The surgery went well, with no complications. The OR at the Cleveland Clinic was a sight to behold, and Dr. Krishnaswamy is a master of his craft. My TAVR procedure was Monday morning and they sent me home Wednesday. Hard to believe I had valve surgery this week and I'm already feeling great. With twilight sedation, I hoped I would remember the actual procedure, but even though they say I asked some questions, I don't remember anything after they started my IV. My aortic area has gone from 0.74cm to 3.3cm, and measured velocity and pressure are dramatically improved. Slight para-valvular leak but the doctor says that amount is common and not problematic. The most likely complication would have been a pacemaker, but so far I'm ticking away without one, which is especially fortunate given my right bundle branch block. Amazingly, the sound I hear when I lie down to sleep has changed from a loud whoosh to a pronounced beat--the first time I heard that was stunning. So, I'm really happy about this outcome, and am hoping for some good years with my new aortic valve.
I have an update. After meeting with 10 doctors at 4 hospitals over 8 weeks, and sorting through three different treatment recommendations, I have chosen to do a TAVR at the Cleveland Clinic, and to keep my native mitral valve however many years it works well. The TAVR could be replaced with another TAVR when it wears out, but (based on current treatment options) it seems more likely that I will do an open surgery in a few years that will replace both the TAVR as well as my native mitral valve (which is likely to be more stenotic down the road). My hometown of Boston has great hospitals, and I was impressed with the doctors at MGH, but the doctors I saw in Cleveland have more experience with radiation heart disease, and they are able to offer the TAVR based on more experience with patients in my situation. I am hoping for a successful TAVR in a few weeks, and hoping that this choice will work out for the best in the years ahead. Thanks for your support!
Thirty years ago, in 1987-88, I was treated for Hodgkin's Disease with radiation and chemotherapy. I am now 55yrs, fit and very active, but I have developed severe aortic stenosis (AS) and have been told I need a valve replacement. I also have moderate stenosis of the mitral valve, which is likely to progress. The doctors say I have a classic case of radiation heat disease. The Valve Center at Massachusetts General Hospital (MGH) recommends an open procedure now to replace the aortic *and* mitral valves with permanent mechanic valves; this is proposed as a "one and done" procedure followed by longterm blood thinners. The doctors I have consulted at the Cleveland Clinic propose a TAVR procedure, which assumes the need for additional procedures down the road when the the tissue valve wears out. Note that trans-catheter mitral replacement is still only in trials. All the doctors say that radiation survivors should never do two open procedures because the adhesions that occur after the first open procedure lead to poor outcomes for second open-heart surgeries. I can't believe there is no medical consensus here. I am struggling to decide what I should do. I'd be interested in hearing from anyone with thoughts/experience relevant to this choice, and from anyone who had radiation treatment and developed valve problems.