camgough
Well-known member
I am going to try and keep this short and sweet, but include as much useful information that may assist others in the future.
Personal: I am 34 year old male from Ontario, Canada. I have a family and work as a police officer.
History: At 30 years old was diagnosed with BAV and ascending aortic aneurysm. Never had any symptoms, but in July 2010 had valve-sparing aortic root replacement surgery at Ottawa Heart Institute. My BAV was re-implanted as it was functioning well. My backup plan was to have a mechanical valve incase my valve could not be spared. I was told that nothing is a guarantee, but that 90% of valve-sparing patients are surgery free for 10 years. This initial surgery was complicated and i ended up in ICU for 8 days after an in=operation bleed and numerous blood transfusions. This lead to a lung infection (ARDS) and kidney failure. I was in hospital for 3 weeks before receiving a dual lead Medtronic pacemaker, and finally discharged! I returned to accommodated work duties at the end of September 2010. I was on no medications.
2011 was lot's of walking and getting back into shape. I always felt that I was behind in my recovery, but tried to stay positive. My annual echo showed that my heart and valve were doing well. I was able to return to full police duties August 2011. No restrictions and no medications.
2012 was a lot of work with the pacemaker clinic. My health and cardio were improving, but the pacemaker settings were limiting my progress, primarily because my heart rate would go above the maximum pacemaker settings. After several appointments and a meeting with a Medtronic engineer my settings were right for me. I could safely get my maximum heart rate up to 200bpm if needed (rare).This years annual echo showed that the aortic valve regurgitation was a little worse, but not a concern. The echo also showed a potential blocked artery, which caused me to have a CT Angiogram, and then a follow-up Persantine stress test. At the end of the day the doctor's were not concerned, but it was very stressful. I now have a job in the Detective Office, second son is born, no medications and no restrictions. .
2013 was much of the same with continuing to workout, play ice hockey, be busy with family and generally good spirits. There are some bouts of anxiety that were caused just knowing my valve was worsening and the thought of another surgery really scared me, given my first experience. This years annual echo showed that my regurgitation was again a bit worse, however my heart function was the same. I wish I knew the numbers, but I don't and I was told to keep with the annual echo's and let them know if I have symptoms.
2014 is again a good year, playing hockey and enjoying life. I had my annual echo in October and was called back to the surgeon for a clinic visit. The echo showed my left ventricle had enlarged more and my ejection fraction (EF) was now 35%. I still did not have any symptoms and the surgeon ordered a MUGA. In January 2015 the MUGA confirmed at 33% EF with a severely dilated left ventricle at 8.3cm. Time for surgery to replace my aortic valve!
Feb 17 - early morning go to the Ottawa Heart Institute and sign into the day unit. My surgeon ordered a cardiac catheter angio to check my arteries before surgery. Remember my blocked artery, he wanted to see if any bypasses should be done during the valve replacement. The angio confirmed a blocked circumflex artery on the back of my heart, but the surgeon was not concerned as there were larger arteries there delivering blood. The angio was relatively painless, it took an hour to stop the bleeding in the groin incision and then 4 hours of bed rest. I stayed over night in the hospital.
Feb 18 - awoken at 5:30am, shaved and scrubbed down with anti-bacterial soap. I was taken to the OR around 8:00am after brief visits with family. I remember being in the pre-OR area and talking to the other guys waiting for procedures. I was rolled into the OR and don't recall much after that. At 2:30pm the surgeon found my wife in the family room and told her all had gone well. My BAV was calcified, thickened and in rough shape! I had received a 25mm On-X (my request) and it was functioning well. The surgeon commented that during the surgery he observed my left ventricle actually shrink, and my mitral valve had began to function better. Crazy how quick a proper functioning valve can really change the heart! I finally had the ventilator taken out at 6:00pm, and by the time my wife had come at 8:00pm I had stood at the side of the bed and had some broth. I don't recall too much of this day and slept the night in the ICU.
Feb 19 (Day 1) - Woke up in the ICU and was told all was still good and stable. I was in some pain, but managed fine. I had my chest tubes taken out, it pinches a bit, but you can breath better after. The ICU doctor said my heart sounded like a diesel engine! Around 2:00pm I was taken to a recovery floor. I was still pretty medicated this day, but for some reason my nurse thought I should reduce my pain meds. This was a bad idea and I suffered pretty bad and barely slept all night. I did manage to eat some real food, go for a 60m walk, but it was a painful day and night.
