Made it to the other side

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Unicusp

Well-known member
Joined
Jan 30, 2021
Messages
169
Hello again from the other side. Luckily, I was part of the 98%. Made it thru the surgery this past Friday fine. The wait was worse, and glad it is over. Recovery so far is going well, even better than last time. And I had a full sternotomy this time vs. mini-sternotomy “keyhole” last time in 2013. Then, my enlarged ascending aorta was replaced with Dacron graft. Now the unicuspid valve, which was diagnosed as severely stenotic with calcification, was very heavily calcified.

Currently on day 4 and very minimal pain. Just acetaminophen for past 2 days. Fentanyl for ICU was effective but short lived and with wild side effects. Hallucinations, go from chills/shaking to sweats even though temp was normal. Guess I don’t have to worry about becoming an addict!

Surgery done at Cleveland Clinic by Dr. Lars Svensson (same as first surgery). Was in ICU for 2 days which is minimum protocol now. Had 4 drain tubes vs. 2 last time. That part sucks when they remove the tubes, although feels better when out. Was walking on day 2 in ICU. They said I could have been released today due to my recovery, but have to wait for INR level to drop before heart wires can be removed. So, probably Thursday with wire removal tomorrow.

The valve. So, as I mentioned in a previous post I spoke with surgeon right before surgery and left the final decision to him as to which specific valve would be best for my anatomy. So even though he was a SJM proponent and I thought we were going in that direction……he sized both brands and determined that the On-X was best for me. So, I now have a 23mm On-X. I’m fine with that as it was my first or initial choice. I believe they are very similar with minimal unique characteristics.

Valve noise: I can’t really hear it, and I have very sensitive hearing. It was even hard using the stethoscope. It is very muffled. I’m wondering if the Dacron graft combined with the chest muscle are noise suppressing.

Thanks for all of the very helpful information.

A final comment. I strongly recommend the Cleveland Clinic for any heart related issue. Simply the best. I noticed improvements in the process since 2013.
 

Superman

Well-known member
Joined
Oct 3, 2009
Messages
1,140
Location
Grand Rapids, MI, USA
Congrats! Great to see you’re doing well and in good spirits! Drain tubes do suck!

Funny. I thought just the opposite. That the Dacron amplified things.

Looking forward to more good news and updates!
 

tezza

Active member
Joined
Nov 4, 2020
Messages
36
Congratulations on getting through to the other side successfully! Yep, the drain tubes... But it is all up from here. Good luck!
 

NorthWoods

VR.org Supporter
VR.org Supporter
Joined
Nov 22, 2020
Messages
27
Location
Champlin, MN
Congrats on doing well! I'll bet it is a relief to be done and healing.
My AVR is tomorrow so I'll keep everyone posted. Surgeon is wanting to do a Mini-Sternotomy so I hope he is able to do it and have a faster recovery time.
 

Unicusp

Well-known member
Joined
Jan 30, 2021
Messages
169
Congrats on doing well! I'll bet it is a relief to be done and healing.
My AVR is tomorrow so I'll keep everyone posted. Surgeon is wanting to do a Mini-Sternotomy so I hope he is able to do it and have a faster recovery time.
Thanks and good luck! You're in the hard part now. Easier once you get thru and wake up in ICU. Not as bad as most expect.
 

Sheenas7

Well-known member
Joined
Apr 22, 2014
Messages
176
Location
Va, Fairfax County
Hello again from the other side. Luckily, I was part of the 98%. Made it thru the surgery this past Friday fine. The wait was worse, and glad it is over. Recovery so far is going well, even better than last time. And I had a full sternotomy this time vs. mini-sternotomy “keyhole” last time in 2013. Then, my enlarged ascending aorta was replaced with Dacron graft. Now the unicuspid valve, which was diagnosed as severely stenotic with calcification, was very heavily calcified.

Currently on day 4 and very minimal pain. Just acetaminophen for past 2 days. Fentanyl for ICU was effective but short lived and with wild side effects. Hallucinations, go from chills/shaking to sweats even though temp was normal. Guess I don’t have to worry about becoming an addict!

Surgery done at Cleveland Clinic by Dr. Lars Svensson (same as first surgery). Was in ICU for 2 days which is minimum protocol now. Had 4 drain tubes vs. 2 last time. That part sucks when they remove the tubes, although feels better when out. Was walking on day 2 in ICU. They said I could have been released today due to my recovery, but have to wait for INR level to drop before heart wires can be removed. So, probably Thursday with wire removal tomorrow.

The valve. So, as I mentioned in a previous post I spoke with surgeon right before surgery and left the final decision to him as to which specific valve would be best for my anatomy. So even though he was a SJM proponent and I thought we were going in that direction……he sized both brands and determined that the On-X was best for me. So, I now have a 23mm On-X. I’m fine with that as it was my first or initial choice. I believe they are very similar with minimal unique characteristics.

