Bryan's Journal

Thomas Brusstar  Ahhhh, she's so beautiful! That's what we take care of ourselves for. Get your surgery done as soon as they let you, it will be great to have that behind ... Read more

Thomas Brusstar  Ahhhh, she's so beautiful! That's what we take care of ourselves for. Get your surgery done as soon as they let you, it will be great to have that behind you. She's only going to get heavier, so better for you to be laid up early than late!

Bryan Savage  Thanks. I'd like to get it done ASAP but I was recently told June, July, or August. It's hard to say because nothing like this has ever happened before. I ... Read more

Bryan Savage  Thanks. I'd like to get it done ASAP but I was recently told June, July, or August. It's hard to say because nothing like this has ever happened before. I had a CT scan done about 2-3 weeks ago and arteries and heart look good besides the valve regurgitation and mild left atrium enlargement. I feel like my chest pain discomfort is worsening. Did any of you experience a nagging chest painspre-surgery? Not quite painful, but uncomfortable. I was told waiting another 4 months will not be an issue, but the unknown waiting period is annoying.

Thomas Brusstar  My coronary arteries were also fine, the pre-surgery angiogram showed. So nice not to have to worry about that. Shortens surgery time.

But my mitral valve ... Read more

Thomas Brusstar  My coronary arteries were also fine, the pre-surgery angiogram showed. So nice not to have to worry about that. Shortens surgery time.

But my mitral valve had a "flail" leaflet, with a chord or two broken. So it was flapping in the breeze in there. So the valve dysfunction was pretty severe, with severe regurgitation. This severe situation did cause me some nagging pressure or ache in what I thought was my lower lungs -- because people thought I had pneumonia at first. A common misdiagnosis. (They probably should have gone straight to a fresh echo to check the heart when I had shortness of breath/ coughing from "pneumonia," because my mitral valve prolapse was a known problem.) So yes, I had a pain down there. I will say that my left atrium ballooned to 4x its normal size pre-surgery, and I also developed severe pulmonary hypertension. The pressure in that vein should be basically 0 between beats and mine was 75. That's just a result of all that backpressure. There is no valve between the left atrium and the pulmonary vein, so left atrium enlargement / dilation is happening at the same time as that pressure is being transmitted back into the lungs. It will ultimately show as right ventricle enlargement also, as it gets harder to push blood into the lungs against that backpressure. Upon repair of my valve, my LA volume came down to HALF its pre-surgery size immediately (lying on the table, measured with a fresh echo before they finished). And presumably that pulmonary hypertension resolved immediately also (that's kind of impossible to measure directly without a catheter stuck in there). The RV enlargement has gone away now (last tested at echo 13 months post surgery, and I'm at like 20 months now), but the LA is still enlarged, not quite double normal but just under that. My cardiologist says at this point it has probably come down ("remodeled") as far as it will. We don't know what damage that pulmonary hypertension did while it persisted (we guess the valve was "flail" for just over a year), but conceivably there is some impaired lung function as a result of that era. So I guess the point is that my situation was not diagnosed quickly, with definite long-term enlargement to at least my LA. If I were you, I would assume that chest discomfort is a combination of the LA enlargement, some pulmonary hypertension, and maybe some RV exerting itself. I know the delay isn't of your own making, and there's no reason to freak out (I had to wait 45 days after diagnosis to get in with my preferred surgeon); but I would take the first available table.

Susan Lynn  Bryan - I had the side entry mini-thoracotomy mitral valve repair and would highly recommend it. It takes about the same amount of time on bypass as traditional ... Read more

Susan Lynn  Bryan - I had the side entry mini-thoracotomy mitral valve repair and would highly recommend it. It takes about the same amount of time on bypass as traditional OHS - that was important to me - and the recovery time is shorter. There's minimal scarring and no driving restriction. My surgeon didn't require me to choose a valve, but I probably would have selected a bio valve in lieu of a mechanical one. I prefered not to be on blood thinners. It's a very individual choice - make the decision that's right for you. If you have any questions, please feel free to ask. ❤

Alex Sigalov  Hi Bryan, you being 34 i would recommend mechanical if u had to choose one. The most bovine will last u is 20 years (less if ur young) so ur possibly looking ... Read more

Alex Sigalov  Hi Bryan, you being 34 i would recommend mechanical if u had to choose one. The most bovine will last u is 20 years (less if ur young) so ur possibly looking at potentialy 3+ surgery and recovery gets harder and operations risk goes up as u get older, just fyi i am 39 and chose have mechanical On-x aortic.

Marie Myers  I would have to agree with Alex’s assessment above. At age 34, I personally would have gone with the On-X valve. The younger you are , the shorter the lifespan ... Read more

Marie Myers  I would have to agree with Alex’s assessment above. At age 34, I personally would have gone with the On-X valve. The younger you are , the shorter the lifespan that tissue valves have. When I had my surgery at age 63, I went with the tissue valve. It was still the hardest decision I made in my life.Hopefully, you will get a repair, and won’t have to make that decision.

Jim Wilson  Surely a tough decision Bryan and one that your age may well play the strongest role. I personally selected a bovine valve as a life of blood thinners and the ... Read more

Jim Wilson  Surely a tough decision Bryan and one that your age may well play the strongest role. I personally selected a bovine valve as a life of blood thinners and the associated risks didn't interest me - in addition, a replacement valve could easily be installed via TAVR. I just have too many sharp objects and similar activities in my life. I'm in complete agreement with Marie...hopefully the repair is successful and the rest becomes a moot point!

