Andrew Dial  Hey Greg, appreciate the reply. I would say I couldn’t agree more in what you you said about surgery changing the way one thinks mentally and physically. I think the priorities change and shift. If I can’t be happy myself, how can I be a good husband and father to my girls? 

Life is short, no regrets, and cherish every moment. 

Andrew Dial  It sounds like things are improving for you,so that’s good. Recovery is soooo long, as we are all seeing. But always headed the right direction. Your ultrasound is going to be flawless, I already know :)  and I’m glad you’re able to talk to someone about your mental stuff- keep that up! 

I am actually making a HUGE change… I am leaving my job. My job is very physical, and it completely drains my energy, so when I get home I have no energy to play with my daughter, and no energy to get any real exercise in. Lately, my only days of exercise are on Wednesday’s when I go to physical therapy. So I am going to be leaving my job, getting a new exercise routine at home, dropping off and picking up my daughter from kindergarten, and I also am starting my own business working on cars. It’s risky, but my wife is so amazing and is a big reason we are able to make this happen. She is so supportive and thinks this will help in a huge way, and will get me back to my normal happy self. 

Susan Lynn  Andrew - Good for you! Glad to hear you're making a job change to improve the quality of your life and your family's. Great decision!!

The one free bonus that comes with every heart surgery is clarity. Sometimes our most challenging experiences shine a bright light on everything around us. We see what we didn't notice before. We may heighten our awareness to what we want to achieve in our futures. Every day becomes more deliberate and focused. Priorities are clearer. Decisions are easier and more meaningful. All that at no extra charge! Heart surgery has a great way of creating perspective!


I wish you the best of luck with your new venture! Please keep us posted!

Andrew Dial  Wow Susan, you could not have said that any better! My surgery has definitely changed my perspective and the way I view life. My wife and daughters, my health, their health, everyone’s happiness in my home, spending more quality time with one another, all those small moments, are what matter. 

Honestly, before surgery, I had this feeling that my surgery was going to change me, change something on how I viewed life and my priorities. I had my surgery and months went by and I’m thinking to myself… uhh when is this gonna happen? Well sure enough, almost 6 months later, the changes started to trickle in, the priorities shifted, and I feel as if I can see much clearer now..

Thank you for the support, and you guys have mine as well with whatever comes next for you. 

Pamela Gregory  I think it is awesome you are making a change to better the quality of your life. As my mother always says "life is not a dress rehearsal" and I can tell you from personal experience that you want to cherish every minute you get with your children

Deena Elani  Right on, Andrew. You have become a wise man before your years. Your precious little girl (and beautiful wife) must be so happy that Daddy is not just gonna be alright, but even better.

Ana Brusso  Dear Andrew, I’m late reading this post but congratulations on making a decision that will improve your health, your family life and your wellbeing. Trust God and you will be successful, do not fear. 

Andrew Dial  Hey there. Ya I think the people that have told me that and the things you read online  is used as a general statement, for people that might not eat so healthy already, have to maybe watch what they eat and to monitor INR closely until they get it dialed in. Each persons idea of eating healthy is definitely different from one person to another. I am really glad tho to hear you are having a good experience with your mechanical valve :) 

Andrew Dial  Hey Earl, glad you were able to meet with UW Heart Institute! So the main differences between mechanical and Ross. Well… mechanical is supposed to last a lifetime, so no surgery later in life, Which is huge, and in many cases what patients want. Downfall, is the blood thinners for life. And having to watch your diet and INR levels closely. I think most people adapt well… others Not so much. The Ross, the big advantage is not having to take those blood thinners and can eat pretty much whatever you want, live a perfectly normal lifestyle, etc. I am 33, and the Ross was a no-brainer for me… I’ve been told that at 20 years, there is a 20% chance of reintervention… so that puts me into my mid 50s for my next and hopefully last surgery. The Ross is highly technical as I’m sure you’ve read. I believe They both require a full sternotomy, so recovery is the same if I’m not mistaken. I think the main factors really for you are your age, if your pulmonary valve is able to be swapped over, and you are aware of the length of time you will potentially get from the Ross. I hope this helps….  Please continue to ask all the questions you want, I’m always on HVS.com. And others on here are always willing to help and share. 

