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Hello to all, First an update on my Mom - she had AVR on 8/08/17 and is doing remarkably well. She went home on day 4 post op and went back to work this past week at 8 weeks out. She has also lost 25 pounds or so! I'm so happy that things have been going so well for her. Update on me - I was scheduled for redo AVR on 9/13 and delayed surgery to 9/20. I chose a mechanical valve; however, the surgeon was not able to fit me for a mechanical because my valve opening is too tight. I learned when I woke up from surgery that I have a bovine valve. I had no idea that there was a possibility that I would not be able to receive a mech valve. Clueless. This was never mentioned to me by my cardiologist or surgeon. All discussions were simply "it's up to you." I have no choice but to reconcile myself to the fact that I will face another replacement at some point. That was the first hiccup. On 9/22, the nurse practitioner removed the pacing wires and I began bleeding and the chest tubes filled up with blood. It was very scary for my husband and me. And my right lung collapsed. This all happened within minutes and I was rushed back to surgery, chest reopened, stitched up inside, another round of fluids and anesthesia, etc. I am very thankful that the nurse practitioner and staff. They all remained calm, acted quickly to get back into the OR, and saved my life. I am especially thankful for the nurse practitioner's command of the situation. She had the nursing staff call the OR to get a room ready and call my surgeon to meet her there. She did her job and I will be forever thankful. I ended up with 3 blood transfusions, just to give you and idea of how much blood I lost. I will say that this recovery is going very, very slowly. I don't have my pep back in my step yet. I am feeling better than I was a week ago, just wishing things were moving along a little faster. That little hiccup did a number on me and the collapsed lung didn't help. I use the spirometer everyday but I still can not get it above 1250-1500. And I cough a lot. A lot. As in all day some days. It's ridiculous! I will post more soon. Lisa
 
This is my post. I don't know why it doesn't show up as me because I was logged in. Or why my post looks like one paragraph when I didn't type it that way!
 
Lisa2
Or why my post looks like one paragraph when I didn't type it that way!
Hi Lisa - sorry to hear you have had a rough time with your redo AVR :( The issue with your post appearing as one big paragrapgh is because there are several technical problems on the forum at the moment. There are a lot of other issues such as buttons don't work and so on - Hank is looking into it. Do keep us posted on your recovery {{{hugs}}}
 
Lisa2
I chose a mechanical valve; however, the surgeon was not able to fit me for a mechanical because my valve opening is too tight. I learned when I woke up from surgery that I have a bovine valve. I had no idea that there was a possibility that I would not be able to receive a mech valve. Clueless. This was never mentioned to me by my cardiologist or surgeon. All discussions were simply "it's up to you."
I don't know if this might explain, but I was referred to a surgeon recently because my replacment valve of three years is "small", ie too small, and he said the only way forward would be to do aortic root replacement so that a bigger valve could be put in BUT another surgeon has already told me that even with aortic root replacement or aortic root enlargement there is no guarantee that a bigger valve can be put in.
 
PS - can't do edit and post went....to continue, the smallest mech valve must be a bit bigger than the space the surgeon had to insert a new valve so he must have had to chose a tissue valve which, I suspect, fits in a smaller space than the smallest mech....does that make sense ? Do ask your surgeon when you get a chance and let us know.
 
Paleowoman, yes, you have it right. The tissue valves are more flexible and can be fitted into a smaller space. He tried a 19 mech, the smallest he was willing to go, and it was too large. He said he could have possibly fit a 17mm but that is more of a child's size and my result would have not been good. He said I would basically have gone through all of that and ended up with the same gradient, heart function, etc. as I had before surgery.
 
Lisa2 as I understand it the problem isn't flexibility its that (both) smaller diameter (thus smaller surface areas) make the opening pressure higher with the mechanical than is desirable and (importantly) panus is a more significant problem in smaller diameter valves. There may be other reasons, however tissue prosthetics still have a stainless steel ring for stitching and holding their shape.
 
even wikipedia has a good page on this:
BiologicalValves.JPG
lossless-page1-474px-The_replaceable_model_of_implantable_heart_valve_bioprosthese_de_Menezes_Lyra_R_1992.tif.png
 
Thanks, Pellicle. I do,plan to ask the surgeon when I see him next week. I am sure that the word "flexible" was just a poor word choice in an attempt to dumb it down for me to understand....also, I was still under the influence when we had the initial conversation so perhaps I heard something he didn't actually say :)
 
Lisa,
So glad that the surgery is behind you, but very sorry to hear about those bumps and 'surprises'. I wish you GodSpeed and no more surprises.

One day at a time...be gentle with yourself. You know the drill.
BTW...those nurses are walking angels!
Also, glad to read that your Mom's surgery went well.
 

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