Tracy Fallu  It is a very tough but personal choice. At 46 I chose mechanical,
I wanted to avoid another heart surgery. It was not an easy decision, I agonized over it. ... Read more

Tracy Fallu  It is a very tough but personal choice. At 46 I chose mechanical,
I wanted to avoid another heart surgery. It was not an easy decision, I agonized over it. . Like your surgeon; my surgeon was most confident he could repair. In the end, I had a repair.

Deepak Khanka  Hi Alex , thanks for your reply. How do you feel with the valve I.e. is life getting back to normal , do your hear it a lot when you sleep on your left or right ... Read more

Deepak Khanka  Hi Alex , thanks for your reply. How do you feel with the valve I.e. is life getting back to normal , do your hear it a lot when you sleep on your left or right , do you bleed a lot if you have a small cut , if you have a dental procedure or any other surgery how do we manage waferine, does it needs to be taken at a fixed time / once anytime during the day , what foods to avoid
Thanks

Alex Sigalov  hi Deepak, i think valve is ok(have not had my 6 month echo yet), I am doing rehab now and seem to be tolerating it well my heart rate goes to 120-130 and not ... Read more

Alex Sigalov  hi Deepak, i think valve is ok(have not had my 6 month echo yet), I am doing rehab now and seem to be tolerating it well my heart rate goes to 120-130 and not having any issues; getting used to it clicking at times mostly when lie down and more on left side or sit in certain position, but mostly during the day i don't even notice; the weirdest part is the thumping feeling which really only happens when heart rate is high or take deep breath or yawn; the biggest issue I am having issue with arrhythmia and intermittent spikes in BP, but i thinks it more surgery related then any issues with valve it self. I have not really cut my self significantly yet, but do go to do weekly blood test in a lab and i cant say that my bleeding afterward is any worse then it was before the surgery. Not sure about dental procedures yet, i was waiting for after 3 month mark once i am on lower INR to do anything(i think if its surgery i might have to stop taking warfrin); I am not a big green food eater in general, eat couple of salad with my meal a week and some string beans, esperagus; always hated kale and broccoli so never ate it before and was not gonna start now. I take warfrin with my dinner wich is usually around same time every day. just to recap my biggest issue is with arrythnmia(not Afib, but more like PVC or PAC) and spikes in BP; otherwise thing relating to Aortic On-X vale seem to doing well. Hope this helps.

Willie Radl  Bryan, hopefully the repair goes well and you don't need the replacement. FWIW, I have the On-x in the aortic position and the warfarin/INR hasn't been an ... Read more

Willie Radl  Bryan, hopefully the repair goes well and you don't need the replacement. FWIW, I have the On-x in the aortic position and the warfarin/INR hasn't been an issue, I am usually between 2-2.5 when I test . One thing you should verify is the INR level for mitral vs aortic, I think a mech. valve has a higher INR range for mitral position, that could make dealing with INR more of an issue. Also, I think a bovine may last longer in that position because it's a lower pressure valve. Good luck!

Lorraine Mobley  I had the same percentage of repair - 95% and luckily it was repaired through OHS on 10/29/19. If it had to be replaced I had chosen the Onyx mechanical valve. ... Read more

Lorraine Mobley  I had the same percentage of repair - 95% and luckily it was repaired through OHS on 10/29/19. If it had to be replaced I had chosen the Onyx mechanical valve. I did not cherish the thought of it having to ever be replaced. As a pharmacist, I knew that mechanical would mean warfarin/anticoags for the rest of my life but now a days you can check your own INR at home so it would not be as inconvenient as having to go to a lab every 4-8 weeks. Definitely a personal choice but mine would have been mechanical. Good luck and hopefully it will be a repair with a baby aspirin daily like mine ended up being.

Thomas Brusstar  I had a mitral repair about 18 months ago. My surgeon said 98% chance he could repair it. He would have used bovine, as he doesn't like to put people on thinners. ... Read more

Thomas Brusstar  I had a mitral repair about 18 months ago. My surgeon said 98% chance he could repair it. He would have used bovine, as he doesn't like to put people on thinners. As Jim Wilson says, replacement valves in the future could be done through a trans-arterial procedure rather than an open procedure. I've done great on mitral repair. My surgeon here at Northwestern prefers open for a patient like me: he gets better access and options in case he discovers anything unexpected in there, and he says patients have less pain going straight through the mid-line of the sternum where he doesn't have to cut any muscles. If you use a surgeon who has done thousands of valves, I'm sure he'll be able to repair it, in which case you shouldn't need any further repairs to that valve for the rest of your life. My mitral valve at a year was still leaking zero percent, so the fix is working fine for me. I waited too long (not knowing what the problem was) with a severe regurgitation and "flail" valve, so my left atrium was pretty badly stressed and I had high pulmonary hypertension due to the pressure all backing up into my lungs. The left atrium has "re-modeled" down from 4x normal to just under 2x, so that's going to have to do; and I hope I don't have any permanent effects in the future from the period of pulmonary hypertension. I would just say get it done as fast as possible. It doesn't pay to keep your heart working overtime to make up for that leaky valve. At your age, you'll do great. Even at my crusty 55 years old, my recovery went so well that home nurses and cardiac rehab nurses basically said I didn't need to be there, but were happy to have me.

Deena Elani  Hey everyone, with all the progress being made with the trans valve - tavr- I an hopeful that surgery through the chest for valve replacement and repair will ... Read more

Deena Elani  Hey everyone, with all the progress being made with the trans valve - tavr- I an hopeful that surgery through the chest for valve replacement and repair will be not as commonly used. Don’t you think so?!