One of my best friends....damn.

KFC911 · 03:19 AM

Missed a call from one of my best friends of over 30 years yesterday....figured he was setting up a fishng trip or something.
Nope....he's at minimum gonna have his chest cut open a few inches to have a heart valve replaced next week. He had no clue he had an issue...genetic, since birth. Non-smoker, takes care of himself, and we've competed on the b-ball court, volleyball (beach), shared more good times than I can recall....fishing, sailing, etc. over the decades. I'm still a bit shell shocked....he's 51

.

We had a long phone call last night, and shared a bunch of laughs despite the serious nature of what he faces...

I just had to vent...damn

pavulon · 03-10-2017, 03:27 AM

Mitral valve replacement?

KFC911 · 03-10-2017, 03:35 AM

Quote:

Originally Posted by pavulon

Mitral valve replacement?

He might have mentioned it by name, but I was shell-shocked and don't recall. He said it was the valve that pumps blood out of the heart and through the body.

He said the doc told him if he didn't have the surgery, then he could just drop dead in his yard soon. I told him to stay out of his yard....we laughed a lot....he's facing it head on though...

livi · 03-10-2017, 04:01 AM

Serious stuff. Sorry to hear this.

KFC911 · 03-10-2017, 04:14 AM

Thanks Markus!

Paul_Heery · Paul_Heery's Garage

Quote:

Originally Posted by KC911

...shared a bunch of laughs despite the serious nature of what he faces...(

This is the best thing that you could have done with your friend, Even a momentary respite from the fear and anguish that is on his mind I am sure he welcomed.

Drbraunsr · 03-10-2017, 06:04 AM

The biggest question is: replace or repair ?
I'm recovering from the same surgery (2 weeks ago). Birth defect of the mitral valve.
Mine was a repair. If a replacement, a bit more tricky since it's a lifelong Coumadin routine (if mechanical valve is used) and the valve (since he's young) will most likely need to be performed again if it's a tissue (pig) valve.

This is lifesaving to your friend since the end result is heart enlargement with ultimate failure.
Traumatic sure. Your support will certainly be welcome.

If he has any specific questions, I'd be happy to offer my thoughts (via PM).
Good luck

gamin · 03-10-2017, 07:13 AM

My brother had valve replacement surgery about 6 mos ago. He didn't have the luxury of making an appointment. It was forced on him by a very near fatal heart attack. His nurse lady friend saved his bacon. 4 days in hospital and he is back at the gym again. Been a runner/jogger all his life. 6 years younger. Now he has to deal with the bad hips and knees.

sc_rufctr · 03-10-2017, 07:21 AM

Awful... I wish your friend the best but at least he has a fighting chance.

A friend of mine has lung cancer. Basically there's nothing they can do for him.
He's 58 and never smoked!

aschen · 03-10-2017, 07:31 AM

A person that works in my department had a similar procedure done about 10 years ago. He was out for a while but He has been completely healthy and active since. He was mid 40s at the time I believe

LWJ · 03-10-2017, 07:36 AM

Perspective? My grandmother had a pig valve put in late 1970's or early 1980's. She lived way beyond it's anticipated expiration date until 2004. She died at 95 from being good and old. Heart still pumping. Never heard her even mention it other than in a joking way. It was a great fix.

Tobra · Tobra's Garage

Quote:

Originally Posted by pavulon

Mitral valve replacement?

Friend of mine is the first guy doing them through the catheter in the groin around here. Seems like they would do it that way as much as possible to save them the baling wire to the chest deal.

They will probably give him a little heart shaped pillow, but if they do it open, tell him he will need a little throw pillow to hug to his chest for after when he coughs or sneezes.

pavulon · 03-10-2017, 10:09 AM

Quote:

Originally Posted by KC911

He might have mentioned it by name, but I was shell-shocked and don't recall. He said it was the valve that pumps blood out of the heart and through the body.

That describes the aortic valve. I hope your friend does well!

pavulon · 03-10-2017, 10:15 AM

Quote:

Originally Posted by Tobra

Friend of mine is the first guy doing them through the catheter in the groin around here. Seems like they would do it that way as much as possible to save them the baling wire to the chest deal.

The TAVR procedure is certainly less invasive but I don't think it's indicated 'routinely' at this time. AFAIK, TAVR procedures are indicated for people with situations that make open chest replacement more challenging.

KFC911 · 11:43 AM

Quote:

Originally Posted by pavulon

That describes the aortic valve. I hope your friend does well!

Thanks! Is this your specialty? The valve will be replaced by a mechanical one. He goes in for some type of test, best case he's looking at leaat a 4" incision, and based upon the test maybe even more intrusive. Doc says if he's not in perfect health otherwise, he won't operate and he does 350 procedures per year....seems to be in capable hands. Buddy is ready to get it done....he feels great (has never had any symptoms) and can't take any more of his wife's nagging

. You can't do this, you can't do that....she's a sweetheart though. I first met her as we were heading on a three day regatta in the Atlantic....I told her I went to college at Buddue....I was a drunken sailor. It was several years before she realized I meant Bud U

pavulon · 03-10-2017, 01:12 PM

No. I'm an anesthetist.

It's good that your friend is confident in his surgeon. Just ask him to do his homework and to be skeptical of anyone quoting numbers and absolutes. Of course everyone wants their surgeon (or anyone providing a service) to be confident but try to be sure that they're being honest.

aap1966 · aap1966's Garage

If he's "had it since birth" it's more likely a Bicuspid aortic valve than a mitral valve issue.

Repair is not an option if aortic, so option is tissue or mechanical replacement. Decision as to which way to go is largely age related. Mechanical will last forever, but (currently) looking at lifelong warfarin (coumadin) with the attendant dietary hassles and regular blood tests. (Mind you, the NOACs-Novel Oral Anticoagulants-such as rivaroxiban may be an option if current trial data proves favourable). Tissue is less hassle anti-coagulant wise, but your friend is not going to get the duration out of the valve. Is he prepared to go through a redo in 15 years when the tissue begins to fail?

TAVR (percutaneous replacement) is early days and results are extremely operator / centre dependent. If my 82 year old mum needed an AVR, I'd go TAVR. If I needed an AVR, then at this stage I'd still go the old fashioned sternotomy route. TAVR valve durability is the big unknown that no-one likes to talk about.

Anyway, best of luck to him. Big operation, but pretty good mortality / morbidity outcomes these days at the high caseload centres. Tell him post-op physio will be hard, but it's vital, as is adequate analgesia. Narcotics are your friend post-op.

SCadaddle · 03-10-2017, 09:45 PM

Been through this discussion for the last several months in my family.

My Uncle (Dad's brother) last year at age 98 had the TAVR procedure. Recovered in a matter of weeks and then soon became the MVP at the local gym.

Dad on the other hand at age 96 needs both the aortic and the mitral valve. They say they can replace the aortic valve with the TAVR surgery but not the mitral valve. And if you only do the one then it complicates the other. So he's having neither.

And the boys are now 99 and 97 respectively.

KFC911 · 03-11-2017, 05:10 AM

Thank you all for sharing your experiences and expertise!

fintstone · fintstone's Garage

Some of the best in the world in your area. My much younger brother had a massive heart attack there recently and they seemed to have him back to normal very quickly. He would have likely died where I live (very rural).