Alexander Casler  Hi Earl, it seems like you're doing the same sort of research that I've been doing for the last year or so.  I haven't had surgery yet, but I can share with you what I've been reading about the Ross, as it was my original choice but I've since changed my mind.

Baylor Scott & White recently published a pretty remarkable study on their Ross patients, 20 years of follow up.  In their series they found that the reoperation rate at 20 years was 45%. 

Link to the Baylor Study: 

https://www.annalscts.com/article/view/16841/html#:~:text=Long%2Dterm%20survival,-Median%20follow%2Dup&text=Estimates%20of%20freedom%20from%20all,74.8%E2%80%9388.3%25)%2C%20respectively. 

The only other source I could find that had actual data going out to at least 20 years was from the German Ross registry which published a study last year of 2444 Ross patients.  It showed similar but slightly better numbers when compared to the series at Baylor, reintervention in this series was 38.5% at 25 years.

Link to this study:

https://www.jacc.org/doi/10.1016/j.jacc.2021.01.034?_ga=2.233792606.1944251297.1668220297-1648845142.1648920319&_gl=1*1l5quif*_ga*MTY0ODg0NTE0Mi4xNjQ4OTIwMzE5*_ga_2V8VW4Y237*MTY2ODIyMDI5Ny4yLjAuMTY2ODIyMDMxMi40NS4wLjA.

One other thing to keep in mind is that since two valves were operated on, it means two valves will need intervention, and there's no guarantee they will fail at the same time.  There's a link to Arnold Schwarzenegger's heart valve surgeries on this website, it's believed he had a Ross procedure in 1997, then a pulmonary valve replacement in 2018, then an aortic valve replacement in 2020, so three surgeries in 23 years.  In addition reoperation on the pulmonary autograph (your new aortic valve) will likely be another open heart procedure, according to Dr. Stelzer of Mt. Sinai "Importantly, stenosis of the autograft has never yet been seen which makes valve-in-valve catheter-based therapy impossible for the failed autograft with current technology."

The Pulmonary Homograft can usually be replaced with a transcatheter valve but not always, in Schwarzenegger's case it ended up being another open heart, and based on what Dr. Stelzer said about the Pulmonary Autograph, that was also likely an open heart procedure.

From what I've gathered the recovery is similar to any other SAVR option.  Operative mortality is also similar if you have the surgery at a center with a high volume of Ross operations.

Overall it seems like the Ross has some great advantages, but it comes with some real risks in relation to reoperations as well.  Some surgeons will argue reoperations aren't a huge deal, others show increasing risks with every surgery, owed to scar tissue and such.

Greg Lewis  If i could add a couple thoughts here: if you have to take blood thinners, its not just the meds that are at issue...your blood does not clot well. You then have to be careful what you are doing. I work where there is a high potential to get cut. And i work alone in remote areas, so not ideal. Also with a natural valve it can be monitored for its gradual decline. I dont believe a mechanical will have that. It will just stop, if it quits working. But when i was deciding, it was for sure something i considered, that i may not need another valve replacement, with mechanical. Also, can they do TAVR on mechanical? Insert a new valve into the old one? For me, it boiled down to the blood thinners, and the stroke risk, and the serious event of the mechanical getting clotted, and the gradual decline monitoring. But there are no guarantees here! As i have learned. So, i think you do what you feel is right for you, and then NEVER look back! Good luck!!!

Andrew Dial  Greg is absolutely right, the one you choose for you, is the right one! 

i also work at a high risk job for getting cut. That was something I thought about as well. 

Andrew Dial  Yeah there are many different studies from many different places, surgeons, schools, hospitals… talk to as many people as you can and get all the information you can before choosing. The information I have been given is from actual surgeons, and that’s ultimately why I chose what I did. Hope that helps! 

Rita Savelis  Mechanical valves don't "just stop".  All valve choices are good choices, none of them are perfect. Replacing a valve is never ideal. Then you do it and life goes on.

