensson's repair when he does an operation on a Monday after a relaxing weekend compared to a surgery on an identical case on a Friday the 13th morning when he forgot to drink coffee (if he even drink's coffee)? I say that all jokingly. The hardest part for me is that I want to go to the guy that will do the best job repairing the valve, if it's even possible, but there will never be any way of knowing that. I am at a point where I am comfortable enough with the direction I'm headed, and all the while, I'm laughing at how there is no perfect or definitive answer and I will never know if the choice I make will be the best one. But I'm okay with that - I'm enjoying the experience and laughing at all its nuances because that's all I can really do.

I do sometimes wonder if working out so much has impacted the situation, but a more likely scenario is that the stress I've put myself under while trying to build and maintain a small business has probably brought about problems with a genetically weak valve. Even if I knew all the stress I've taken on caused the problem, I'm not sure I'd change it if I could re-live the past years of my life.

It's been a while since I've been to Philly, but I did sometimes go there to travel to Egg Harbor Township to sell product to Spencer's. If I'm ever in the area, I'll reach out to you, but if you're ever in Vegas, please let me know! I hate being away from family here, but I've seen some family (e.g., aunts/uncles/cousins) more while here than when I lived 30 minutes away from them in other cities. It seems a lot of people travel here for one reason or another.

 

[cldlhd]

I understand asking opinions on surgeons out here but the two reasons I figured a private message might be good is because . #1- geography, there's people out here from England, Australia and I assume points in between so these recommendations might be useless to them, although the one time I was down to see Bavaria there was a guy who st flew in from Italy to see him about his surgery. #2- this is a life saving surgery so if your surgeon does a great job and you get back to your normal life I think there's a tendency to think that yours was the best. It's an emotional thing in a way and for some reason the heart seems to have a certain psychological hold on most of us humans. So I imagine a lot of people take these accolades with a grain of salt. Ya they are human and everyone has an off day now and then , not much you can do about that. I was scheduled to have my surgery on a Friday but the operation before me ran late so it was cancelled and pushed to Saturday morning and I got the impression that it was supposed to be his teams day off and one surgical 'fellow' seemed a little irritated and that bothered me a bit.
One of the things I liked about having Bavaria doing it , besides the fact that everyone at the hospital talked about him like he walked on water, is that he was a Castle Connelly Top Doc 15 yrs in a row . I don't know all that goes into that ranking but it seems to be held in high regard.
If you're familiar with the area I live in the northeastern suburbs of Philly, Bucks County ( named after Buckinghamshire in England for all you Anglos ) . When my Dad retired my parents moved to Henderson right outside Vegas but in a few years they relocated to Arizona. About a year and a half ago my wife, son and I flew to Vegas and took a road trip to the Grand Canyon then down past Tucson where they moved to. Interesting to visit but not for me on a permanent basis. To each their own eh?

 

[Zoltania]

I understand asking opinions on surgeons out here but the two reasons I figured a private message might be good is because . #1- geography, there's people out here from England, Australia and I assume points in between so these recommendations might be useless to them...

I think it's valuable to have the information here in the public forum because then it gets into the archives for future visitors to search for. I know I did a lot of searching the archives for surgeon names and locations before my surgery, and I appreciate the efforts of everyone who took the time to post that kind of information.

 

[cldlhd]

Good point, I just imagined the eyes rolling out here as I sung my surgeons praises....

 

[BillyG2]

#1- geography, there's people out here from England, Australia and I assume points in between so these recommendations might be useless to them, although the one time I was down to see Bavaria there was a guy who st flew in from Italy to see him about his surgery.

If you told me the best surgeon for possible repair was on Mars, I'd definitely consider it. There are unfortunately limits to my search, such as cost/insurance, but I'm willing to consider all options.

#2- this is a life saving surgery so if your surgeon does a great job and you get back to your normal life I think there's a tendency to think that yours was the best. It's an emotional thing in a way and for some reason the heart seems to have a certain psychological hold on most of us humans. So I imagine a lot of people take these accolades with a grain of salt. Ya they are human and everyone has an off day now and then , not much you can do about that.

Agreed, and I won't take anything anyone says as definitive towards guiding me to a final decision. I won't even consider my own thought process or experience definitive I made the right/best decisions, but I am not going to look back and regret anything, either.

Bavaria was high on my list, but I hadn't found him until more recently - probably just a couple weeks before you privately shared your experience with him. This experience of searching for a surgeon has been interesting. For example, the one surgeon that started to stand out to me in Vegas (e.g., he was the only guy that kind of popped up from the online community and a (non-cardiac) surgeon friend said he'd have the guy operate on him in a second) was not even on my cardiologist's list! I kept probing, and she finally told me that the guy I identified in Vegas used to be her go-to guy locally, but she had started to see issues with his outcomes. Okay, so maybe she knows best . . .

