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wlaldridge

Gosh, where to start. Hello out there.
I have been following this site for a couple of weeks now, and what a great group you seem to be. You already have been more help than anyone physically near me.
I am 59 yars old, was diagnosed with mild Aortic Stenosis in 1995 and told "take antibiotics for invasive procedures" , probably had a bicuspid valve and I might need to talk about valve replacement in 15-20 years. I had just completed a stress echo with 16 minutes up to a rate of 175 and no sign of problems other than mild stenosis. I did what I was told but did not take it as too serious since the navy doctors had always thought my heart sounded a little "funny" back in the early 1960's. I felt great and was sure that I was no different than 30 years earlier. My father died at 48 from "heart attack" but since I was past that age with no evidence of blockage, whats to worry, right?
Last February during my physical I asked to do another echo to check on the valve. I had a skin cancer that concerned me more than my heart, did not hear anything from the echo. Assumed "no news is good news" but in June I requested written results of all the cancer post op and physical, by the way also the echo cardiogram, please. Well, "no news is just NO NEWS", echo report missent to wrong doc and no one followed up til I requested stuff. Now the stenosis is severe a 30% decline in 7 years, oh, oh. Not good news, I thought. Still no symptoms, one cardio said wait for symptoms, another said you got less than 5 years with out surgery. A new echo showed another drop to .61 cm sq cross section. They wanted a heart cath and to setup surgery. valvereplacement.com gave me the confidence to get the cath done on Aug 15 as Walter Weir was going for his big surgery. Now here I am, no artery blockage but looking to replacing that valve. Happy to hear that Walter is doing well. I gives me hope, but boy am I scared to death. I think everything medical is going to do me in. Tonsils at age 31, skin cancer last February, heart cath, now they all seem trivial by comparison. I am going to need your help, Please. Thanks for being out there and sharing your experiences. It has already made this thing seem more bearable.

Sorry for the lenght of this but felt the need, I guess.
 
Hi,
I have an open heart surgery set for September. Ever since i found out I was going to have the cath and surgery i have been reading tons of information on www.heartcenteronline.com. I think it's helped me a lot. I'll still be nervous when i enter the hospital the day i go in for surgery. (i was really nervous just having the cath done) I hope the website helps you at least some. It goes over different types of surgeries, medical procedures, has a newsletter, etc.

Good luck on your surgery.
 
Hi you guys-

Welcome to this terrific site. Everyone here understands tons about valve surgery and beyond. We'll all be here for you during your pre-surgery period.

My husband is the patient and he's had 3 valve surgeries due to rheumatic fever as a teen. He's also had 2 lung surgeries and has a pacemaker, plus has had lots of other serious medical problems. He's 71 years old and still chugging along.

The surgery sounds awful when you first hear about it, but it's a real life saver. The surgeons who do this are highly skilled and are in the chest area all the time. They know how to take care of all the problems. There are lots of choices to think about. There are lots of different valves to consider and various surgeons and hospitals to research. This site can help in that respect. Just read as many of the posts as you can. Once you have informed yourself, you'll be a lot less apprehensive. I promise.

Glad to have you here, and post often with questions and anything you have learned along the way.
 
Hi Bill,

You were wise to follow up on your tests. With an aortic opening of only 0.61 sq cm it sounds like it's time for replacement. You definitely do NOT want to wait until your heart suffers permanent muscle damage from compensating for a damaged valve. That should help motivate you to proceed with replacement surgery ! (It convinced me anyway). Have you decided on a valve type yet?

At age 58, I liked the idea of the Bovine Pericardial Tissue Valve. These are made from the pericardium of a cow's heart and shaped to resemble a human valve. Durability numbers are 90% at 15 years and counting and of course, lifelong Coumadin Anti-coagulation therapy is NOT normally required. I believe the Cleveland Clinic (#1 rated Heart Hospital) favors this valve.

Unfortunately for me, my surgeon decided to use a mechlanical valve because of radiation damage from years ago and I'm on Coumadin for life. It still beats the alternative.

'AL'
 
Welcome Bill....

Welcome Bill....