Feb 20 (Day 2) - I felt okay after not sleeping, and the new pain meds were helping. I was taken to the pacemaker clinic first thing and had my settings adjusted. I was put in the Medtronic MVP mode, which allows my heart to beat on it's own when it can. When I returned to my room I had some visitors. I did a 120m walk, and was quite tired. All the meds made my feel nauseous and light headed. All my vitals were good.
Feb 21 (Day 3) - today was a bit of a rough day. My head and stomach felt off all day, and I didn't have much energy. I didn't even get any walks in and felt really hot all day. I tried to rest and kept cool with clothes on my forehead. Finally a nurse found a fan, and this made a world of difference. The nurses said it was common to have a quiet day 3/4 as the adrenaline stops and the body adjusts. I think it is partly because each nurse treats you differently, has their own opinions and preferences for meds. It seemed the doctor had everything ordered, and each nurse picked what they like. I was stopped and started on lasix depending who was working, which made me confused and mad. All my vitals were good.
Feb 22 (Day 4) - I felt a bit better today and did 2 x 120m walks. My pain was better and head felt more normal. It was again really hard to sleep in the hospital, and my room was across from the nursing station. I had lot's of visitors and tried to rest! All my vitals were good and had my first bowel movement.
Feb 23 (Day 5) - Had a physio meeting in the morning and walked 18 stairs. I went to part of a discharge class, but left since I didn't feel well. It's all the same information I heard 5 years ago. At around 1:00pm I met the surgeon again and by 2:00pm was discharged! I was happy to be getting out, even though I was not feeling great. All my vitals were good and I figured I needed to rest at home. The 2 hour drive home was good and getting to my own bed was awesome! I was sent home with a sleeping pill, which really helped!
Feb 27 - I've been home for 4 days and am feeling great! I even went out for lunch today. I was sent home with 81mg aspirin, stomach meds, ACE inhibitor, warfarin and pain killers. My initial warfarin was 4mg, but my blood tests yesterday showed my INR was 1.7 so I am to take 5mg of warfarin tonight.
I'm sorry for the long topic, but I tried to cover lots. There are other forum entries where I've covered some of this in detail. Please let me know if there are any questions about my first or second surgery.
The only suggestion I have, is if you are a younger patient and are offered a valve-sparing/ valve repair, understand it might last as long as the studies show. Our bodies are different and these valves, as well as tissue tend not to last as long in us. So far I am very happy with my mechanical valve and progress.
Personal: I am 34 year old male from Ontario, Canada. I have a family and work as a police officer.
History: At 30 years old was diagnosed with BAV and ascending aortic aneurysm. Never had any symptoms, but in July 2010 had valve-sparing aortic root replacement surgery at Ottawa Heart Institute. My BAV was re-implanted as it was functioning well. My backup plan was to have a mechanical valve incase my valve could not be spared. I was told that nothing is a guarantee, but that 90% of valve-sparing patients are surgery free for 10 years. This initial surgery was complicated and i ended up in ICU for 8 days after an in=operation bleed and numerous blood transfusions. This lead to a lung infection (ARDS) and kidney failure. I was in hospital for 3 weeks before receiving a dual lead Medtronic pacemaker, and finally discharged! I returned to accommodated work duties at the end of September 2010. I was on no medications.
2011 was lot's of walking and getting back into shape. I always felt that I was behind in my recovery, but tried to stay positive. My annual echo showed that my heart and valve were doing well. I was able to return to full police duties August 2011. No restrictions and no medications.
2012 was a lot of work with the pacemaker clinic. My health and cardio were improving, but the pacemaker settings were limiting my progress, primarily because my heart rate would go above the maximum pacemaker settings. After several appointments and a meeting with a Medtronic engineer my settings were right for me. I could safely get my maximum heart rate up to 200bpm if needed (rare).This years annual echo showed that the aortic valve regurgitation was a little worse, but not a concern. The echo also showed a potential blocked artery, which caused me to have a CT Angiogram, and then a follow-up Persantine stress test. At the end of the day the doctor's were not concerned, but it was very stressful. I now have a job in the Detective Office, second son is born, no medications and no restrictions. .
2013 was much of the same with continuing to workout, play ice hockey, be busy with family and generally good spirits. There are some bouts of anxiety that were caused just knowing my valve was worsening and the thought of another surgery really scared me, given my first experience. This years annual echo showed that my regurgitation was again a bit worse, however my heart function was the same. I wish I knew the numbers, but I don't and I was told to keep with the annual echo's and let them know if I have symptoms.