But then I started to research one of her top recommendations for a local surgeon and found an article about how he had one of the worst mortality rates at a previous hospital in a different state! I asked my cardiologist if she had seen that article or knew anything about it, and she said, "No, I have only seen his experiences from after he left that hospital at another hospital and then since he moved here, but maybe we should cross him off the list." I also know how the media works, though. The article talked about how two local independent surgeons took over the cardiothoracic surgery division at the hospital after that guy left, so the article could have had a political agenda behind it.

I think the one thing I was searching for, which you definitely addresses, was surgeons that might be able to attempt a repair. The two surgeons I saw in Vegas said they would not even attempt a repair of an aortic valve. Except for about 3 surgeons (Bavaria being one of them), I've found it hard to find stories from patients that have had a successful aortic valve repair. I know it's rare because only a small percentage of aortic valves are even possible candidates for repair and because many surgeons will not even attempt a repair, but I think people should be made more aware that a repair might be possible. Based on my initial research, I was ready for a replacement, thinking it was the only solution. Curiosity caused me to keep digging, though, and thankfully I read enough to know that the local surgeon that said repair was not an option for any aortic valve (ever) was simply telling me that he was not the right surgeon for me.

If you're familiar with the area I live in the northeastern suburbs of Philly, Bucks County ( named after Buckinghamshire in England for all you Anglos ) . When my Dad retired my parents moved to Henderson right outside Vegas but in a few years they relocated to Arizona. About a year and a half ago my wife, son and I flew to Vegas and took a road trip to the Grand Canyon then down past Tucson where they moved to. Interesting to visit but not for me on a permanent basis. To each their own eh?

I don't live in Henderson, but I'm fairly familiar with it. I'm not sure why Vegas is not for you, which is fine, but since your parents have lived here, you've probably seen the non-entertainment side of Vegas. I actually don't live in a casino on the Strip! I'm from the Midwest and miss the lake, trees, grass, and family. I moved here for business, and through my swimming and working out, I've met a lot of great people - lawyers, doctors (I met my cardiologist through swimming), surgeons, pilots, entertainers, and normal people. My girlfriend also works for the only food bank in Southern Nevada, so we meet a lot of normal people through her work. I miss "home," but I would miss things from here if I did not live here. I just enjoy whatever the moment has to offer at the time, wherever it may be.

Quick interesting story: I was just outside Boston at my girlfriend's parents' house and met my girlfriend's second cousin. She had just moved to the Boston area from the Phoenix area for school (and eventually a job). I was talking about Vegas and all the brown compared to Indiana and all the green, which to me is much prettier. She said, "I enjoy the trees here in Boston, but things back home in the Phoenix area were much prettier. All these different shades of brown are so pretty! Here, everything is just green." I found that funny because to me, all the things herein the desert are "just brown," while back home in Indiana, things were pretty different shades of green (and more). As you said, to each his/her own.

 

[Paleowoman]

In the UK the Society for CardioThoracic Surgery has listed a national database for the number and types of operations by all the UK cardiothoracic surgeons which includes their mortality rates in comparison to national averages. They also have the same data for the hospitals so that it's easier for patients to find surgeons near them: http://www.scts.org/patients/default.aspx A lot of cardiothoracic surgeons do CABG so if you want one who has done a lot of aortic valve or mitral valve replacements or a mixture, it's easier to find the numbers there with the tables they have produced for each surgeon over the prevous three years so that you can find one with a lot of experience in particular 'fields'. I found it good, after asking a couple of doctors who they would go to if they needed AVR, to do my initial research from that website as it was, of course, unbiased being based soley on number and type of ops done plus mortality - and if one particular surgeon had undertaken more risky procesudres which woud skew his or her mortality rates this was shown too. (Although the UK has the NHS, patients can use a 'Choose and Book' facility which allows them - at least in theory - to choose their own surgeon and get referred to them.) Does a national database like this exist in the US and other countries ?

 

[cldlhd]

If you told me the best surgeon for possible repair was on Mars, I'd definitely consider it. There are unfortunately limits to my search, such as cost/insurance, but I'm willing to consider all options.



Agreed, and I won't take anything anyone says as definitive towards guiding me to a final decision. I won't even consider my own thought process or experience definitive I made the right/best decisions, but I am not going to look back and regret anything, either.

