Guest Post: After Bicuspid Valve Replacement Surgery, Theresa Focuses On Recovery Progress

By Adam Pick on July 27, 2012

One of my favorite parts of this project is hearing from patients after their surgeries. Yesterday, Theresa sent me a thoughtful note that touched on several elements of the surgical process. That said, I thought you might like to read and learn from Theresa’s experience.


Theresa Lomanco - Heart Surgery Patient With Red Heart Pillow
Theresa LoMonaco – Heart Valve Replacement Patient


Here is Theresa’s note:

Hi Adam – I wrote to you recently with a question about the risks of doing an aortic valve replacement with a mitral valve repair.   I have been researching aortic stenosis and heart valve replacement since I was first diagnosed with mild stenosis some 10 years ago.   I later found your informative book and then your heart valve blog.   I want to say what a good job you do with the blog and the latest version is so professional and informative.

I wanted to let you know that I went ahead and had my aortic valve replacement with Dr. Jeffrey Swanson on 7/10/12.

I chose a bovine tissue replacement valve; I believe it was an Edwards Life Sciences valve.  I had a median sternotomy.    I developed thickening of my left ventricle from the time I had my echo last December to my test in May, 2012.   I went from moderate to severe stenosis to severe stenosis in 5 months.   I had no symptoms other than being tired but I attributed that being 65 years old and working full time and doing lots of volunteer work.   My blood pressure did start to go up right before I before I saw my cardiologist.

Besides replacing my bicuspid aortic heart valve, Dr. Swanson was able to remove the excess muscle from my left ventricle; I didn’t even know this was possible.   I had also been told that I had rheumatic fever when I was 7 years old when I got very sick for 3 months with strep throat.  Dr. Swanson said many people were misdiagnosed with this condition.   My echo showed mild stenosis of my mitral valve, but Dr. Swanson told me that I never had rheumatic fever and I had no scarring and no narrowing of my mitral valve.   My mitral valve and my coronary arteries are in perfect condition.


Dr. Jeffrey Swanson – Theresa’s Surgeon


My biggest fears about open heart surgery didn’t come to pass.   I was worried about pain management, being on the heart/lung machine, and what my incision would look like.    I haven’t had much pain, just soreness and I had minimal issues with my cognition/memory for about a week or so, and my incision is healing well because I have good skin that doesn’t scar  My chest is still very bruised and it’s been 17 days since my surgery.   I felt really bad the 3rd and 4th day in the hospital, as I was nauseated and I felt feverish (I had no fever) and I was very weak.   I forced myself to walk first holding someone’s hand and then on my own.    I’ve had to drink a lot of ginger ale as my stomach has been upset on and off and that was the worst of this.   The nursing staff in ICU and CRU were great and they helped me deal with all of my symptoms.    I concur that the best thing was my first real shower that a nurse helped me take on the day I got released.   She didn’t want me to be afraid to shower and to look at my incision.   I was in the hospital 5 1/2 days and I was in ICU for a little over a day because they were waiting for a bed for me on the cardiac recovery unit.

The unexpected things that happened to me was that I gained 20 lbs. of water weight on the day of surgery, as I was on the heart/lung machine for 1 3/4 hrs.   It came off in about 10 days thankfully.   I felt like the Michelin Tire Man cartoon and I look normal now.   I was also taken off one of my blood pressure medications in the hospital, but my cardiologist to put me back on it and increased the dose of another one of my blood pressure medications because my blood pressure went up when I got home as I’m not in bed or in a chair most of the day.   My cardiologist will re-evaluate my medications again in mid to late August.

Dr. Swanson said that my blood pressure might go up because the stenosis was like a dam holding back my blood and now it’s rushing through my arteries full force.   I’ve been making progress with my respiratory exercises.   I found the spirometer really challenging.   Dr. Swanson found out I sang in years past, so he suggested I start singing from my diaphragm as my lower lungs were compressed.   I have been singing along loudly to my favorite Broadway shows, like Camelot and South Pacific.   I would never have thought of that myself.   I can ace the spirometer after singing.

