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Schwarzenegger had another OHS

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Superman

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Ross in the 1990’s. Pulmonary valve in 2018. Aortic valve in 2020. Three surgeries for the price of one. But what I’m annoyed by are the commenters in the news articles. “Steroids. See what happens?”

Yes. We all brought our heart defects on ourselves. If only I had lived right as a kid I wouldn’t have had my valve replaced at 17. Too much pizza and soda apparently as a 6’ 4” 180 lb kid.

What did all of you wrong to lead to your heart surgery?
 

pellicle

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Ross in the 1990’s. Pulmonary valve in 2018. Aortic valve in 2020.
An exemplar of what I have against Ross. I would expect he'd be fine now if he'd had a mechanical.

What did all of you wrong to lead to your heart surgery?
The usual, got born.

What I did get lucky on was the decade I got born into ;-)
 

ottagal

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Saw this, too. Does it sound like he received a bioprosthetic valve or a mechanical? OHS?
Wow...hopefully third times the charm for him.
Wishing him all the best for a speedy recovery.

I dtto: What did I do? I was born!
 

pellicle

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Does it sound like he received a bioprosthetic valve or a mechanical?
probably they stitched him up on the usual TAVR line ... just like they were saying 10 years ago, it'll be the norm in 10 years.

dunno how they're fixe his stuffed up pulmonary valve (nothing wrong with it before it was explanted by the researcher surgeon) ... OHS I guess
 

Superman

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My understanding is 1990’s, Ross procedure. 2018, planned TAVR for the pulmonary valve. Couldn’t do it for whatever reason but had the OHS team at the ready and replaced the pulmonary valve. 2020, AVR. I don’t think they even tried a TAVR on the aortic.

I don’t believe he ever had a mechanical valve in either position. Good chance he would have been one and done if he did. No mention of his aortic root or ascending aorta.

If he does develop an aneurysm, the trolls will be out en force.
 

ottagal

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My understanding is 1990’s, Ross procedure. 2018, planned TAVR for the pulmonary valve. Couldn’t do it for whatever reason but had the OHS team at the ready and replaced the pulmonary valve. 2020, AVR. I don’t think they even tried a TAVR on the aortic.

I don’t believe he ever had a mechanical valve in either position. Good chance he would have been one and done if he did. No mention of his aortic root or ascending aorta.

If he does develop an aneurysm, the trolls will be out en force.
Thanks Superman. I presume the newly replaced aortic was another bioprosthetic then? Not really important, just interesting to see what Cleveland would suggest 3rd time OHS.
 

Cactus52

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It sounds like in the article I read that he had the Osaki procedure. My doc at the Cleveland clinic tried to get me to do it but there just want enough data on longevity for me.
 

Jmprosser.lab

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Is 3 OHS really the fault of him getting the Ross Procedure? Sorry I’m ignorant on some of this. Why didn’t they fix this one in 2018?

and I know many here REALLY are skeptical of TAVR, but I find the progress encouraging. I know someone who had that procedure done. I doubt it will be the go to in the next few years but my cardio said they’ve been using it increasingly in the last two years. Both UCLA And Cleveland Clinic have said that. Is it possible you can you fix a leaking valve AND an aneurysm through TAVR? I know OHS is more common, but curious if addressing two is even possible through TAVR?
 

ATHENS1964

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Is 3 OHS really the fault of him getting the Ross Procedure? Sorry I’m ignorant on some of this. Why didn’t they fix this one in 2018?

and I know many here REALLY are skeptical of TAVR, but I find the progress encouraging. I know someone who had that procedure done. I doubt it will be the go to in the next few years but my cardio said they’ve been using it increasingly in the last two years. Both UCLA And Cleveland Clinic have said that. Is it possible you can you fix a leaking valve AND an aneurysm through TAVR? I know OHS is more common, but curious if addressing two is even possible through TAVR?
Αscending aortic and aortic arch aneurysms can not yet be treated
with endovascular only with open surgery .
I would like to ask, if someone had a complete sternotomy in the next operation can it be done with a small incision? what happens to the wires?
 

Enigmalady777

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I recall he had OHS for a valve replacement in 2018 - the exact same day I had mine - at a hospital a few miles away from mine. Weird. I need to go read up about his latest OHS.
 

pellicle

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Is 3 OHS really the fault of him getting the Ross Procedure?
here is my view (having had 3 OHS)

  • The Ross brings little to the table that a cryopreserved homograft does not (with similar results depending on age
  • The Ross essentially destroys a perfectly placed natural valve (the pulmonary) and does with it what a homograft of the wrong valve would do, replace the diseased valve, which is the aortic (so why stuff up the perfectly functioning one
  • The pulmonary must be then replaced, usually with a bioprosthetic (which will then be set to certain failure in the future
As a strong and active man he should have had a mechanical. He'd still be on that and his native pulmonary valve would still be fine.
 

pellicle

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I would like to ask, if someone had a complete sternotomy in the next operation can it be done with a small incision? what happens to the wires?
I don't know if you know what complete sternotomy means but it means that it needs to be cut entirely open down the middle (I've had 3). It of course can not be done with some key hole incision, the cut needs to be like a pyrmaid with the skin opening at the base working down to the apex.

