Questions

[lucky401]

i have posted in the pre-surgery thread but wanted to ask these questions in the hopes that maybe someone in heart talk will be able to give me some insight. I am scheduled to have surgery in June and I have an ascending aneurysm that is 4.4. I also have a bicuspid aortic valve that is stenotic and will be replaced. My question is the doctor says he may just repair the aorta and not replace part of it. Has anyone had an aorta repair? Does the repair supposedly last a lifetime? I'm worried that the aneurysm will continue to grow and then I will need surgery again in the future. Anyone have any thoughts on that. Also my tricuspid valve may need repair and the doc said if he has to repair it I may need a pacemaker. Has anyone had a repair to their tricuspid valve and gotten a pacemaker? If so how has that affected recovery and lifestyle? Thanks for your help.

 

[AgilityDog]

I had my mitral valve replaced, and a maze procedure, which resulted in needing a pacemaker. I have complete heart block from scarring as well as the damage that was done prior to surgery from the valve failure, as well as a bunch of other cardiac inconveniences. The pacemaker wound takes a while to heal, you have movement restrictions for 4 to 6 weeks, and if you are female you may need to change lingerie styles to accomodate the new shape. Again, if female, you may have some issues getting your mammogram done - They always wind up doing a sonogram on me, because I won't let them squish my wires or pacemaker. I'm so picky that way (sarcasm). And you get hand-checked going through security.
Like everything else with heart problems, there a lot of psychological stuff that goes along with a pacemaker or defib. and everyone reacts differently.

There are a few things you can't do- scuba dive (the device is not depth rated), get an MRI, etc. It may take a while to get your pacemaker's response time adjusted to your satisfaction, but it will take time for you to get back to speed after surgery anyway, or to your new "normal" if that is less than full speed, depending upon your general condition.

 

[Duff Man]

i have posted in the pre-surgery thread but wanted to ask these questions in the hopes that maybe someone in heart talk will be able to give me some insight. I am scheduled to have surgery in June and I have an ascending aneurysm that is 4.4. I also have a bicuspid aortic valve that is stenotic and will be replaced. My question is the doctor says he may just repair the aorta and not replace part of it. Has anyone had an aorta repair? Does the repair supposedly last a lifetime? I'm worried that the aneurysm will continue to grow and then I will need surgery again in the future. Anyone have any thoughts on that. Also my tricuspid valve may need repair and the doc said if he has to repair it I may need a pacemaker. Has anyone had a repair to their tricuspid valve and gotten a pacemaker? If so how has that affected recovery and lifestyle? Thanks for your help.

Lucky, you're getting it repaired relatively soon for the size of the aorta. The gold standard right now is like 5 to 5.5 cm. Is your valve giving you problems that make it more necessary?

I've personally not read about a repair of an ascending aortic aneurysm that doesn't involve a dacron graft. It kind of sounds like he may just repair a section of the aorta that's dilitated and leave the rest. The grafts are supposed to last a lifetime and most have no issue staying open according to the studies I've just recently read.

I have no idea about the tri-cuspid/pacemaker issue.

 

[lucky401]

Aaron,

My valve is at .6 and I am having symptoms. My mitral valve has severe regurgitation as well. They are replacing the aortic valve and repairing the mitral valve. They may need to repair the tricuspid as well which has moderate to severe regurgitation. The surgeon hopes (as I do) that by replacing and repairiing the other two valves the tricuspid valve may fix itself. The anuerysm is small and that is why he said he hopes to do a repair to the aorta however I am a very small person 4' 11" and the surgeon said what is considered small on an average person may be large on someone my size. So he is going to look at the aorta and then make a decision on what he is going to do. My surgeon is Dr Bavaria at University of PA Hospital. He has a good reputation and I can't ask for more than that.

Agility Dog thank your for all your information. I am a 58 year old woman so I am relating to what you have said. Hopefully I won't need the pacemaker. I am trying to go into this with a positive attitude even though I am very nervous and scared.

My son is graduating high school and I have planned a large graduation party at my house (for which I plan to do most of the cooking) two days before my surgery so I can keep busy and not think about my surgery too much.

This forum is terrific and I am reading all I can which I find very helpful. Thank you all for your support.

Barb

 

[briansmom]

My son came out of his second surgery with complete heart block so he got a pacemaker a few days later. Agility dog covered the pacemaker issues pretty well. My son has had his for a little over a year with no problems after the first few weeks.

 

[Susan BAV]

Regarding aorta repair, my descending aorta had a tight area in it called a coarctation and sometimes the tight area is small enough that it can be cut out and then the ends can be sewn back together (although in my case they had to add a dacron graft). I don't know about ascending aorta repairs thought, particularly if an aneurysm is involved.

Are you positive he meant that he might try to repair the actual aorta itself and did not mean he might try to repair the aortic valve?

 

[Lionheart]

My question is the doctor says he may just repair the aorta and not replace part of it. Has anyone had an aorta repair? Does the repair supposedly last a lifetime? I'm worried that the aneurysm will continue to grow and then I will need surgery again in the future. Anyone have any thoughts on that.

Hi Lucky,
I had an ascending aortic aneurysm repair along with my aortic valve replacement. Prior to surgery my surgeon said that he would repair the aorta if the tissue was good enough and if not, then he would do a graft. He was confident that the repair was adequate and a long-term solution. The procedure is called an aortic reduction. Think of it like a shirt sleeve that is too large in diameter, so to fix it and reduce its size you removed a narrow section and then reconnect the edges to get a smaller-sized sleeve. I think that's what they do for the reduction. I was happy to keep my native ascending aorta and I expect it to last a long,long time.
John