Bryan's Journal

Susan Lynn  Bryan - are you having regurgitation or any other symptoms attributable to this leaflet? I would wait to see what the specialist says. They may not be recommending any treatment. If you do need another surgery to re-repair or replace your valve, there are a few heart warriors who have had second mitral valve surgeries. The biggest advice is to find a surgeon who does a high volume of your procedure. Second surgeries require a different level of expertise.
Please keep us posted on your progress.

Bryan Savage  Thanks Susan.  No regurgitation anymore.  If anything, mildly stenotic due to the leaflet. I'll wait and see what the specialist has to say and hope it's a just a watch and wait situation. 

J Alexander Lassally  If or when the time comes, do seek other opinions from the original surgeon who did your valve, though. Good luck ! 

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 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 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 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. . Like your surgeon; my surgeon was most confident he could repair. In the end, I had a repair.

Alex Sigalov  Hi Deepak, i am on 3 mg(my INR now is 2.3) probably going down to 2mg after 3 months mark(I will be alowed to be on 1.5-2 range)

Frank Giovanniello   Bryan, that all sounds great. You have time to decide. I like thru the side, it's gotta be better than Sternum.

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 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 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!

Rose Madura  It's a very personal decision but at your age, I think I'd go mechanical. But hopefully the repair will be the way they go.

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. 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 Z  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?!