Open heart surgery, anyone been there before?

AshleyC

AshleyC

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anyone had first hand experience of open heart surgery?

My other half has been diagnosed with a bad valve and has to go in to get it replaced within the next couple of months. We have appointments with the Consultant / Surgeon coming up and she has to decide which type to go for. You either have a titanium valve put in and its there for the rest of your life but you also have to take blood thinning pills every day for the rest of your life too. Or you go for the organic option, have a pigs valve put in which means no pills but it will wear out in 10-15 years and youre back in getting cracked open again. She's in her early 40's and to say im ******** bricks is an understatement. I'm pretty sure she's in good hands, the Royal Brompton in London seems pretty well respected and the Surgeon's profile makes him out to be the guy you really want to do it but, hell, its still open heart surgery!

Anyway, anyone been here before? How did everything go, recovery times etc? Do you think the right choice of valve was made? Like i say i'm erring on the side of metal but its not me is it and who knows how simple the procedure may be in 15 years times when todays fleshy one needs replacing.
 
My Dad had open-heart surgery for a valve replacement 30 years ago, when he was in his mid 40s. He take warfarin daily because of the valve (which suggests that it's a metal valve). When it's quiet, you can hear a quiet ticking .

I'm not sure how long the recovery was, but I think it was around 4-8 weeks. The recovery time probably depends on underlying health, by the time of his operation my dad was quite ill and was bluntly told to have the operation.

Using warfarin requires a dedicated approach to your medication, you have to very disciplined and you have to have regular checks to keep the dose right.

On the upside, the surgery has given my Dad 30 years he wouldn't otherwise have had and it didn't stop him and my Mum travelling the world for the next 15 odd years.
 
My father too had a triple bypass in 1983.
He wasn't given the option of anything but the pig valves, but was still on Warfarin for the rest of his life, but like Steve's dad, he continued to travel....lived a normal life.
I was amazed how quickly he recovered, even back then, and I'm sure procedures have come on in leaps and bounds.
 
In May 2006 I had a total of 4 MIs (Myocardial Infarctions) each requiring a jump start (resus). 105 days of recovery in hospital and a triple by-pass later and I beat the odds (as 3 senior cardiologists said) by walking out tbe hospital. 10 years on and I am still on my own 2 feet.

Luckily my valves were not damaged but I witnessed men and women in their 60s to late 80s who would be very weak and lacking colour going for CABG (Cardial Arterial By-Pass Graft) AND Valve replacement and repairs. Some mechanical som 'animal'. The majority were up and walking with 2 days of the op, colour back in their faces, breathing better and not struggling from loss of BP.

As mentioned the use of animal valves does require not just the use of Warfarin but very regular blood tests to ensure the blood is doing it's job.

I still voluteer at the hospital and being a patient in a critical care facility you see acute cases.

Life is precious. Most will come through the surgery some are too ill to survive. I was meant to be one of those. It will be 10 years this August I walked out of hospital - 5 days after a CABG....

Be strong and see the future not the here and now. They do mazing work on heartds and the miracles come along regularly

Steve
 
thanks for the replies chaps. Its some reassurance to hear from people who have gone through it :)
 
Can't help you directly, but the man who I used to live next door to as a youngster has had multiple ones done and he's absolutely fine and fighting fit again - was a hell of a shock when I found out, so I can only imagine how your feeling...

Hope everything goes well and your other half is okay
 
I appreciate you are asking for people with experience, which fortunately I am not.

My approach on this would be... in 40's a fair chance of another 30-40 years on planet earth, which would mke me, in that situation, opt for the titanium option as I would definitely prefer it once rather than mutliple times, as generally as age increases, recovery time takes longer. Now obviously there is a chance of something going wrong with either the titanium valve or the pig one, but if one is expected to last forever and another 10-15 years... to me a no brainer.

Working in business analysis / intelligence I guess I would be seeking data as to median lifetimes for both types.... (unlikely to get that)

However I wish her all the best, whatever option you choose.
 
Not direct but my father.

His heart condition was mainly related to the privations as a result of being a PoW and at late 40's he needed a mitral valve replacement. This was (wracking brains) approx 1965 he became what the doctors called their star patient. He had an animal valve but was on digioxin for almost the rest of his life to aid his overall heart health, he passed in 1996 with a contributing factor being his heart...........but that was aged 78. So something like 30 years post surgery!

