Unicuspid Aortic Valve Repair - 8 Weeks Out

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Chet_

Member
Joined
Oct 2, 2016
Messages
9
Location
US
Hello all,
First - thanks to all for sharing your stories and info on this forum.
It's been a great resource for me over the past few months as I prepared for surgery.

I'm 33 and am 8 weeks out from having a valve repair performed on a severely regurgitating aortic valve.
I had this done at WVU Heart and Vascular Institute in Morgantown, WV. They have just heavily invested in recruiting some excellent surgeons and it was close for me.
The procedure is also known as the Ozaki procedure, and more specifically, a trileaflet repair from unicuspid origin with autologous pericardial reconstruction into trileaflet anatomy and leaflet patch augmentation.

I've known about my valve for ~5 years and based on the most recent echo we decided it was time as the left ventricle was showing signs of stress and regurgitation was getting worse.
We caught the valve issue when my Dr. heard a murmur during a physical.
The surgeon was surprised that the valve was unicuspid. It looked bicuspid in the echo but the real thing looked like a floppy horse shoe :)

The plan was repair or replace with mechanical. If it looked like the repair was feasible and would likely be durable, then that was the preferred option.
Durability was and is a concern as this procedure doesn't have 20+ years of data that I'm aware of.
Based on conversations with the surgeon it felt like this fell in the sweet spot for risk/reward between all the options.

2 weeks post-surgery I was readmitted to drain a pericardial effusion and pleural effusion.
That was a decent setback as I was recovering pretty quickly up until i could no longer walk across the room without needing to catch my breath.

A few other notes for folks going into surgery in case it might help:
I got pretty bad nausea from Amiodarone.
Post-surgery was tough but it should get better every day - and if it doesn't let someone know quickly.
I moped around for too long with pericardial effusion before I called to complain - by that point I had 1.5 liters of fluid around my heart.
I had to avoid laughing too hard for the first week or so as it was very painful.
Breathing was tough - use the spirometer!

I'm very happy with the result so far.
My last echo showed improved left ventricle function and trace regurgitation with no increase since surgery.
 
Chet, I am less than a month away from my AVR surgery at Cleveland Clinic. After speaking with the surgeons nurse she mentioned the Ozaki procedure and stated that my surgeon was leaning towards it. I have done some research on the procedure and it does seem interesting. I'm curious as to how your surgeon convinced you of this procedure and what longevity was he looking at with this.
 
Welcome to the other side and thanks for sharing. Clearly your experience is helpful to Patrick and maybe others. I also had pleural effusion with two draining. You exactly described my condition; inability to walk more than a few feet without gasping for breath. Glad to hear you're on the mend.
 
Patrick,
In a nutshell I asked the surgeon to perform the repair if he felt there was a good chance it'd last 20+ years.
He wouldn't outright say the repair would definitely last 20 as there is no published data of that length but felt it had a pretty good shot.

If I were you I'd try to talk with the surgeon again to learn why he's leaning that way.
I had a phone call with mine where he described the repair and how he'd approach - it was a series of "if we see this then we'll do that" scenarios that seemed like a good plan to me.

I'm happy with my results, it is a complicated surgery that luckily went well.
On the other hand going to the echo every year is going to be nerve wracking
There is also a good chance I'll be back on this forum when I'm your age asking about mech valves ;)

It gets better after the first few crappy days.
I had a lot of fun with my kids, 3 and 5. Even went sled riding a week ago.

I'm hoping the best for you Patrick!

Another good reference I found
https://www.jstage.jst.go.jp/article...J-14-0299/_pdf


Agree honeybunny - I was doing pretty well and then all of a sudden I couldn't go anywhere.
I was confused because I had nausea and couldn't eat and thought that was the problem. Nope! it was the fluid!
 
They were surprised to find I had a unicuspid valve. Up until that point they all thought it was bicuspid.
We're the cousins no one talks about :)
 

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