Bill's Journal

Marie Myers  I am curious if the surgeon discussed the traditional open  heart surgery replacement replacement rather than TAVR…

Bill Tynes  By the way, I have read that both open heart and TAVR have the same stroke risk. Maybe I’m mistaken about that. Do you know otherwise?

Yumiko Ishida  I have not had TAVR but a different catheter procedure called valvuloplasy for my mitral stenosis, and during the first attempt developed a clot during the procedure and they had to abort it. Second attempt three months later it was successful, but the benefits did not last long, so less than a year later I got a replacement via sternotomy. I discussed my concerns about clots with the surgeon before the replacement surgery, and he explained to me that sternotomy is safer than a catheter procedure when it comes to clots. During an OHS your heart is essentially disconnected from your body and the machine takes over, so if a clot does form, it does not go to your brain or lung, they just remove it right there. Also your blood is super anticoagulated because of the machine it has to go through. With a catheter procedure, the blood is only semi anticoagulated, and your blood is still flowing from your heart through your body while the instruments are poking about inside. Because I do not have experience with Sentinel Cerebral Protection System I can’t speak to it, but if it is proven to reduce the risk of clots it’s probably worth considering. I think it comes down to your own risk factors. OHS has it’s own risks but they are different from a catheter procedure. I don’t think I would have survived an OHS a year and a half ago, but right now I will opt for OHS, for myself in my current condition.

Marie Myers  Not really sure on that question, Bill. Will be interesting to Hear what the surgeon says about your case. 

Bill Tynes  Thank you for your comments and concern. My stroke concern is because of a very high Calcium score for my Aortic Valve. My understanding is that is raises the chance of a stroke by 2- 4 times. So instead of a 2-3% chance, it is 4-10%. The implication is that more debris is released from the valve when the prosthetic valve is deployed on top of the Stenotic valve. Hence my question about anyone’s’ experience with the Medtronic Sentinel Cerebral Protection System.