St Jude Mechanical AV since 1996. Coming surgery for Asc Aortic Aneurysm..Question!

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AZHiker

New member
Joined
May 16, 2017
Messages
1
Location
Currently, Phoenix Arizona
Hey everyone. It has been over 20 yrs since my AVR with a st jude mechanical valve in August of 1996 at the age of 19 at Indiana University Hospital in Indianapolis.*Bicuspid Native Valve with Stenosis, and regurge since birth*** I am currently 40 years old now.. a HS Biology/science teacher living in Phoenix AZ and doing great since my AVR! Ive read alot of posts on here over the years so glad to finally post! I Just received the news that I will have to have surgery soon for my 5.5 cm ascending aortic aneurysm. Doc just gave me metropolol to keep my bp down. I still haven't met with a surgeon yet.. just got the news on 5/22 that my aneurysm had progressed from 4.9cm to 5.5 after 2 yrs.. so working on getting an appt with Cleveland clinic to see about getting my surgery done there. Where I will travel from Arizona back to Indiana where I'm from closer for the operation. When I talked with my cardiologist last week, he seemed unsure as to whether they would do a procedure, and replace my well functioning St Jude valve, and entire root, with a Composite Valve, and Tube graft, or whether they would excise only the aneurysm,*above the sinuses, * and leave my valve and sinus portion of the root, in tact. Which would be a much easier surgery as well. I had a cardiologist in Indiana tell me 5 years ago , that they would just ckeck my St Jude valve and leave it alone if fine.. As I believe they could last a lifetime, barring complications with it. Does anyone here have any insight into the protocol in this situation.. or any experience with it?? Thanks all - James
 
Hi and welcome aboard
AZHiker;n876873 said:
Hey everyone....
I've read alot of posts on here over the years so glad to finally post! I
...I had a cardiologist in Indiana tell me 5 years ago , that they would just ckeck my St Jude valve and leave it alone if fine.. As I believe they could last a lifetime, barring complications with it. Does anyone here have any insight into the protocol in this situation.. or any experience with it?? Thanks all - James

I can't speak to what they will do there, but when I had my OHS done last time (which was my 3rd OHS, not 2nd as for you) the surgeon preferred that a pre-attached graft was used to simplify the (already complex) surgery (by not needing to attach the valve to the heart, and then the aortic graft to the valve) and essentially kiss goodbye to possibilities of paravalvular leak.

I understood that redo surgeries made for increased risk of paravalvular leak due to the fact that the seat and tissue is disturbed during surgery. It would seem to be one of the most significant risk factors. So from my perspective I'd just go for a new clicker anyway ...

My situation was however slightly different as my valve at the time was a homograft (not a mechanical) and was probably only going to be lasting another few years (although it itself had no problems which I was made aware of).

You sound like you've got it all "under wraps" now and you'll do well.

Best Wishes with surgery :)
 
I had your exact story.

1st open heart in 1990, I was 17 turning 18 in the hospital.
Aneurysm repair in 2009 when I was 36.

They replaced my St. Jude valve with a conduit graft / valve. Also from St. Jude. Part of my discussion was around sizing. I was a tall 17 year old, but they wanted to resize the valve anyway. I was also uncomfortable with a valve stitched in place, then native material, then more stitching holding a graft in place at both ends. Somehow the one piece just seemed more secure to me. I have zero data. Just the proverbial "sleep at night" test.

The surgeon was fine with this. I don't even remember a preference from their end. The only discussion we had revolved around timing. I was at 4.9 cm (I think protocol was 5 cm at that time) and just wanted it done, because with my congenital situation, I knew these things didn't go backward. Couple that with not getting any younger. I also knew that with the direction health had been going, my out of pocket wasn't going to get any cheaper, and I had already met my deductible for the year.

So I got a shiny new valve / graft combo installed. Ticking away for another 7 1/2 years since.
 

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