I keep trying to focus on my progress and not the length of the recovery process.  Getting out of bed without pushing/pulling myself out has been my biggest challenge but my legs muscles are getting very strong.   Yesterday, day 17, was a big day,  I walked with my husband around the track slowly for 1 lap; and today I walked 2 laps.   I have gone out several times since I got home on 7/15/12 and I’m still a bit shaky outside, but I was going stir crazy in the house and you walk just so much in your house.

I just wanted to share this with others if you think it will help them, Adam.   Recovery is challenging, but it’s doable and everyone’s pace will be different.   I worked out up until the day before my surgery to ensure I would have a better recovery and it has still been challenging.

Keep on tickin!

Written by Adam Pick
- Patient & Website Founder

Adam Pick, Heart Valve Patient Advocate

Adam Pick is a heart valve patient and author of The Patient's Guide To Heart Valve Surgery. In 2006, Adam founded to educate and empower patients. This award-winning website has helped over 10 million people fight heart valve disease. Adam has been featured by the American Heart Association and Medical News Today.

Adam Pick is a heart valve patient and author of The Patient's Guide To Heart Valve Surgery. In 2006, Adam founded to educate and empower patients. This award-winning website has helped over 10 million people fight heart valve disease. Adam has been featured by the American Heart Association and Medical News Today.

Anthony Fumo says on July 27th, 2012 at 2:53 pm

Theresa you are a champion,I love your story .Keep at it.You will be running around that track before you know it.Your Friend Tony

Jane Sinclair says on July 27th, 2012 at 4:30 pm

I was intested to hear your account because I will be having aortic valve replacement in August. I had an issue with nausea after my heart cath, so I expect that when I have the surgery too. I havenot met with the anesthesiologist yet. Good luck with your continuing
recovery and God bless.

Kerrigan says on July 27th, 2012 at 6:23 pm

Dr. Swanson and his team did my aortic valve and ascending aorta replacement surgery at St. Vincent’s in Portland 3 years ago. I can’t say enough about how lucky you are to have had his experience and professional care! I too chose a porcine valve which for our age is the ticket. I got the “new type” by St. Jude which is projected to have a good life. No daily rat poison, no complications if other types of care are needed. The rehab work I received at Good Sam in Portland afterward made a the recovery a very doable task. Congrats on your successful surgery! You are now well on the road to total recovery.

Fran says on July 27th, 2012 at 8:43 pm

Theresa, hope you are planning to go to cardiac rehab. Having read Adam’s book, you know how beneficial it is for your heart health. I too, had double valve surgery and 2 plus years later, I try to get in my cardio a few times a week. It does make a difference!


Kim Scott says on July 27th, 2012 at 11:07 pm

Theresa your an inspiration thank you for sharing your story.
I can’t wait to see you!

Julie says on July 29th, 2012 at 12:00 am

Dear Theresa and Adam,

Thank you so much for sharing your story. I was a very busy single Mum until the 17th April when I had a stroke. After further testing and a trans-oesophageal echocardiograth they found that I have a fibroelastoma on my aortic valve. I had no symptoms at all, but it was the tumor that caused my stroke. I am having surgery on the 7th August at the Alfred Hospital here in Melbourne Australia (I’ve been told its the best place to be for heart surgery) they are going to try and remove the tumor but I will most likely have to have the valve replaced. I have been very scared of the outcome of the surgery, but I am so very thankful that I found this site online. Thank you for being so open about your recovery. I think it may take a little longer for me as I still have some right sided weakness post stroke, but thank God I have regained my speech again.
Thank you once again, kindest regards


Kerrigan says on July 29th, 2012 at 11:31 am

Correction: I chose a porcine valve over a mechanical, which were the options at the time. I got the “new type” by St. Jude which is projected to have a good life.

