We spent the last 2 days at Duke getting additional tests for my husband. He had a catherization last Fall that showed no blockages. This time, they wanted ...Read more
We spent the last 2 days at Duke getting additional tests for my husband. He had a catherization last Fall that showed no blockages. This time, they wanted to look at the pressure in his arteries and get a better look at the aortic valve root. The root is enlarged; the artery pressures were good and the aortic valve leak was more moderate than severe as originally thought. Good news. So--why is he so winded, tired, etc. and why is the left ventricle so enlarged? Obesity, long term hypertension and a moderate leaky valve are most likely the reasons. We had pulmonary tests done yesterday and the results were good, so doesn't look like a pulmonary issue. So, do we do surgery on a 77 year old man with a moderate leaky valve or wait until it is worse and he is older and in worse health? That is the question.
Alethea Scally Hi Patricia, I can totally relate to what your are going through. The thought of open heart surgery o ... Read more
Alethea Scally Hi Patricia, I can totally relate to what your are going through. The thought of open heart surgery on my 71 year old father who has underlying lung disease of COPD and moderate-severe Emphysema was daunting. He had the choice of doing Open Heart or TAVR and he opted for Open Heart. My father's shortness of breath came on suddenly; he had several episodes of hypoxia in January which led us to his surgery for aortic valve replacement and coronary bypass just this past Tuesday. In my opinion, there are four things to consider when looking at TAVR:
1) high incidence of perivalvular (sp?) leak. If your husband already has a leak, it could get worse with TAVR.
2) High incidence of stroke during the procedure (also with OHS but some studies say it's higher with TAVR).
3) High incidence of pacemaker post-TAVR (some studies show up to 40% of TAVR patients requiring implantation of a pacemaker post-TAVR).
4) Valve failure anywhere from 6-8 years post-TAVR.
I truly feel for you, I hope you can find the right medical guidance. When we would meet with the TAVR doctors we would lean TAVR. When we would meet with the Open Heart Docs we would lean Open Heart. It wasn't until we met with our current surgeon that we felt we were getting the straight story. Neither option is fail-proof; both TAVR and Open heart have serious drawbacks but in different areas.
It's exhausting but the more information you have the more certain you will be about what route to take. At least that's what it was like for me and my dad. Hope this helps.
patricia ahern Thank you for sharing your experience, Alethea. They are now talking open heart as opposed to TARV. ... Read more
patricia ahern Thank you for sharing your experience, Alethea. They are now talking open heart as opposed to TARV. Surgeon called tonight to say the heart MRI showed definitive issues, but echocardiogram didn't. Now they want to do another echo that puts a camera down his throat to the heart to get a better look. I can appreciate the fact that the surgeon wants to make sure the surgery will improve his quality of life and wants to confirm that there are issues with the valve. I just feel worn down going back and forth.
Alethea Scally Yes, there is a lot of uncertainty and that's what is so draining. Take care of yourself, too. Just t ... Read more
Alethea Scally Yes, there is a lot of uncertainty and that's what is so draining. Take care of yourself, too. Just think about how the testing and diagnostic exams won't last forever, it just seems like they are never-ending right now. You'll be glad you got all the tests done in the lon run. Good luck to you both!
Lynda Ruiz I have COPD from chronic bronchitis (never a smoker), am 66 yo and had OHS 3 weeks ago where they did ... Read more
Lynda Ruiz I have COPD from chronic bronchitis (never a smoker), am 66 yo and had OHS 3 weeks ago where they did 3 different procedures. They told me OHS was for me as "younger" patient. Recovery would be harder near my home in no. AZ at 5200 where I need to use oxygen.
Catie B I hope the TEE gives a much clearer view, so the right course of treatment will come to light. I'm so ... Read more
Catie B I hope the TEE gives a much clearer view, so the right course of treatment will come to light. I'm sorry all this is so stressful, Patricia!
Bob Fessler Alethea..good post. Exactly my dilemma. TAVR or OHS. Pros and cons. Cons and Pros. It's a dilemm ... Read more
Bob Fessler Alethea..good post. Exactly my dilemma. TAVR or OHS. Pros and cons. Cons and Pros. It's a dilemma.
Priscilla Peluso Time to trust the expeerts. Life is worth extending if God will.s
patricia ahern Thank you all for your kind words of encouragement. I, too, am glad the team is being thorough befo ... Read more
patricia ahern Thank you all for your kind words of encouragement. I, too, am glad the team is being thorough before coming out with their final recommendations. Let's hope we know something in the next week.
Anyone have experience with TARV? We've been going to Duke Medical Center in Durham, NC and I am told 95% of their aortic valve replacements are done this ...Read more
Anyone have experience with TARV? We've been going to Duke Medical Center in Durham, NC and I am told 95% of their aortic valve replacements are done this way. We are considering Dr. Carmelo Milano. I have only seen one review of Dr. Milano and would like to know if anyone else out there has had him as their surgeon. Thank you.
Adam Pick Hi Patricia, I'm not familiar with Dr. Milano. But, here's some good information about TAVR - http:// ... Read more
Complete explanation of the TAVR Procedure for aortic stenosis patients with videos, success stories and leading TAVR doctors.
Penelope Bodek I'm a cardiac patient at Duke as well. I have a bicuspid aortic valve and an aortic aneurysm. A fri ... Read more
Penelope Bodek I'm a cardiac patient at Duke as well. I have a bicuspid aortic valve and an aortic aneurysm. A friend of mine had open heart surgery for the same thing at Duke in October. Our surgeon is G Chad Hughes. He is an expert in aortic surgery. I can't say enough good things about Duke Hospital and Dr. Hughes. Good luck.