Hi Bill,

Glad you found us! Isn't this website a blessing? I thought so!
It is understandable that you are scrared, we all were before surgery. But guess what, the more you know the less you fear it. That's how it was for me. Surgery wasn't as bad as I thought it would be. Very little pain actually, and if you feel pain they'll give you morphine. There is discomfort, but you'll learn how to move the painless way very quickly.
Heart surgeons these days talk about heart surgery like they are going to work on your car. They do this all the time and know their way around in the human heart, so put your trust in your God, surgeon and the medical team.
I also would advise you to invest in a comfortable recliner chair to sleep in the first few weeks after you get home from the hospital. To get in and out of bed is not a good feeling, especially trying to stand up straight.
Like you, I also had a Stenosed Bicuspid Aortic Valve, but had no idea until July 2000. I thought it was menopausal problems that were keeping me up at night, tiredness and always being flustered and hot.
I needed surgery soon after diagnosis and had no time to waste because I was in danger of sudden death, I was told. Boy, that got my attention!
I actually had two surgeries within 11 days because of a screw-up at the cardiologist office, but both times I did fine.
I received a St. Jude's mechanical valve and am on Coumadin for the rest of my life. Once Coumadin is stabalized it's not much of a problem. You have to stay on top of it though, and can't be fooled around with. I have a Protime and do my own testing at home. (see ad on this page)

Well, ask away Bill, and all of us will be there to guide you over that mountain as we call it. You'll do fine, and before you know it you'll be on the other side of surgery!

Christina
AVR's 8/7/00 & 8/18/00
TMC, Tucson. AZ
Dr. Gulshan Sethi
St. Jude's Mechanical
 
Thanks to you all for the quick reply. It warms me, that folks are so kind and caring for strangers. I have read many of your personal stories and am amazed at your strength. As I said earlier I was pretty sure the Heart Cath was going to be the end when everyone was saying it is a "piece of cake", so I understand hkitch's fear.

Al hit it right on the head, it looks like it is time. That is why when my doc and the first cardiologist said wait because I am not symptomatic, I wanted to see more info.

Christina, I do believe that knowledge will be the key to releiving the fear. But, I got some way to go yet.

I didn't mean for it to sound like I had no support at home. My wife of 38 years, Connie, is terrific and our three grown sons all support the old man, they call regularly.
Our youngest, Joe is stationed in Korea with the 82nd Airborne and he is coming back to the states on Sept 5 for the surgery.

As for the choices, I have had few up til now. Have been taking what ever guy I was refered to. The hospitals in Pensacola, Fl. are well staffed but not like Cleveland Clinic, Mayo, Johns Hopkins etc, we would probably not go to one of those unless it was some very compelling need. My cardiologist said he thinks a mechanical but to take the advise of the surgeon. We will see.

I would have liked to see the surgeon before this but none was available til nest week.

Thanks for the support so quickly.
 
Well, hey there, Neighbor. I am in DeFuniak Spgs - had quad bypass in Pensacola March 2000. Dr Branco was my cardio and since I saw the surgeon very briefly each time, I have forgotten his name (pumphead deficiency, I guess), but he was very good and I was treated so well by all staff. Still go for my checkups to Pensacola yearly.

I found VR after surgery and even tho I did not have valve surgery as all others have, they just took pity on me and let he hang around with them. This are a kind bunch and I love them all dearly. Helped me so much as I am sure they will help you, as well. Read all you can to educate yourself, ask questions about EVERYTHING you can think of, even if it seems trivial to you. With the collective experiences in here, you should be able to get every question answered and breeze through without a hitch. And you won't believe the support.

Welcome and God bless
 
New version of the stress test was tried out on me this a.m.

Had first appointment with surgeion scheduled for 10:30 this a.m.
They called at 8:45 a.m. and asked me to come early about 9:30 would be best. I am 30 minutes away from the hospital/heart center. I dropped everything and rushed there. No parking was available within a quarter mile. When I finally relented and parked and took the hike, I had not had symptoms til maybe now. I was shown into the smallest examining room/broom closet, I have ever seen and told the doc would be right there. One hour and ten minutes later I decided to look out in the hall. A couple of employees asked me if I needed something, DUH, I says I have been here ove an hour. They didn't even act like I should be concerned. I saw the surgeon about one hour after my oringinally scheduled appointment. He asked about me and I explained that I had probably "failed" this special "stress" test but wanted his opinion anyway.
He set forth the opions in terms of valve and timing. Pig or mechanical (St. Jude or some other) now or after heart damage. He favors now but feels the choice is tought at age 59 as to valve. Thinks stentless pig is pretty good if the phisiology of my body will allow it. Now I have lot to decide.
The date is set for Sept. 12, 2002 which was my first choice.
 