Theresa says on July 29th, 2012 at 9:49 pm

To Julie in Australia: I will be sending healing wishes your way on 8/7/12. You sound like you have the toughness to handle your surgery as you already have a demanding life. Be armed with information and trust in your surgeon. I knew I had determination but I couldn’t let me fears immobilize me. I hope you have supportive friends & family. The nursing staff will also be your cheerleaders. Good luck to you. – Theresa

Hetty says on August 2nd, 2012 at 4:46 am

Hi everyone,
Great to read you are recovering well Therese.
I arrived home from hospital Yesterday post open
heart surgery to repair an anomalous coronary artery.
I posted on this site somewhere before the op
as i was soooooo scared. I am in Australia as well Julie.
Best of luck to you for you surgery. one hint, read
the bra site on here, and take a soft one with you to
wear post surgery……it really helps. I went to the Epworth
in Melbourne.


Stacey says on August 8th, 2012 at 11:12 pm

Thank you for sharing ur story. Im 41 and found out that i have to have avr very soon. Im so scared. All i do is cry i have a new baby and a 5 yr old. They meed their mommy. Im so scared of dying. Were u really frightened?

Hetty says on August 9th, 2012 at 1:33 am

I was beyond frightened, i was so petrified i could hardly function, i cried if anyone looked at me. I was a total mess, it is normal to be scared, just try to remember that your surgical team has done this surgery heaps of times before………Although i knew that myself, i was still scared, remember knowledge is power, if you know what to expect when you wake up, it won’t be so alien. The couple of days directly after surgery are not very comfortable, but the staff will be watching you very closely and making sure you don’t have much pain. It wasn’t as bad as i thought it would be. Best of luck, i will be sending you positive thoughts for your surgery and recovery.


Theresa says on August 9th, 2012 at 8:34 am


I second everything that Hetty has said, as that was my experience. I put my fears aside and focused on what I needed to do to recuperate. My faith in my surgeon and the fact that he had done several thousand of these surgeries (with the same assistant and anesthesiologist) really helped. I had an entire team on my side and my husband, family co-workers & friends were so supportive. I also had a lot of people praying for me & one lovely person sent me the “luck of the Irish.” Keep in mind that 250,000 heart valve surgeries are done worldwide every year. The mortality rates are very, very low. The first few days after surgery are the worst but I was never in pain, just not feeling well. As soon as they got me up & walking, my recovery started & it’s accelerated over the last 4 weeks. Every day is better although I still have a way to go. I was able to go out and see friends 2 1/2 weeks after surgery and I walk 1 mile every day now. I, too, want to wish you luck and a speedy recovery.


bonnie says on August 9th, 2012 at 11:21 pm


October 4, 2012 will be the 2 year anniversary of my mitral valve repair surgery at the age of 59. My recovery closely resembled yours. Almost 2 years later I can honestly recall that my minimally invasive surgery was “not so bad”! I also worked out up until a few days before my surgery. 3 months after surgery I was back to my full work out schedule and took up spinning. I now spin 3-4 days a week along with my regular weight lifting workouts, yoga and pilates classes. I, too was totally asymptomatic and in shock to get my diagnosis and face open heart surgery 15 months later. Although terrified, I adopted the same positive attitude and dug in deep to tackle the recovery as my full time job. So, here I am almost 2 years later and can say to you, KEEP UP THE GOOD WORK . For all those facing surgery, know it will all work out just fine in the end. You too will look back on your experience and say “it really wasn’t so bad”. Best wish to all.

jack Scher says on August 14th, 2012 at 1:41 pm

Dear Theresa:

I hope you are progressing well after your surgery.
In April 2008 I had a bovine valve placed in the aortic position due to aortic stenosis.
Following surgery my left ventriculary hypertrophy which is concentric has not mediated and now is severe. In your bog you mentioned that Dr. Swanson was able to “cut away some of the excess muscle from your left ventricle. I too did not think that was possible and it could be the only solution to save my life as my LVH has caused almost total “obliteration” of the space required to pump blood from the left ventricle. Oddly my ejection fraction is 70% but it is only a matter of short time that I will be in big trouble.