Alexander Casler  Mechanical valves themselves are pretty bulletproof, I believe most of the literature puts them at a reoperation risk of roughly 0.6% per patient year.  From what I've read this isn't because the valve just stops, rather it's caused by paravalvular leak, pannus formation, or inadequate ACT leading to thrombosis.

Ultimately the best decision is the one you make, all the options have pros and cons.

Greg Lewis  Earl, as Andrew says get all the info you can. We made our choice after talking with my surgeon, and cardiologist, that gave us their recommendations. 

Andrew Dial  Yeah I actually haven’t drank a drop off caffeine in like 2.5 years.. I probably could now, but I figure it’s probably better for my heart if I just not drink any. 

Andrew Dial  Feeling pretty good today. Got a good nights sleep last night. I think a big part of what’s going on maybe, is the fact that I work a very physical job, lift heavy, and in a non heated shop. 

Deena Elani  Could be Andrew/Andy.  It takes a long time for the heart to COMPLETELY heal.  Took my heart 14 months.  I am older but also in very good shape and it took that long for my resting heart rate to drop to the low 70s.  Still wasn't there at 12 months.  That aside, I know the NW isn't like the NE in terms of cold, but seriously no heat?!!  Is bringing a space heater in to much to ask?  Though my guess is the space you work in is huge or you are sometimes  outside.  Are you getting a second opinion on this?  Perhaps a stress echo could be done, because you would be running on a trend mill and that would test stress on your heart.  

Andrew Dial  Hi Klara. I’m doing okay. I definitely have some minor stuff going on. When I inhale, I have this like small pain/ache in my right shoulder. It’s very very subtle. And to go along with that, the last few days, when I use my right arm when lifting things, or holding it up. It starts feeling super tired really quickly. It’s the weirdest thing. I’m in the process of trying to figure out what’s going on….

Thanks for asking :) 


How are you???

Klara Čičić  There is this thing called reffered pain in your right (or both) shoulder which comes from phrenic nerve irritation...which can be due to many different reasons (it can occur after thoracic surgeries or if someone has gall stones, gall bladder inflammation or liver problems...or diaphragm spasm...truly many reasons). I hope your doctors can find out the cause with some more lab/imaging... 
I am struggling with pain in my shoulderblade, but it lasts since the surgery so I am not worried since it is probably due to nerve damage during thoracotomy. I must be patient. Keep us posted and hang in there! We are thinking of you.

Andrew Dial  I def had some shoulder blade pain as well, … it eventually went away thank god. Did you have full sternotomy?

I’m looking into paralyzed diaphragm, as a lot of the symptoms feel spot on to what I’m experiencing…. 

Klara Čičić  Well paralyzed diaphragm is a serious thing and I believe you would be having some more serious symptoms, especially breathing difficulties, it is unlikely in your case I think considering all the facts, it would be seen by now... But you know medicine, nothing is impossible. Tests will show. I bet they will do everything in their power to figure out the cause. Try not to google and panic... There are really number of issues that can cause your symptoms and good history taking, physical examination, labs, imaging...it will all help finding the cause. 

Marie Myers  I am wondering if you have gastritis from the aspirin. One thing you can try is 2 weeks of famotidine. The over the counter dose is 20 mg. I believe the name brand is Pepcid. If you feel better in 2 weeks, you might have an answer..

Patsy Stewart  Thank you, Richard and Ana. It was wonderful to meet them.
Sorry, Andrew. My post ended up on your guestbook post. I deleted it and hopefully, it posted on my page this time. 

Andrew Dial  I think by that time, he had done around 60 or more Ross procedures. how close are you to cedar Sinai in New York? I believe they’ve done the most. Find Tim Andre on here… that’s where he went.

Matthew Malooly  Good to know. NY is over 1000 miles away. There’s actually no one specifically recommended for 500+ miles away.  I was offered Ross as an option assuming they feel my CT is compatible.  There’s a pediatric/congenital guy here that would be doing along WITH the other surgeon, so the fact that there’s two both gives me some confidence, but also suggests
they don’t do much.  I guess we’ll find out in a couple weeks.  Thanks!