2014 is again a good year, playing hockey and enjoying life. I had my annual echo in October and was called back to the surgeon for a clinic visit. The echo showed my left ventricle had enlarged more and my ejection fraction (EF) was now 35%. I still did not have any symptoms and the surgeon ordered a MUGA. In January 2015 the MUGA confirmed at 33% EF with a severely dilated left ventricle at 8.3cm. Time for surgery to replace my aortic valve!
Feb 17 - early morning go to the Ottawa Heart Institute and sign into the day unit. My surgeon ordered a cardiac catheter angio to check my arteries before surgery. Remember my blocked artery, he wanted to see if any bypasses should be done during the valve replacement. The angio confirmed a blocked circumflex artery on the back of my heart, but the surgeon was not concerned as there were larger arteries there delivering blood. The angio was relatively painless, it took an hour to stop the bleeding in the groin incision and then 4 hours of bed rest. I stayed over night in the hospital.
Feb 18 - awoken at 5:30am, shaved and scrubbed down with anti-bacterial soap. I was taken to the OR around 8:00am after brief visits with family. I remember being in the pre-OR area and talking to the other guys waiting for procedures. I was rolled into the OR and don't recall much after that. At 2:30pm the surgeon found my wife in the family room and told her all had gone well. My BAV was calcified, thickened and in rough shape! I had received a 25mm On-X (my request) and it was functioning well. The surgeon commented that during the surgery he observed my left ventricle actually shrink, and my mitral valve had began to function better. Crazy how quick a proper functioning valve can really change the heart! I finally had the ventilator taken out at 6:00pm, and by the time my wife had come at 8:00pm I had stood at the side of the bed and had some broth. I don't recall too much of this day and slept the night in the ICU.
Feb 19 (Day 1) - Woke up in the ICU and was told all was still good and stable. I was in some pain, but managed fine. I had my chest tubes taken out, it pinches a bit, but you can breath better after. The ICU doctor said my heart sounded like a diesel engine! Around 2:00pm I was taken to a recovery floor. I was still pretty medicated this day, but for some reason my nurse thought I should reduce my pain meds. This was a bad idea and I suffered pretty bad and barely slept all night. I did manage to eat some real food, go for a 60m walk, but it was a painful day and night.
Feb 20 (Day 2) - I felt okay after not sleeping, and the new pain meds were helping. I was taken to the pacemaker clinic first thing and had my settings adjusted. I was put in the Medtronic MVP mode, which allows my heart to beat on it's own when it can. When I returned to my room I had some visitors. I did a 120m walk, and was quite tired. All the meds made my feel nauseous and light headed. All my vitals were good.
Feb 21 (Day 3) - today was a bit of a rough day. My head and stomach felt off all day, and I didn't have much energy. I didn't even get any walks in and felt really hot all day. I tried to rest and kept cool with clothes on my forehead. Finally a nurse found a fan, and this made a world of difference. The nurses said it was common to have a quiet day 3/4 as the adrenaline stops and the body adjusts. I think it is partly because each nurse treats you differently, has their own opinions and preferences for meds. It seemed the doctor had everything ordered, and each nurse picked what they like. I was stopped and started on lasix depending who was working, which made me confused and mad. All my vitals were good.
Feb 22 (Day 4) - I felt a bit better today and did 2 x 120m walks. My pain was better and head felt more normal. It was again really hard to sleep in the hospital, and my room was across from the nursing station. I had lot's of visitors and tried to rest! All my vitals were good and had my first bowel movement.
Feb 23 (Day 5) - Had a physio meeting in the morning and walked 18 stairs. I went to part of a discharge class, but left since I didn't feel well. It's all the same information I heard 5 years ago. At around 1:00pm I met the surgeon again and by 2:00pm was discharged! I was happy to be getting out, even though I was not feeling great. All my vitals were good and I figured I needed to rest at home. The 2 hour drive home was good and getting to my own bed was awesome! I was sent home with a sleeping pill, which really helped!
Feb 27 - I've been home for 4 days and am feeling great! I even went out for lunch today. I was sent home with 81mg aspirin, stomach meds, ACE inhibitor, warfarin and pain killers. My initial warfarin was 4mg, but my blood tests yesterday showed my INR was 1.7 so I am to take 5mg of warfarin tonight.
I'm sorry for the long topic, but I tried to cover lots. There are other forum entries where I've covered some of this in detail. Please let me know if there are any questions about my first or second surgery.
The only suggestion I have, is if you are a younger patient and are offered a valve-sparing/ valve repair, understand it might last as long as the studies show. Our bodies are different and these valves, as well as tissue tend not to last as long in us. So far I am very happy with my mechanical valve and progress.
