Bob's Guestbook

Dan Baltazor  I've (Stephanie) done it to Dan's on accident too. If you just right click on a photo it changes your profile picture all too easily.

Bob Fessler  Hi Michelee! My case is certainly different than yours. As an engineer who doesn't do anything without researching the heck out of it, I too would want to find out how many aneurysm surgeries they do each year. Ask me about echos, TAVRs, etc and I've probably researched it. Nothing about aneurysms though. I was even signed up to possibly have a TAVR which UDub was doing for a national low risk patient study until I did the research, talked to the TAVR surgeon and decided it wasn't for me.

I also interviewed Dr Verrier and though I'm sure it would have worked out fine, he gave me the impression that since it is a teaching school a lot of the operation would be done by students with him being present. I didn't find that comforting. My first choice was Dr Glenn Barnhart at Swedish based on his video and research on this and other heart surgery sites. When I interviewed him, he indicated that I needed surgery VERY SOON. I liked his demeanor, his knowledge and how he talked and explained everything to me using my CT scan, echos and angiogram results. I decided he could do the job. So I agreed to have the operation the next day. I knew I needed surgery as soon as I could schedule it but next day was a surprise. At least I didn't have to fret, worry etc. I just got it done.

I considered going out of state to Cleveland Clinic since this is my life we are talking about, but aortic valve replacement with or without coronary artery bypass is now so common that it is done lots of places with outstanding results. If it was a mitral valve repair, multiple valves or something more complicated or specialized than a single valve replacement, I might have more seriously considered going elsewhere. More than a few people on this site have gone to CC and have had different problems so though CC may have great surgeons and perform tons of operations, crap can happen anywhere.

Good luck on your search and research!
Bob

Bob Fessler  Hey Gerald. I have an Edwards Perimount Magna Ease 3300. The surgeon said at 20 years 80% of the valves are still going. I figure if I get 15 years, I'll be 80 and they will have perfected the TAVR peocedure by then. They just don't last long enough right now to be practical for us young guys.

Gerald Poulton  I am getting the edwards bovine as well, not quite sure of the model but will know tomorrow when I get my orientation, I hope to be in shape for a second as the tavr are not great at this time but valve technology has come so far, who knows ...

Bob Fessler  Thanks for the response Alethea. I've read that they can put another TAVR inside a TAVR but will ask that question to verify. I know they did this in the high risk Partner trial to correct bad placement in 4 patients. I read that The new Sapien 3 valves have better markings and placement instructions to minimize leakage and reduce the chance you'll need a pacemaker. Another item to verify. The research never ends.

Alethea Scally  To me there seems to be an issue with the valve-in-valve theory: if the first TAVR valve fails, why would one want to fix it with another TAVR valve? That seemed to make no sense to me. What happens if the second TAVR valve fail? Do they fix it with a THIRD TAVR valve?

Bob Fessler  I don't think it is immediate TAVR valve failure that is the problem. More likely that would be bad placement than valve failure. I want to know if they can put a new TAVR valve in after the original one fails in hopefully 10+ years? You are right that there has to be a practical limit to the number of replacement valves. I also don't know why they couldn't open you up, take out the old TAVR valve and sew a new valve in. But I'd rather have that done now. Leakage and pacemakers are my main concern since these are rare in SAVR but common in TAVR. The more the leakage, the higher the mortality rate sooner.

Alethea Scally  Sounds like you're leaning toward SAVR. Those were my dad's thoughts, too. TAVR has too much of a risk of short term re-op or valve-in-valve. SAVR had short term pain and complications but longer term function. Good luck!

Bob Fessler  Thanks Maron for the quick response. Less time on the bypass machine sounds like a winner to me. Since they are a teaching hospital, might they use a less experienced surgical team than other hospitals. They have to train those students to be future surgeons. Something I wonder about anyway.