johnp
Well-known member
Background
I was originally referred to a team of cardiac specialists due to serious issues with ventricular (VT and VF) events, a few requiring an ICD shock. During a routine evaluation, I had an updated Echo (in Nov) which now indicated severe mitral regurgitation, so I opted to have an MV repair as soon as possible. After more tests, I was determined to be a candidate for robotically assisted/minimally invasive. In the end, I opted for this versus open chest. The surgery was Dec 27 (at the Mayo Clinic MN), I was discharged from the Hosp on Dec 30 and returned to work Jan 6.
I just had a 1-month follow up after the Robotic MV Repair. Read on if interested.
I had an echo, an EKG, a 24 hour 12 lead monitor, and an ICD interrogation.
The Echo confirmed evidence of successful MV repair with only minimal or trace regurg. The cardiologist further noted there was some early evidence of (atrial) cavity size reduction versus his own records. He did say my EF was lower now (.5 versus .65 to .7 pre-op), but he said this decrease was frequently observed following MV surgery. It was later explained that the EF often does go down after MV surgery since the heart is no longer pumping blood back up into the atrium (the easy way). But I am not sure if there is an expectation that my EF might increase over time. I hope so, but no symptoms, which is good I guess.
The 24 hr 12 lead actually showed an increase in PVCs versus the last 24hr test (October 2010). I had a little over 1000 PVCs back then, and now 3000. I was on a much higher beta blocker back then. PVCs were still multi-form and still correlated with active periods of the day, suggesting a catecholamine (adrenalin) basis. I found this result quite odd since the sensation in my chest is very different from my pre-op days. I seldom feel these PVCs, I certainly felt them before!
The ICD device interrogation showed just two short (non-sustained) runs of VT over the month post-op, neither of which required treatment by the ICD. But this still has me conerned. I can ony hope they subside as the healing continues.
The Electrophysiologist and I talked about options should there be renewed risk of VT/VF events (ablation, sympathetic denervation, increase in anti arryth meds), but we agreed it was way too early. We agreed to let the healing/heart remodeling process further run its course, and then see to what extent the PVCs (and PACs from a modified Maze procedure I also had done at the same time) subside. BTW Atrila Fib is very common after MV repiar, I am told, but the Maze procedure I opted for should significantly reduce the risk of A Fib. But as noted, I am showing a number of PACs, but the Dr said these should subside over time.
We also talked about my easing back into some limited exercise. It was agreed an exercsie stress test and possible cardiac rehab were the next logical steps. I used to be heavy into endurance sports like triathlons, they know my number, and I practically had to promise the Dr I would not overdo it and push myself too hard.
Overall I am feeling very well. I am walking briskly at least 30 mins a day, and taking the stairs every chance I get.
I clearly see that my cardio fitness is a far cry from where it was pre-op, but I am told this is normal and recovery will take considerable time.
There is still some numbness and minor soreness in the chest area (on the incision side, my right side), but this is not a concern - there is no longer any need for even Tylenol. I will be going off the blood thinner at the 6-week mark, which is coming up soon.
I will be calling to schedule a stress test next week, that should be interesting. The last time I did a stress test, months before surgery, I had short runs of V tach and they kicked me off the treadmill. I told them I could do much better, but they told me they had seen enough.
More to come...
I was originally referred to a team of cardiac specialists due to serious issues with ventricular (VT and VF) events, a few requiring an ICD shock. During a routine evaluation, I had an updated Echo (in Nov) which now indicated severe mitral regurgitation, so I opted to have an MV repair as soon as possible. After more tests, I was determined to be a candidate for robotically assisted/minimally invasive. In the end, I opted for this versus open chest. The surgery was Dec 27 (at the Mayo Clinic MN), I was discharged from the Hosp on Dec 30 and returned to work Jan 6.
I just had a 1-month follow up after the Robotic MV Repair. Read on if interested.
I had an echo, an EKG, a 24 hour 12 lead monitor, and an ICD interrogation.
The Echo confirmed evidence of successful MV repair with only minimal or trace regurg. The cardiologist further noted there was some early evidence of (atrial) cavity size reduction versus his own records. He did say my EF was lower now (.5 versus .65 to .7 pre-op), but he said this decrease was frequently observed following MV surgery. It was later explained that the EF often does go down after MV surgery since the heart is no longer pumping blood back up into the atrium (the easy way). But I am not sure if there is an expectation that my EF might increase over time. I hope so, but no symptoms, which is good I guess.
The 24 hr 12 lead actually showed an increase in PVCs versus the last 24hr test (October 2010). I had a little over 1000 PVCs back then, and now 3000. I was on a much higher beta blocker back then. PVCs were still multi-form and still correlated with active periods of the day, suggesting a catecholamine (adrenalin) basis. I found this result quite odd since the sensation in my chest is very different from my pre-op days. I seldom feel these PVCs, I certainly felt them before!
The ICD device interrogation showed just two short (non-sustained) runs of VT over the month post-op, neither of which required treatment by the ICD. But this still has me conerned. I can ony hope they subside as the healing continues.
The Electrophysiologist and I talked about options should there be renewed risk of VT/VF events (ablation, sympathetic denervation, increase in anti arryth meds), but we agreed it was way too early. We agreed to let the healing/heart remodeling process further run its course, and then see to what extent the PVCs (and PACs from a modified Maze procedure I also had done at the same time) subside. BTW Atrila Fib is very common after MV repiar, I am told, but the Maze procedure I opted for should significantly reduce the risk of A Fib. But as noted, I am showing a number of PACs, but the Dr said these should subside over time.
We also talked about my easing back into some limited exercise. It was agreed an exercsie stress test and possible cardiac rehab were the next logical steps. I used to be heavy into endurance sports like triathlons, they know my number, and I practically had to promise the Dr I would not overdo it and push myself too hard.
Overall I am feeling very well. I am walking briskly at least 30 mins a day, and taking the stairs every chance I get.
I clearly see that my cardio fitness is a far cry from where it was pre-op, but I am told this is normal and recovery will take considerable time.
There is still some numbness and minor soreness in the chest area (on the incision side, my right side), but this is not a concern - there is no longer any need for even Tylenol. I will be going off the blood thinner at the 6-week mark, which is coming up soon.
I will be calling to schedule a stress test next week, that should be interesting. The last time I did a stress test, months before surgery, I had short runs of V tach and they kicked me off the treadmill. I told them I could do much better, but they told me they had seen enough.
More to come...
