Valve No 2 .... Make That No 3

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Mentu

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My surgery was performed at Oklahoma Heart Institu
Hi, everyone, well, as sometimes happenes I encountered some "bumps" in the road. I expected a routine straight forward TAVR. Then my Doctor added a Basilica procedure. Still nothing too exciting. They started my 1 hour replacement at 6:30 as planned but didn't finish until 2:00.

The Basilica routine went as planned. The left leaflet was split to keep it out of the left carotid artery and all was well. Next, the balloon was inserted into the ring of my old Edwards 23mm Magna to fracture it to make room for the 26mm Medtronic CoreValve then "stuff" happened....fast. The ring was shattered, my heart stopped and quickly blood pressure dropped to zero which is rarely a good thing. Quickly the team of gorillas went to work pounding my chest while others brought the power lines into play to zap my heart. It worked and deep breaths were drawn all around.

Continuing, since my old valve was in ruins, the new valve was soon brought through and positioned. The wonderful moment arrived and it was released to fly free. It's position and pressure were just right to close that same left carotid artery. You know the drill. My heart stopped and blood pressure dropped dropping off to zero yet again. Once more the gorillas went to work and the power company was called to action and .... nothing worked. I understand that the gathered throng were not happy so they went to work. The TEE buoy was yanked out and I was (none too gently) intubated. Meanwhile, back at the ranch part of the team charged in with ECMO and put me on heart bypass. The gorillas were still at work by the way. As you have already surmised, my heart surrendered to the multifaceted assault and started pumping on its own. Once again, all around deep breaths. My Conductor had previously collapsed the new valve and out of concern for what happened, he pulled it out and parked it in the right side of my aorta. With valve No 2 out of the way No 3 was unwrapped and brought on line through the catheter. That is to say through catheter No 1 now that catheter No 2 (on the other side) had been brought into play. So, with a zap my heart began to beat as valve No 3 was carefully put in place and with the whole team holding their breath, the good Doctor set it free. And it worked. It might have asked "what is all the fuss about"?

I guess that after a suitable interval of admiring their handy work ...
and breathing deeply, they sent me off to the CT scanner to assess the toll.

This was the moment I woke up feeling cozy warm and filled with enough drugs that even the gorillas would have been laid back. Happily, four days later I am home and without brain damage. After hearing abought the "the events of the race" I even feel bad listing my aches but not too bad to actually do it. My left index finger is numb. My right arm is weak because It has been stressed. The left and right sides of my groin are magnificent displays of color. I have more punctures and in more places than I ever expected. My mouth and tongue are bruised and my chest hurts but only when I breathe. Astonishingly, the gorillas didn't break any of my ribs so I sent them a whole stalk of bananas. In the end, all is well and CoreValve No 3 is serving me well. So, "that's all folks" .... until next time.

Larry
Still in Tulsa
 
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Seaton

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May 13, 2015
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London, UK
Wow, Larry. What an experience. So very glad things worked out well in the end.

Thank you for the write-up and detail. Always appreciated.

I send you the best for the recovery days ahead and beyond.
 

pellicle

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Queensland, Australia
Wow Larry, interesting reading (to say the least).

Glad it went "well" with rescue alternatives available for the "unexpected outcomes".

Did they have a possiblity of a surgical option had things gone differently?

I hope your recovery is less eventful and that you can keep us appraised of how it all went.

Please be a poster child for how good this procedure is.

Best Wishes
 

Keithl

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Apr 20, 2019
Messages
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Wow, truly amazing story and glad it worked out. Makes me truly extremely appreciative every day that my surgery went off without a hitch and my recovery has been so amazing.
 

Duffey

Me and Granbon
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Hi Larry. Unfortunately you sure didn’t have the same luck with your TAVR that Tobagotwo did. His was practically a nonevent; out to dinner within 48 hours of the procedure. Best wishes for a quick return to your daily routine.
 