Hi Bill-

I put you on the calendar, so here you go! Just enough time to get all your stuff done prior to surgery, and not enough time to worry too much, I hope.

These next couple of weeks will be very busy.
 
Bill
Good Luck with your surgery.
I agree with Nancy, she is the voice of wisdom. 9-12 gives you time to do what you need but not enough time to spend useless energy worrying too much.
I wish I had had my surgery soon after I was told I needed it. I waited 3.5 months. I had surgery 5 days after my wedding and the wedding plans were set, my husband's family and friends coming over from Scotland, so my mom talked me into waiting until after. In hindsight, with the smooth way things went, I wish I had just had it two weeks after the cardio and the surgeon told me I needed it.

We'll be thinking of you.
-Mara
 
WELCOME BILL

WELCOME BILL

Hello Bill, and welcome to this wonderful place.

My husband is 59 and in June had AVR with a mechanical replacement. Actually, June seems a long way back, even though it's been 8 weeks post op. He was very much like you, totally asymptomatic for about 3 years prior and our cardio said, wait till the numbers are right. Well, he went from being asymptomatic to being in atrial fibrillation (196 beats per minute) and that began our relationship with this wonderful place. Our cardio told him that the afib was "his sign" and off we went. Our surgeon, Dr. James Taylor, from St. Francis Heart Center in Roslyn, NY, recommended a mechanical as did our cardiologist....both because they said he shouldn't have to have a second surgery when he is 75 and secondly because of his "young" age. We went with both of their opinions and have not looked back.

Yes, Tyce is on coumadin for the rest of his life---not a big deal as far as either of us is concerned. We were fortunate enough to have our insurances cover the Protime system, so home testing is easy, but fingersticks at the cardio's office was easy, too.

If you happen to look back at some OLD threads, both in the pre and post surgery, you'll see ours...AVR a wife's questions, and Tyce's surgery??? I think those are the names. This wonderful group of people got us both through presurgery, surgery, and after care, and believe me when I tell you that they will do the same for you. You couldn't be in a better place than here.

If I can help you in any way, don't hesitate.....I know how I felt presurgery and all of my concerns, and I'm sure you and your family share the same.

My very best, and I will put you on my prayer list effective tonight!!

Evelyn
 
You folks are so great. I can hardly believe all the kindness I have gotten already. Thank you, Thank you!!

On June 28 the cardio convinced me that I was going to get this done sooner rather than later. Time has flown. But, today sealed the deal.

Oddly, my wife, Connie, is in Tallahassee helping our daughter-in-law settle into her new apartment. We helped them move from Tampa this week earlier then I came home for the doctor. I'll be going back there tomorrow or Saturday to finish up.

Today is our 38th Anniversary, we are spending it apart. We spent our first anniversary apart for 3 weeks way back when, and now all these years later events conspired to separate us for the day, so maybe this is a good sign. We might get a few more years out of this relationship, the good Lord willing.

This writing feels so self centered and yet don't know how it can be much else til I am on the "other side of the mountain" being a cheerleader for others to follow. I can not give much to anyone else at this point other than my heartfelt prayers. Gosh, this site just breeds "heart" puns, I can't seem to avoid them.

Thank you all, again from the the area below my bad valve caked with calcium.
 
Bill,

If I were in your shoes, I would ask your surgeon for the *durability statistics* on the PIG valve he suggested and how those compare with the durability statistics for the Carpentier-Edwards Bovine Pericardial valve.

GENERALLY speaking, COW valves last 50% to 100% LONGER
than standard PIG valves. Neither one requires Coumadin anticoagulation therapy but they will eventually wear out and require replacement surgery. IF you choose the Bovine Valve, you want to also choose a surgeon who has considerable experience with this valve.