Bavaria was high on my list, but I hadn't found him until more recently - probably just a couple weeks before you privately shared your experience with him. This experience of searching for a surgeon has been interesting. For example, the one surgeon that started to stand out to me in Vegas (e.g., he was the only guy that kind of popped up from the online community and a (non-cardiac) surgeon friend said he'd have the guy operate on him in a second) was not even on my cardiologist's list! I kept probing, and she finally told me that the guy I identified in Vegas used to be her go-to guy locally, but she had started to see issues with his outcomes. Okay, so maybe she knows best . . .

But then I started to research one of her top recommendations for a local surgeon and found an article about how he had one of the worst mortality rates at a previous hospital in a different state! I asked my cardiologist if she had seen that article or knew anything about it, and she said, "No, I have only seen his experiences from after he left that hospital at another hospital and then since he moved here, but maybe we should cross him off the list." I also know how the media works, though. The article talked about how two local independent surgeons took over the cardiothoracic surgery division at the hospital after that guy left, so the article could have had a political agenda behind it.

I think the one thing I was searching for, which you definitely addresses, was surgeons that might be able to attempt a repair. The two surgeons I saw in Vegas said they would not even attempt a repair of an aortic valve. Except for about 3 surgeons (Bavaria being one of them), I've found it hard to find stories from patients that have had a successful aortic valve repair. I know it's rare because only a small percentage of aortic valves are even possible candidates for repair and because many surgeons will not even attempt a repair, but I think people should be made more aware that a repair might be possible. Based on my initial research, I was ready for a replacement, thinking it was the only solution. Curiosity caused me to keep digging, though, and thankfully I read enough to know that the local surgeon that said repair was not an option for any aortic valve (ever) was simply telling me that he was not the right surgeon for me.


" When I talked to Bavaria he seemed to be saying that most insufficient valves can be repaired as long as they aren't stenotic. I was originally assigned a surgeon he trained who was highly recommended but the more I heard about Bavaria the more I wanted him to do my surgery. It was a little strange at first as my cardiologist seemed to be saying I was asking a bit much ,as if I didn't rate high enough to have him do my surgery and a lot of people at the hospital were also said how "lucky" I was to have him but it it was simple- my wife called and made an appointment."


I don't live in Henderson, but I'm fairly familiar with it. I'm not sure why Vegas is not for you, which is fine, but since your parents have lived here, you've probably seen the non-entertainment side of Vegas. I actually don't live in a casino on the Strip! I'm from the Midwest and miss the lake, trees, grass, and family. I moved here for business, and through my swimming and working out, I've met a lot of great people - lawyers, doctors (I met my cardiologist through swimming), surgeons, pilots, entertainers, and normal people. My girlfriend also works for the only food bank in Southern Nevada, so we meet a lot of normal people through her work. I miss "home," but I would miss things from here if I did not live here. I just enjoy whatever the moment has to offer at the time, wherever it may be.

" I didn't mean to imply I didn't like it out there , I definitely enjoy visiting it just doesn't feel like home. I guess that changes once you've lived there long enough.The one thing my dad didn't like is he said everything was too new- all the shiny new buildings , around here is a lot like Boston and the surrounding areas so there's a lot of buildings ranging from the 1600's all the way until today. I definitely prefer the "greenness" around here and I like the changing of the seasons. It's fall foliage right about now.It gets a bit too hot out there for me even though I'm aware it's a dry heat."

Quick interesting story: I was just outside Boston at my girlfriend's parents' house and met my girlfriend's second cousin. She had just moved to the Boston area from the Phoenix area for school (and eventually a job). I was talking about Vegas and all the brown compared to Indiana and all the green, which to me is much prettier. She said, "I enjoy the trees here in Boston, but things back home in the Phoenix area were much prettier. All these different shades of brown are so pretty! Here, everything is just green." I found that funny because to me, all the things herein the desert are "just brown," while back home in Indiana, things were pretty different shades of green (and more). As you said, to each his/her own.

Ha that's pretty funny . my mom would say the same thing about all the "pretty colors of the desert " as we drove down the rode . To me it just looked brown and then when we came back home in the early spring it looked like technicolor green.

 

[cldlhd]

For some reason when I quoted your post in individual areas what I wrote basically became part of your text. Just wanted to let you know in case you wanted to read my responses to some of the things you wrote. I went back and put what I wrote in quotes.

 

[BillyG2]

Ha that's pretty funny . my mom would say the same thing about all the "pretty colors of the desert " as we drove down the rode . To me it just looked brown and then when we came back home in the early spring it looked like technicolor green.

Now that I've lived here for almost 3 years, I do see some awesome colors in the mountains and skies, especially in the mornings and evenings when the sun is setting. The different shadows at those times (and sometimes with clouds) is pretty impressive. And since we're in the middle of a large valley, you can see things (e.g., mountains, planes, clouds) very far off that creates a unique perspective.