Which Aortic Root Procedure??

[Bad Mad]

I got this email through from my cardio this morning. He is referring to his consultation with a surgeon (who incidently did my AVR 1st time around - six and a half years ago).

"Just to let you know he agrees that the valve needs replaced and that he suspects that the aortic root will require attention as well but that he would only be able to tell which procedure at the time of surgery."

The dilatation is in my ascending aorta - 4.5cm approx.
I thought it was as simple as saying: "Yes we will need to do a Valvegraft conduit operation." Or maybe this is the case, but he doesn't know how much of the ascending aorta/root to take out?

Is this common for the surgeon to wait until you are opened up before before he knows how much of the aorta needs replaced? Or do you think he means a Di test just prior to the op to determine this? I'm a little confused.

Do they take away the portion of the root and then replace with the graft or is there another procedure depending upon how much of the root needs replaced??

Any genuine answers/thoughts would be much appreciated folks

Kevin

 

[hensylee]

I don't know the answer, but others have had this same situation and they will be along soon. Today is a holiday in the U.S. (Columbus Day) and some may be out enjoying the free day. Just hang in and they will be along.

 

[Susan BAV]

I had a slightly different situation; but when going into AVR they didn't know if my mitral would also need replaced or not. So after replacing my bicuspid, they did a TEE test while I was still under and the mitral was enough better that it didn't need replaced also. So there are at least some big decisions like that which occasionally aren't known until they get in there.

Hopefully others will soon post with specific experiences you need related to your question. You know the drill; bump this up as needed. Take care.

 

[Bina]

When I had my heart cath I was told that my aorta was slightly enlarged and that they would evaluate the situation once I was open. When I woke up I had a new AV and nothing else was needed.

 

[dot4toto]

I was told the same exact thing by my surgeon...This is how he explained it...he needed to see when he got in there if my "sinuses" or aortic root were so dialated and large, they couldn't be used and would have to be replaced. That tissue would have to go. This would mean a valve and graft all in one. Bio or not was my choice.

If the heart sinuses were ok or a normal size he could replace the valve then use my natural tissue(sinuses) then a aorta dacron graft.

My asending aorta was 5.3cm and the sinuses were ok. I was told how things went during surgery by my surgeon 24 hours later when I was awake enough to understand. But my husband was informed while I was still in surgery,a nurse came out and told him.
This was a big deal for me and I was on the phone with my surgeon the night before surgery reviewing everything we talked about. He called me around 10pm (poor guy) but I told him what I'd like,what my fears were and he told me he'd do the best option. I said great, thanks, see you in the mourning.

Hope this helps,
Tina

 

[tcopel]

I would think, although I am not sure, that most surgeons cannot 100% predict what they may see at the time of surgery. The caths, CT scans, echos are certianly the great 'roadmaps' to help determine what is actually present for the surgeon but it isnt until they can actually see with their own eyes what the tissues and valves and structures are like to make final decisions. There are always those pesky unexpected things that pop up. I have to believe that that most of the time, things go as predicted as the studies suggest. Perhaps that is what your doc is alluding to.