Valve noise: I can’t really hear it, and I have very sensitive hearing. It was even hard using the stethoscope. It is very muffled. I’m wondering if the Dacron graft combined with the chest muscle are noise suppressing.

Thanks for all of the very helpful information.

A final comment. I strongly recommend the Cleveland Clinic for any heart related issue. Simply the best. I noticed improvements in the process since 2013.
Bravo! The waiting I do think is really hard. I also had my valve surgery at Cleveland Clinic 2001. Best wishes for a quick recovery.
 

Unicusp

Well-known member
Joined
Jan 30, 2021
Messages
169
Bravo! The waiting I do think is really hard. I also had my valve surgery at Cleveland Clinic 2001. Best wishes for a quick recovery.
Thanks! Wire pulling time. Hope for no bleeding! Lowered INR to 1.6 for it.
 

BillDaThrill

Member
Joined
Apr 17, 2016
Messages
21
Location
Los Alamos, NM 87544
Great to hear Unicusp! Dr. Svennson's team is reviewing my medical records now and, with severe AS, I think my time is near. Thank you for the report. Going to travel across the country for him and the CC. Your post makes me confident that is worth the effort. Wishing you the best with your On-X and sleeve!
 

Unicusp

Well-known member
Joined
Jan 30, 2021
Messages
169
Great to hear Unicusp! Dr. Svennson's team is reviewing my medical records now and, with severe AS, I think my time is near. Thank you for the report. Going to travel across the country for him and the CC. Your post makes me confident that is worth the effort. Wishing you the best with your On-X and sleeve!
Thanks. Definitely worth the trip! They are very precise and have seen it all. Lots of practice.
 

caro

VR.org Supporter
VR.org Supporter
Joined
Jan 7, 2020
Messages
44
Location
NYC
SO happy to hear this @Unicusp !! Thank you for the report! Cleveland Clinic is amazing. Nice to hear about on-x. I was and still am surprised by how quiet it is. Happy for you!
 

MdaPA

Well-known member
Joined
Jul 8, 2020
Messages
111
They said I could have been released today due to my recovery, but have to wait for INR level to drop before heart wires can be removed.
Hum.....when my wife had her OHS at CC in 2017, they snipped the exposed temporary pacing wires and left the internal wires. They told her they did not want to pull them out because of the risk for internal bleeding (recall her INR was just around 2.5 as they required that for check-out).

Curious as to why they are removing yours but did not lower her INR to remove hers? It's good that they are removing them for you though as my wife has had difficulties finding facilities that will give her an MRI (for non-heart related stuff) because of her retained pacing wires. She has cards with the MRI considerations for her St Jude valves but they don't give such for pacing wires.

Glad to hear you are recovering well!
 

Unicusp

Well-known member
Joined
Jan 30, 2021
Messages
169
Hum.....when my wife had her OHS at CC in 2017, they snipped the exposed temporary pacing wires and left the internal wires. They told her they did not want to pull them out because of the risk for internal bleeding (recall her INR was just around 2.5 as they required that for check-out).

Curious as to why they are removing yours but did not lower her INR to remove hers? It's good that they are removing them for you though as my wife has had difficulties finding facilities that will give her an MRI (for non-heart related stuff) because of her retained pacing wires. She has cards with the MRI considerations for her St Jude valves but they don't give such for pacing wires.

Glad to hear you are recovering well!
Appears to depend upon individual surgeon opinion. My surgeon says if you don't need it, it comes out. Another patient here told me his were snipped per his surgeon. So, not consistent.
 

MdaPA

Well-known member
Joined
Jul 8, 2020
Messages
111
Are those pacemaker wires? I have them left in there and thus no MRI for me ever.
Sheenas7,
If you have retained temporary epicardial (not intracardiac) pacing leads/wires, you should be able to get an MRI (see below resource). Confirm with your Dr.

Note you may have to go to a larger hospital (e.g. that performs OHS) where the Imaging folks have more dealings with this whereas a smaller facility/hospital may turn you away. After contacting a few imaging facilities and hospitals, my wife was able to find a local hospital that would do an MRI on her while having retained temporary epicardial pacing leads/wires (and 2 St Jude mechanical valves). She was able to get an MRI and had no issue.

Temporary Epicardial Pacing Leads
Although there is a theoretical risk that MRI examinations in patients with retained temporary epicardial leads (which consist of electrically conductive materials) could lead to cardiac excitation or thermal injury, such retained leads which are relatively short in length and do not form large conducting loops have not been found to pose a substantial hazard to patients during MRI procedures.
MRIsafety.com - Safety Information Article
 

Unicusp

Well-known member
Joined
Jan 30, 2021
Messages
169
Wire pulling? Are those pacemaker wires? I have them left in there and thus no MRI for me ever.
Glad you are in recovery now!
Yes, the temporary wires (2) installed during surgery in case a pacemaker was required.
 
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