Cathleen Weed I had TAVR in August 2015...after 3 open heart surgery AVR's in the past, this was so easy it hardly ... Read more
Cathleen Weed I had TAVR in August 2015...after 3 open heart surgery AVR's in the past, this was so easy it hardly seemed real lol. If your husband qualifies for TAVR he will have a much better experience than going through a brutal OHS. That would be a lot for him with his other medical issues right now. My TAVR was done at Cedars Sinai in Los Angeles by Dr. Raj Makkar. My 3 former open heart surgeries were done by Dr. Trento, the head of the department. They are both amazing surgeons. Good luck! xo
p.s. I'm happy to offer free advice on Heart Healthy living with great nutrition and fitness tips after he is done with the surgery. It will be VERY important that he get his cardiovascular health and weight under control...many of the issues you listed on his journal are caused by being overweight. I can help him reverse that. He will feel so much better and his quality of life will go way up, not to mention his longevity. I know you want him around for as long as possible. xo
patricia ahern Adam, thank you for the TAVR write up; will certainly review the info. Penelope and Cathleen, thank ... Read more
patricia ahern Adam, thank you for the TAVR write up; will certainly review the info. Penelope and Cathleen, thank you for your responses. Good to hear positive things about TAVR as well as Duke. Cathleen, I've been married to this man for 25 years and at age 77 now, I doubt he is going to give up his bad diet and nonexistent exercise regiments, but it is worth a try! Will keep you updated after surgery.
My husband has been dealing with A-Fib for about 8 years now (he's 76), on blood thinners, and was diagnosed and hospitalized about 10 years ago for CHF. A ...Read more
My husband has been dealing with A-Fib for about 8 years now (he's 76), on blood thinners, and was diagnosed and hospitalized about 10 years ago for CHF. A minor leaky aortic valve was discovered about 5-7 years ago and has been monitored, but over the past 6-8 months, he has been very winded, tired and in my opinion, not as sharp mentally. He went to his cardiologist and after a stress test and echo, it looks like his leaky valve is worse and his heart has enlarged more than it has been. Had a catherization, and everything was clear, no stents needed. He's never had any blockages. Doctor wants to do a heart MRI to get a better view of heart. It's been 2 months since he was diagnosed with increased leaky valve and MRI won't be scheduled until January because equipment won't be available locally until then. I want to go to another facility two hours away to get this done NOW. if he will require valve repair/replacement, we will need to travel. Husband thinks I am being too anxious about this, but this is a man on 12-15 daily meds, obese, who has numerous medical issues (hypertension, borderline diabetes, etc.). Am I making too big of a deal about this? Doctor just changed his diuretic and seems to think January for an MRI isn't a problem.
Catie B My thinking would be more like yours, Patricia. To get things checked out sooner rather than later, i ... Read more
Catie B My thinking would be more like yours, Patricia. To get things checked out sooner rather than later, if at all possible. Shortness of breath and tiredness can be symptoms related to valve issues.
Phyllis Petersen I was originally given a date a couple of months away, but after the cardiac imaging people spoke wit ... Read more
Phyllis Petersen I was originally given a date a couple of months away, but after the cardiac imaging people spoke with my cardiologist they moved it up to only a month wait. Unfortunately, they have a hard time scheduling these things. I was surprised how many months it took to get through everything and into surgery. Thankfully, they let me have my knee replacement before having the heart fixed or I would have been living in that extreme pain with a twisted knee for probably another year. If they felt it was urgent, I'm sure his doctor would make sure it happened sooner. But if you have the option to go further and get things moving sooner, maybe you should look into that. Have you gotten a second opinion?
Vicki Hake Where are you located? I found out today that my mitral valve replacement is scheduled for Jan. 10. ... Read more
Vicki Hake Where are you located? I found out today that my mitral valve replacement is scheduled for Jan. 10. I live in the St. Louis area and Barnes is a great hospital. Don't wait!
patricia ahern Thanks for all the feedback. We have had a variety of tests over the past few months, a second opini ... Read more
patricia ahern Thanks for all the feedback. We have had a variety of tests over the past few months, a second opinion, and now we are working with a team at Duke University Hospital in Durham, NC. Hubby needs an aortic valve replacement. Next week, we have another catherization and maybe a few more tests (still working out details) before we meet the following day with the surgery team. Duke typically performs the TAVR surgery, which is less invasive (95% of their AV surgeries are done this way). Anyone have experience with this process?
Phyllis Petersen Patricia, You may want to repost your comment as a new journal entry so more people see it. There are ... Read more
Phyllis Petersen Patricia, You may want to repost your comment as a new journal entry so more people see it. There are people on here who have had TAVR and the comments I've seen are generally good.
1) high incidence of perivalvular (sp?) leak. If your husband already has a leak, it could get worse with TAVR.
2) High incidence of stroke during the procedure (also with OHS but some studies say it's higher with TAVR).
3) High incidence of pacemaker post-TAVR (some studies show up to 40% of TAVR patients requiring implantation of a pacemaker post-TAVR).
4) Valve failure anywhere from 6-8 years post-TAVR.
I truly feel for you, I hope you can find the right medical guidance. When we would meet with the TAVR doctors we would lean TAVR. When we would meet with the Open Heart Docs we would lean Open Heart. It wasn't until we met with our current surgeon that we felt we were getting the straight story. Neither option is fail-proof; both TAVR and Open heart have serious drawbacks but in different areas.
It's exhausting but the more information you have the more certain you will be about what route to take. At least that's what it was like for me and my dad. Hope this helps.