They simply cut through the wires and this is one of the complications of multiple surgeries (or the Redo that is so blithly spoken of here when somone says "I'll have a tissue with a redo later if needed". Its not a cafe order "I'll have a latte with cinnamon thanks, and may come back for bit of cake soon", its a super major surgery.

My 3rd put in a mechanical valve an an aortic graft because I also had an aneurysm.

The wires of multiple previous surgeries (as well as other bits and pieces of metal junk (staples) are visible in my X-Ray ... the older ones are much smaller, perhaps as I was a child then they used finer guage steel wire? They become embedded in the bone.



this X-Ray was after my 3rd, and you can just see the valve over on the left. Although it is a kind of ceramic carbon it is also made visible to X-Ray by design
 

Superman

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here is my view (having had 3 OHS)

  • The Ross brings little to the table that a cryopreserved homograft does not (with similar results depending on age
  • The Ross essentially destroys a perfectly placed natural valve (the pulmonary) and does with it what a homograft of the wrong valve would do, replace the diseased valve, which is the aortic (so why stuff up the perfectly functioning one
  • The pulmonary must be then replaced, usually with a bioprosthetic (which will then be set to certain failure in the future
As a strong and active man he should have had a mechanical. He'd still be on that and his native pulmonary valve would still be fine.
Only potential issue is being an action movie star, and lack of home testing at the time, a bio prosthetic may have made more sense. No Warfarin in his case but still only one bad valve and only one to replace when the inevitable happens.
 

MdaPA

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Not really important, just interesting to see what Cleveland would suggest 3rd time OHS.
My wife went to Cleveland Clinic for her 3rd OHS. She went with full intentions of getting bio-prosthetic AV and MV's again but the surgeon strongly advised against it to reduce odds for further OHS. She ended up getting mechanical AV and MV's. Before going to Cleveland, a consultation with a surgeon at another hospital pushed for bio-prosthetic but she was not comfortable with that surgeon (he was a real jerk to say the least). So it depends on the surgeon and each decision needs to be individualized.
 

MdaPA

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  • The Ross brings little to the table that a cryopreserved homograft does not (with similar results depending on age
  • The Ross essentially destroys a perfectly placed natural valve (the pulmonary) and does with it what a homograft of the wrong valve would do, replace the diseased valve, which is the aortic (so why stuff up the perfectly functioning one
  • The pulmonary must be then replaced, usually with a bioprosthetic (which will then be set to certain failure in the future
My wife had a ROSS procedure in 1997 and her PV and AV's faired her well for 20 years (they could have gone longer but her surgeon replaced those during her 3 OHS when her MV was critical and needed to be replaced). The main push for the ROSS back then was no anti-coagulation, especially if pregnancy was being considered, and the hope that the PV in the aortic position would last longer than a cadaver or animal valve would (not sure if the data now supports or contradicts this).

And yes, a major concern/risk of a ROSS procedure is that it makes "single valve disease into a double valve disease".

Here are some advantages of a ROSS procedure:
Advantages of the Ross Procedure Include:

  • No need for lifelong anticoagulation medicine (blood thinner)3
  • Excellent hemodynamic performance (blood flow) at rest and during exercise4,5
  • Only operation shown to restore life expectancy similar to that of the general population3
  • Quality of life similar to those who have not undergone aortic valve replacement3
  • Low risk of thromboembolism (blood clots)3
The Ross Procedure - The Ross Procedure
 

Astro

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Best wishes to Arnie. He looks great in the photos.

He got at least 20 years from the Ross procedure. That is good for such an active man who continued to lift so many weights. He would have burnt out a prosthetic valve much earlier. I understand that he wanted to avoid warfarin so he could continue action movies. The Ross procedure was a good fit for him. The downside is that now he has had to deal with the double valve challenges. I bet that his surgeon from 2018 now wishes that they replaced the aortic valve at the same time as the pulmonary valve. It must have deteriorated unexpectedly quickly.

Great to see that a bicuspid valve did not stop his career (he just wears a lot of T-shirts now to hide the scars).
 

pellicle

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he main push for the ROSS back then was no anti-coagulation, especially if pregnancy was being considered, a
given that homografts existed back then too (I had mine in 1992), I find it hard to see how they consciened it in that evidence, except in the furtherance of their "research". Do your research on Homograft ... similar benefits list ... I got 20 years out of mine and I was operated on at 28 and was quite active before and after.
 

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