NealR

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Jan 23, 2010
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West Chester OH, USA
Larry, sorry for the ordeal. Wish it was perfected but see we still have some ways to go. I too am out of valve sugery (ohs}, and the echmo was used on me. Happy to report 3 weeks out of surgery I'm over 6000 steps a day and recovering well.
 

dornole

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Holy cats, Larry. Sounds like you probably missed a lot of swearing. Glad the team was able to pull you through and that you are back home resting. Wishing you a good recovery.
 

ottagal

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Wow, Larry what an ordeal and turn of events. Sincerely hope that you now have an event-free and smooth recovery from today forward. Be kind to oneself.... That is alot to take in.
Have been hoping to get an update from you.

Keep us posted on how things are going with you.
Thinking of you....
 

Johan

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Cape Town, South Africa
Scary stuff Larry! Happy that you pulled through all that! Thanks for the detailed step by step story. Did not know that fracturing the ring was even possible. I know that expandable rings are now used in latest model valves, for just this purpose, but in the old days wasn't it solid titanium? How do they fracture it? Pure balloon pressure? Side-cutters on catheters come to mind :)
All the very best for your recovery and keep us posted.
 

Mentu

Premium Level User
Joined
Nov 9, 2008
Messages
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My surgery was performed at Oklahoma Heart Institu
Johann, so good to hear from you. I seem to back to the first days after the open heart surgery. After any activity I must rest. And, yes, the ring is broken with a balloon. That part worked but my heart didn't respond well. However, I am home with my dogs now and this is better. I'm hoping this recovery is more rapid. Talk with you later.

Larry
rhight02@gmail.com
 

vitdoc

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Southern Ca.
This points out that any procedure has risk and the fewer procedures the better. This is apropos in considering what type of valve to put in when you are not very old. Also I wonder if any consideration was given to opening the chest. Sounds like things were pretty ify. You lucked out.
 

Keithl

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Apr 20, 2019
Messages
116
This points out that any procedure has risk and the fewer procedures the better. This is apropos in considering what type of valve to put in when you are not very old. Also I wonder if any consideration was given to opening the chest. Sounds like things were pretty ify. You lucked out.
I agree. I don’t care how low the percent of risk is to me every operation, even TAVR has risk and thus fewer the better. Again I have been so fortunate that my recover (4 weeks tomorrow) is going so much better than expected, but I still would not want to do this again.
 

Eva

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What a scary horrible ordeal you had gone through, Larry. Happy that all ended well.

Wishing you safe and speedy recovery. Keep us posted.
 

Mentu

Premium Level User
Joined
Nov 9, 2008
Messages
1,311
Location
My surgery was performed at Oklahoma Heart Institu
Medtronic CoreValve x 2.jpg
Well, everyone, here is an image showing my "devices" on the lower right one can see the band of my old CE Magna. Center bottom is my 2nd Corevalve, the one working for me now. You can see its wire mesh support. Top center is the extra CoreValve. On the left are the sternal talons used to close my sternum 10 years ago.
I've been doing better until last Saturday when I came down with an intestinal bug which really knocked me down but today I am better. It started just after my best day when the dogs and I had our longest walk yet.

Things are stabilizing, however, after a year of hearing my heart beat in my ears due to the 65 mmhg pressure gradient, it is gone. The other "minor" problem is that bladder control has not yet returned to normal and bladder capacity is half what I expect because of the foley catheter. It's just annoying.

Still things are better today and the orange juice at breakfast was delicious. All of you be well.

Larry in Tulsa



normabecause
 

Keithl

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Apr 20, 2019
Messages
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Wow, sternal talons? Holy crap those things look like they could hold back a truck. Such an extreme difference from the measly wires they use.
 

pellicle

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View attachment 887102
Well, everyone, here is an image showing my "devices" on the lower right one
wow ... still got a twist tie in there for "old times sake" too
(btw I like that sake and sake is a spelling identity issue, and was one of the things I used in Japan when explaining why learners of either English or Japanese should go off Romanji as soon as possible)

(a shot I took one new years)


for memories sake ;-)
 

Keithl

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Joined
Apr 20, 2019
Messages
116
Personally I’m hoping for sternal talons when the time arrives for my next avr.
Those Talons look massive there is some new X shaped thing they screw in now that is supposed to be very good, which they would use that as I think my sternum is still moving at 5 weeks I feel the occasional pop and crack, very annoying that in 2019 they are using essentially twisty ties to hold your chest together. I am trying to get them to x-ray me and check me to verify, but darn doctor are all booked up.
 
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