On the other hand, The standard St. Jude Mechanical Valve has an excellent record and should outlast all of us, thus not requiring a second surgery BUT it does require lifelong Coumadin anticoagulation therapy, commonly refered by the misleading term 'blood thinner therapy'. This is probably the 'safe' approach from both the durability standpoint and the surgical standpoint since any heart surgeon worth his salt should be quite familiar with this valve.

Whatever you decide, I would proceed as quickly as possible.

'AL'
 
Hi Bill-

Happy Anniversary to you. I liked your line in the above post "We might get a few more years out of this relationship, the good Lord willing."

That's what this is all about. You'll do fine and it is a life saving operation.
 
Thanks Nancy,

My wife tells everyone that this is being done to save my life, end of story.

Al,

I did take your earlier advice about the bovine valve and ask the surgeon. He just said "not enough history" he is not convinced, I don't have many choices of surgeons here and they are pretty much in agreement, I am told.

He said the stentless pig valve will last longer but still might not "fit" where it needs to on my heart. The mechanical St. Jude will likely minimize the time the aorta is "cross clamped" and thus the time on the pump, also.

I do have a little time to consider the options and get more research. Thanks for your help, I am asking around about the bovine and other surgeons.

As a minor issue that annoyed me today, I was told I would be resopnsible for what ever the insurance comany would not pay but they declined to advise the "surgical fee", now I believe the surgeon when he told me the office girls needed to tell me, but they told me I had to ask him. Total Bulls**t, I plan to know just for my own satisfaction..

Thanks to you all.
 
Hello Bill, sorry to see another person being hit with a non-approved stress test. There seem to be several different procedures running around that are used to induce stress in patients. I had not yet seen the "broom closet" variant, but I suspect we will hear from others who have experienced it.

I'm 43 with 2 St. Jude mechanicals and I'm finding the Coumadin to be no big deal now that my dose has been figured out. I was on the pump for only 2 hours even though I had some calcification of the valve roots that had to be dealt with.

Don't worry about sounding self-centered. You're amongst friends here who know exactly what you're feeling. Your wife hit it right on the head...this is being done to save your life. Keep up your spirited approach and don't let 'em push you around!

Johnny
 
Hi!

Just thought I would add a word of encouragement. My husband, now age 56, had two valves installed this past October. He is 56. Because he ended up needing his mitral valve replaced, not repaired, they surgeon implanted two St. Jude valves. He had aldready been on coumaden for a-fib, a cardioversion had already been attempted, so the coumaden thing was not an issue in the decision making process.

We also plan on spending many more years together....we will be at our 34th anniversary this coming February. (Yes, we were both pretty young.) He had therefor already made up his mind, since he was so young at the time, that he really didn't want to go through the surgery again. So, he made the decision to go with the mechanical. I think it was a good decision.

Each person needs to come to their own decision about what and when, and there is just loads of information out there to help in the process. I know that you will make the right decision, for you.

Wishing you peaceful days pre-surgery -

Marybeth
 
Hi Bill,

It sounds like the surgeon you interviewed is not very familiar with the Bovine Pericardial valve so I wouldn't want *him* installing one in me.
The Bovine Pericardial valves were first introduced around 20 years ago and fully approved by the FDA at least 12 years ago.

The surgeon who did my Bypasses only offered me the choice of a Bovine Pericardial and St. Jude Mechanical Valve. He refuses to implant (standard) pig valves because of their short lifetime.

I believe the 'stentless' porcine valve may be better than regular pig valves but I confess I don't know that much about them other than they do offer a larger opening for greater blood flow. I'm pretty sure this valve has been available for even less time than the cow valve.

In any event, if you are comfortable with a mechanical valve and Coumadin therapy, that choice should last forever and keep you away from a repeat surgery and I would expect every heart surgeon to be familiar and comfortable with that valve.

I don't know my final numbers, but 3 months after they told me it was time (0.9 square cm), I experienced chest pain 2 days before my scheduled surgery. They sent me by ambulance to my chosen hospital 100 miles away and a baloon pump was inserted through a leg catheter the night before surgery to 'lighten the load on my heart'. I would not have wanted to postpone surgery even another week so, my recommendation is to make your decision SOON and schedule that surgery while you are still standing.

'AL'
 
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