Pre-Surgery Questions

[csutherland]

My husband will be 65 next month. Last Feb while preparing for outpatient surgery the anesthesiologist asked him about his murmur (He didn't know he had one). An echo was done and he had moderate & severe regurgitation in the mitral & aortic valves, respectively. After 3 mo of Altace these had improved to mild & moderate. After 6 more months severe stenosis has been diagnosed with the valve area being .7 cm. (down from 1.7 last Feb). LV function is still OK, but there is some hypertrophy. Symptoms are shortness of breath on exertion and lately indigestion during the night. Not sure if that's related, but it's pretty consistent every night. Surgery is coming up within a month. We're a little afraid of coumadin for him since he's very active, normally works hard and already has thin skin that bleeds easily. However, he doesn't like the idea of a redo in 10 yrs either. His parents lived to be 95 & 102 so he could need several redos! By the way, in Oct he was also diagnosed with Mycosis Fungoides (a cutaneous t-cell lymphoma) that affects the skin. He's in remission right now but it'll come back sometime. Treatment for that includes UV light treatments and prednisone, until it goes to the next stage which is ugly. We hope that doesn't ever happen. Any input about valve type would be helpful. Sorry for length--I'll do better next time!

 

[deborahj]

Thunderbirds are go

Thunderbirds are go

Hi Csutherland proxy!
Yes, you are up and running. Hope to hear from you again soon
debs

 

[hensylee]

Hi C - You have come in loud and clear and we are here to help, if we can. There are many members and your answers will be from a to z with all the info you may need. All of them good. God bless

 

[sylviayasgur]

hi csutherland !
got your posting and we all await you here on this site. this is the most wonderful, supportive place. the members here have helped me through my husband's surgery and have truly been life-savers to me.
we look forward to hearing from you soon.
-sylvia

 

[Bill Hall]

Hi C - Sorry to hear your husband has to go through this. I avoided the coumadin by having my Mitral repaired and having my Aortic replaced by homograph (human valve) last Jan. I am concerned about a second surgery (age 47), but just decided to avoid the medication. The surgery was scary, but not that bad to recover. I would not be as scared next time. I probably would still opt for my decision even if surgery was guaranteed at ten years. Right now, I have no indication that surgery will be needed in ten years, it might be shorter, but probably longer. Once the mechanical is there, they say it will last, no further surgery required. The coumadin is not too bad from what I read on this site. I guess it is a small decision because either path is not too bad from my view. Hope this helps.

 

[Nancy]

Hoi Csutherland, Welcome

Hoi Csutherland, Welcome

This site is a great place for handholding pre-surgery and afterwards also. You'll find lots of friendship and support here. Everyone here understands the situation and we love to answer questions. So ask away. You'll have lots of answers.

My husband is the patient, he's had 3 valve surgeries. He has 2 mechanicals and just had a repair on his mitral. His aortic valve is 25 years old and the mitral valve was put in in 1999, with the repair July 18, 2001. He also has had 2 lung surgeries and has a pacemaker. He's been on Coumadin for 25 years, with no problems. He's 70 years old and wasn't supposed to live past 50, so you can see that this surgery works.

Prior to the last repair, Joe had Congestive Heart Failure with severe symptoms. He was breathless, and his stomach was upset and filled with fluid, his lungs also, plus the blood vessels in his throat, and his legs were swollen. Your husband might be experiencing some of this at this time. After surgery this should be vastly improved. I'm not sure if CHF can be completely cured, but it can be controlled and the symptoms can be kept within normal limits with medication, if the underlying problem is corrected.

I wish you and your husband the best and we hope to see you here often. It's a tense time, but help is in the wings. See you at the site.

 

[csutherland]

Thanks. I feel better already getting some replies! Nancy, your mention of blood vessels in the throat makes me wonder about something else. My husband says along with the indigestion he feels as if there's a marble rolling around in his throat. I wondered if it was stress-related, but maybe not.

 

[Nancy]

Hi csutherland-

Re: Your husband's throat problems

My guess is that it's related to his heart problem, maybe some fluid buildup there. I could actually see the blood vessels in my husband's throat bulging out, and he was hoarse and sometimes could only talk just above a whisper. Although stress can get to everyone at this stage, your husband's problems are probably primarily heart related.

It's good that he's having surgery in the not too distant future.

 

[Gerry]

Hello csutherland,

I am sorry that your husband finds himself in this situation.

You asked about valve types. Essentially there are two categories - the mechanical type (which require the patient to take Warfarin for life) and the biological type. The mechanicals will last "forever", meaning a repeat surgery is most unlikely. The biological (bovine, pig or homograft) can last anything from 10 years to 25 years but don't require the Warfarin.

Making the choice is a very personal decision, assuming your husband is a candidate for choosing. By this I mean it may be that his other medical conditons may preclude certain choices.

I suggest you read up on the various valve choices (plenty of links on the internet) and then go armed with questions to your cardiologist. If his advice makes sense to you and you feel comfortable with that, then go for it. But whatever you do, try to get the best surgeon in the field - one who specialises in valves, not just a "normal" cardiac surgeon. It will be the surgeon's skill that will ensure a satisfactory outcome, no matter what valve you go for.

Hope this helps

regards

Gerry

 

[sylviayasgur]

hi csuthreland!
for info on different valves there was a great thread back in aug of 2001 entitled "making the choice". it was started by peter easton. please check it out; i found it to be very helpful.
good luck and please let us know what you decide.
-sylvia