Where is Dr. Swanson? Also did they use any stem cells where they cut away muscle in the left ventricle. I believe that is exactly what I need. Does anyone anywhere else have any comment or information that could help me? Please…….. Good luck with your recovery Ms. LoMonaco.

Kind Regards and Well Wishes, Jack

Theresa says on August 14th, 2012 at 2:18 pm

To Jack,

I continue to improve, thanks. Dr. Swanson is at Providence St. Vincent Hospital in Portland, OR.

I had some thickening of the muscle around my left ventricle and it was trimmed and stem cells weren’t involved. The muscle thickening occurred in the 7 months preceding my surgery, as my heart was working too hard because of the decreased blood flow. My left ventricle was normal in size. I’m sorry to hear of your situation and I don’t know if it’s similar to mine. I’ll be asking Dr. Swanson more about this when I see him again. I wish you all the best, Jack. Maybe someone else has more information about this than I do.


jack Scher says on August 14th, 2012 at 3:33 pm

Dear Theresa:

I am glad to hear that you are continuing to improve I am very happy for you.
Thankk you for your kind response so quickly.

I did send a note to Dr. Swanson. The heart is such a complicated and amazing engine.

It compensates, re-models and does its best to “keep in ticking”. It seems that ablation type of procedures are not relevent to LVH when there is fibrous as well as live thickening of the interior walls. I sure hope there is some new research on this . Heart transplants seem to be the only solution I see.

Fortunately, for may there usually is a lessoning of the size of the thickness as pressures relieved by the valve replacement reduce how hard the Left ventricle must work. Even with my blood pressure down the walls seem to keep increasing. There are other genetic pre-dispositions going on. The key has to be in turning off the cells growing switch in the muscle or getting rid of the dead cells that are fibrous. It is not just the pressure making the walls enlarge, there are other issues impacting the growth, in my opinion.

I hope for the best and I pray for good outcomes for all.

We are all in the same boat…..we just don’t know how long we have to row.

Kind Regards,


Terry says on September 16th, 2012 at 6:25 pm


My name is also Teresa so odd I found this site. My older brother suffered complicatons at age 50 after his surgery and did not make it out of the hospital. I am going thru tests at the moment for atherosclerosis of the aorta and regurgitation of the mitral valve. you answered my question completely. That was if I could still have mitral repair even if, praying not, I have to have aortic valve replacement. You did and are doing fine. I am only 52, very active, low blood pressue, low cholesterol, but just now stopping smoking which was my one and only vice in life. I don’t even drink alcohol.
It is believed that mine may be hereditary as my mother, brother and father all had aortic valve issues. Mom and dad had aneurysms. So, I am praying that my results on Wednesday are good.
I cannot thank you enough for sharing your story of hope! All I read online was horrible until I found your post. Thank you so very much and God Bless all of you dealing with this medical issue.


Theresa says on September 16th, 2012 at 8:15 pm

I’m so glad to hear that you found my post informative and hopeful, Terry. I wish you the best no matter what the outcome of your tests. Heart valve repair and replacement have come a long way and are becoming more routine, albeit still challenging for the patient. I’m 9 weeks post-surgery and I went back to work 2 weeks ago and I also started cardiac rehabilitation at that time. I’ve even back to doing my volunteer activities on the weekend. I won’t kid you that it wasn’t hard for the first 4 to 6 weeks, but I was able to go out in public 1 1/2 weeks after I got home from the hospital and I started driving 4 weeks after having surgery (using a pillow to cushion my chest). I’m doing really well on the whole. I wasn’t doing that bad before the surgery, but I’m starting to notice that I’m not winded after I climb a double flight of stairs or walking up a hill. I’m so glad that you quit smoking as that will really help to prevent you from having a heart attack or stroke or suffering complications if you have surgery. Good for you. Bless you too, Terry.

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