On June 26, 2012...

Hey Paul!

Thanks for the response below. It's quite interesting to hear another patient's perspective on a condition that's so similar.

I think I misunderstood your comment on video taping the surgery. LOL. For me, I actually wanted the surgeon to record mine so I could have something to scare the future grandkids ;-) Seriously though, my plan was that it would be helpful to have a video record of the procedure should I ever need a follow up surgery down the line.

Regarding your question about my NSR, I actually met with the cardiologist today to go over my latest Holter monitor reading. Heart function was normal, EF was 60 to 65%. The results were better than the previous week when I was on Metoprolol. This time I had no abnormal stops (previously I had a one instance for a few seconds where my HR dropped to 26 bpm). The latest readings showed a slightly low HR while sleeping (lowest was 47 bpm), with an average in the 60's. He also mentioned that at night there were a few instances where my heart switched back into junctional rhythm, which he explained means the heart beat comes from the center of the heart (AV node?)versus the top (sinus node). The Holter also recorded 1400 PAC's and 23 PVCs over the 24 hr period. It sounded like this is something that improves over time and does not affect the heart function. He is generally pleased with all these findings since we are still only 40 days from surgery, but as a precaution wants me to follow up with an electrophysiologist. At this point there is no indication I would need a pacemaker.

That's great news that your switch resulted in being transferred to a very experienced surgeon. As I'm sure you've read, studies show this is the most important factor in the success of valve surgery. Like you, I had the ability to wait, and scheduled my 5/17 surgery back in early February.

Will be eagerly awaiting your updates as the date gets closer. Wishing you an enjoyable and stress free journey these last few weeks. Take care!

-Thomas H.

On June 25, 2012...

Hi Paul,

Just wanted to follow up on your question about videoing the surgery. I think this may definitely be n option you can request. I consulted with 3 surgeons on mitral valve repair surgery. The first 2 agreed to video tape it, but the 3rd, Dr. Gillinov at CCF, did not want to make a video record because he said the camera was obtrusive. In the end I didn't feel this was a big enough issue to affect who I chose for the surgery, and so I stayed with Dr. Gillinov and dropped the issue. I wrote about it in my journal if you want to read a few more details.

It's interesting to see the differences in our health care systems. I have heard we pay much more for surgeries in the US, but it does seem much easier to schedule a procedure in comparison to what I have read here from UK heart valve patients. Do you have the ability to change the date if you want, or would you have to get back in line and wait another month for a different date? Just curious bc my wife is superstitious (I'm not) and wouldn't let me have my surgery on a Friday the 13th.

After reading your note below on why you decided agains a cardioversion, I was intrigued. Because the cardioversions were able to return my heart rate to SR on the first "shock", for an extended period of time (14 months the first time, and for the 5 mnths up until MV repair surgery), I assumed the cardioversion option was a simple choice for anyone in A-fib. I was also under the impression that having the heart stay in A-fib increases the possibility of a blood clot forming in the atrium, but I might have misunderstood my cardiologist on the issue. Since you are now within 3 weeks from surgery, would they consider doing a cardioversion, or is it tha once you elect out, do you no longer have that option? Maybe this is another difference between the US and British health care systems.

It's great to hear that you have finally gotten a date set. These final weeks will really fly! All the best to you and your family and feel free to send me a guestbook note, or email me (tom8hunt@yahoo.com) if preferred.

-Thomas H.

Paul Rose Hi Thomas,
Many thanks for the note and where do I start..

On videoing my surgery, the surgeon Mr We ... Read more

Paul Rose Hi Thomas,
Many thanks for the note and where do I start..

On videoing my surgery, the surgeon Mr Wells already has an amazing video of the surgery he is going to perform, it was a program special on one of the television channels in the UK http://www.youtube.com/watch?v=1duI_ycUORk&feature=related

It is definitely interesting to see the differences in the health care systems. I lived in MA, USA for 20 years so have good and bad exposure and pros and cons for both. The surgery costs if you go private appear similar and can be scheduled to be more convenient. My Private Health does not cover me for a pre-existing condition, it�s all in the small print, although in MA it would have been covered�. go figure. In the UK the procedures appear to be generally scheduled within 12-18 weeks or so on National Heath by the same surgeons who do it privately � so quality is same, indeed any complications seem to drop into the National Health. I had the miss/good fortune that my original surgeon had some problems which resulting in my surgery being cancelled 15 minutes before I was due to go to the Hospital. Not his fault, but I have ended up with a much more experienced consultant:-)Dr Wells has a long waiting list, but not many surgeons have done as many MVP repairs, so worth the wait. I could move the date out, but may have to get back in line.

As with you I�m not superstitious. By now I�m used to number 13�s and my wife just wants it out of the way. My father was born on Friday 13th at 1pm (1300 hrs) and we lived at house number 13. He also had 2 sets of valves replaced 10 years apart and all on the National Health. The second set was literally an emergency where he was admitted only hours after his medical and operated upon next day � in the good old days when it took close to 12 hours to conduct the operation!

I looked at the success percentages that stayed reverted when deciding against a cardioversion and it was not long until I was due to be admitted, so at the time moot, but I had not accounted for my surgery being cancelled and finding another surgeon. I discussed it with the Consultant who said I was not incorrect based (as I recall) on my amount of LV enlargement and severe regurgitation. It is good that yours stayed in SR on the first "shock" -- are you still in NSR? My understanding is the same as yours and the statistics seem to show that having the heart stays in A-fib increases the possibility of a blood clot forming � the risk is reduced by the a regime of drugs. As I�m within 3 weeks of surgery at this point I will just stick with the plan.

So for National Health versus Private, I have not experienced much difference in the quality and when you need it Specialist Centres run very efficiently and as fast as required. My scheduling has had much to do with how urgent it is relative to others. Not a hefty price to pay � in this instance the National Health system Dr has over 5,000 procedures and very good stats.

Thanks Again

Paul