New, Returning Past Member - 1-17-22 Surgery Scheduled

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Dano64

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Jan 3, 2022
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Hello Everyone! I was a member of this forum many years ago. I had a BAV with calcification and underwent Homograft replacement at Duke March 2001. That surgery went great and I lived a pretty normal life with routine ultrasound checks until 3.5 years ago when they finally took a decent look at my ascending aorta and it was at 4.9 cm. Monitored by a surgeon until last month when they noted that it grew to 5.2 cm. Now I am scheduled for aortic replacement in two weeks. My homograft still seems to be doing the job with no other problems, but my surgeon wants to get a birdseye view before deciding whether to replace that also, given that it is going on 21 years old. Nervous all over again!
 

pellicle

Professional Dingbat
Joined
Nov 4, 2012
Messages
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Location
Queensland, OzTrayLeeYa
Hey Dano
I've been there, so no sign of calcification in the valve?

As you may know, I had a BAV replaced with a homograft and at 20 years was still functional but aneurysm drove my replacement. Twenty years is right in the edge of their usual life. Mine was apparently calcified but functioning. No-one in their right mind would have left it in on my third, forcing a fourth.

Is your username and date of birth related?

No reason to be nervous, just approach this systematically and you'll be fine. Everything has improved since you were last in :)

Best Wishes
 

pellicle

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Thanks Pellicle. I am almost 58. What type of valve did you go with to replace the homograft?
Hi
I went with what my surgeon preferred to use which was the ATS (now purchased by another group IIRC).

I had this one because my surgery was going to be lengthy and he wanted to go with a valve which had a pre-attached graft (saving surgical time).

Do not underestimate the significance of surgical time, not least the time on the bypass. Post perfusion syndrome (also known as "pump head) is exacerbated by duration on the bypass (or the pump). I had never suffered from it (previous ops at 10yo and 28yo). Beware of getting sucked into (the bullshit of) valve marketing, because its frequently just that. For example you may find this post and associated data compelling:

For instance, I would be very cautious at believing that the On-X has any particular magic despite its claims of lower INR protocol. Firstly we have no extensive data on that (only a short well controlled test) and secondly we do hear of results of that protocol leading to strokes and TIA in individuals.

Best Wishes
 

Hokiesid

Member
Joined
Oct 4, 2021
Messages
6
Dano!
Just had to say Hey!

Had my reop for my second valve on 12/13/21 at Duke w Dr Hughes. Just got released yesterday from surgery, I left Sat morning after Monday morning surgery. They were awesome. I was kind of opposite of you in that my valve was shot and they went ahead and cleaned up my 4.4 annie. Spectacular results. I did switch to mechanical and advocate that choice. Agree w Pellicle, go ahead and get as much fixed when they have the hood up. Reops are more risky. 21 yrs is awesome and that piece of meat should go somewhere in a Hall of Fame!!! But I would look hard at a mech valve replace. Youdon’t want a third op at age 79 if you are lucky to get 21 years from a second tissue valve.
Sid(@kirbylawsc.com) if you want to talk Duke things
Best wishes and happy healing!
 

Brinntache

Well-known member
Joined
Mar 25, 2021
Messages
68
Location
Hamilton, Ontario, Canada
Hi Dano,
best of luck. I went with mechanical at 50 after watching my dad never really recover cognitively from the same surgery at 72.
I have an On-x, chosen simply because that was what the surgeon was most comfortable with. But I aim my INR at 2.5, not the 1.5 promised by the On-X company. I don't need a stroke, and after crashing my bicycle and not bleeding out at 2.5 INR I am happy keeping it there. (yes, there was plenty of road rash.)
 

pellicle

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yes, there was plenty of road rash.
ouch ... while I'm apparently care free in my scooter videos I'm acutely aware of this possbility (after riding skateboards and bicycles as a kid, and motorcyles all my life.

its true that we can never make the risk of falls zero, but we can do our best to make it bloody close.

Best Wishes
 

pellicle

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oh, @Dano64
I realised that I left the clause dangling:
Do not underestimate the significance of surgical time, not least the time on the bypass. Post perfusion syndrome (also known as "pump head) is exacerbated by duration on the bypass (or the pump). I had never suffered from it (previous ops at 10yo and 28yo)
I suffered from it badly on operation 3 which was of course lengthy (I may have suffered from it in operation #2 but I'm uncertain). I'm not sure I ever totally recovered but as the brain is quite an organ of redirection I was able to regain and relearn things. However I was never really quite as good at holding large abstract data models in my head and had to resort to lots of "wall charts" for projects. I was in IT (PHP, Oracle back ends, so both developer and DBA).

There is lots that people fail to discuss about redo surgery and its interesting to me that those who have not undergone it seem to trivialise in their (apparent) push to refuse to accept an option because it has clear drawbacks. Sometimes the unclear drawbacks of the apparently "soft option" are hidden in the fine print.
 

ValveAdmin

Administrator
Staff member
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Apr 9, 2019
Messages
139
Location
SE USA
Hello, and welcome back. I hope everything will go well with your upcoming procedure.
 

Dano64

VR.org Supporter
Joined
Jan 3, 2022
Messages
29
Well, bad news to report, I guess. My surgery is getting re-scheduled as my wife tested positive for Covid yesterday and I have cold symptoms that aren't going away. I am negative for now. Waiting for a new date. I was told a few people have had to reset their January heart surgeries. Covid is a mess right now but I certainly do not want to add any more risks to this surgery and recovery. As I read more about the aneurysm repair surgery, it is a big deal and I am curious how differently people recovered from this surgery vs. the first.
 

Superman

Well-known member
Joined
Oct 3, 2009
Messages
1,540
Location
Grand Rapids, MI, USA
That stinks. Anticipation is the worst. Hopefully when all the illness has left your house they can get you back in quickly.

As far as differences? You’re more likely to notice a difference in surgeries because of being 20 years older and the team having to deal with existing scar tissue (especially getting through the sternum). The graft itself, I think, created a bit of an echo chamber so any heart noises were louder than they were the first time. Took a long time for that to muffle even a little. I still think my heart beat is louder now after 12 years that it was in the 19 years of just valve replacement. I received a St. Jude both times. The echo chamber thing is just spitballing on my part. But my perception is my reality.

The other thing I noticed in my last surgery is that they pump patients so full of fluid these days. Like ten plus lbs gained during surgery (and I wasn’t eating anything in the OR). It’s ridiculous. I know they didn’t do that in 1990. Not sure about 20 years ago or when they started doing that.
 

pellicle

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Queensland, OzTrayLeeYa
As I read more about the aneurysm repair surgery, it is a big deal and I am curious how differently people recovered from this surgery vs. the first.
No significant difference for me, as I understand it's just that the surgery is longer and more complex and so time on the "pump" is longer increasing the possibility of post perfusion syndrome (which I believe I suffered from).

Glad your back, take care, small steps forward each day, don't over do it.

Best Wishes
 

paulk

Member
Joined
Jan 21, 2022
Messages
10
Hope recovery is going well, it’s all uphill now. What was your valve choice? (no worries if you’d rather not say).
 

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