Undoubtedly methods and post surgical medications have improved since the 60's so best of luck with the surgery and her improved long life.

Oh, he was a Black Cab driver so needed regular medical checks to maintain his green badge license and never had a problem retiring when he reached 65 :)
 
Lynton said:
I appreciate you are asking for people with experience, which fortunately I am not.

My approach on this would be... in 40's a fair chance of another 30-40 years on planet earth, which would mke me, in that situation, opt for the titanium option as I would definitely prefer it once rather than mutliple times, as generally as age increases, recovery time takes longer. Now obviously there is a chance of something going wrong with either the titanium valve or the pig one, but if one is expected to last forever and another 10-15 years... to me a no brainer.

Working in business analysis / intelligence I guess I would be seeking data as to median lifetimes for both types.... (unlikely to get that)

However I wish her all the best, whatever option you choose.
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Lynton

I agree with your "unlikely to get that" point.


In all data analysis there are variables based on unknown/unexpected events which can skew outcomes.

Cost Benefit Analysis of man made solutions also play a part in decision making - as the Apollo 1 and the Challenger Shuttle disasters showed.

All medical devices carry risks. As an engineer, MTBF (Mean Time Between Failure) is not easily defined and quality systems are not exactly 'accurate', but MTBF is dynamic so use = new data = improvement hopefully).

So when it comes to heart surgery, the implanting of natural transplanted products (pig valves) underlying issues from donor animals may exist which can effect viability of the heart valve (genetic inheritance) and in the man-made device, maufacturing defects, biologcal incompatibility and other unknowns sometimes described as the 'law of enexpected consequence'.

I have met a wman on her 10th heart graft... given the self donated pipework I made for my triple grafts (1 x Radial Artery (2 in each arm 1 in each is almost built in redundacy), 1 × mammary artery (2 available and both redundant in male) 1 large vein lower left leg (again redundacy)). Pig valves - unlimited supply, natural, requires anti coagulation meds, replaceable, man made valves, no guarantee on MTBF but used often to indicate reliability.

So what about wider risk issues - 'catastrophic failure - common potential in both solutions. Speed of failure, cessation outcome - death.

Economic issues - man made - quality of production/material/sampling. Animal - cotrolled production, health of donor animals etc (not a Dewhurst solution.

In summation - both solutions exist because there is no 1 solution fits all......
 
I would agree with Lynton and titanium would be my choice too, given your other half's age there is the possibility 10, 15 or 20 yrs time of her not being strong/well enough to undergo more open surgery. Better to do it now while she's younger rather than getting cracked open in her twilight years.
 
I have no advice to give, but would just tell you and your other half, that I have the greatest of respect for the guys (and girls) at the Royal Brompton. I don't know who your other halfs surgeon would be obviously, but I will always be eternally grateful to the surgeon there that performed heart surgery on my then 2 month old daughter, saving her life. Thank you Jonathan Mervis.

The care before, during and after that we witnessed was incredibly comforting.

Im sure she will be in good hands no matter what decision she comes to.

Best wishes.
 
My late father had it done 30 years ago after a heart attack and for the actual opp was taken to a second hospital 10 miles away. It being successfully completed and a pacemaker fitted he was returned to his original hospital to recover. Then at 2 am a fire in an oxygen store adjacent to his ground floor ward caused it to be evacuated and he assisted hospital staff in wheeling fellow bed bound patients out onto the lawns while the fire was contained. He considered that a fair advert for the procedure.
 
AshleyC said:
anyone had first hand experience of open heart surgery?

My other half has been diagnosed with a bad valve and has to go in to get it replaced within the next couple of months. We have appointments with the Consultant / Surgeon coming up and she has to decide which type to go for. You either have a titanium valve put in and its there for the rest of your life but you also have to take blood thinning pills every day for the rest of your life too. Or you go for the organic option, have a pigs valve put in which means no pills but it will wear out in 10-15 years and youre back in getting cracked open again. She's in her early 40's and to say im ******** bricks is an understatement. I'm pretty sure she's in good hands, the Royal Brompton in London seems pretty well respected and the Surgeon's profile makes him out to be the guy you really want to do it but, hell, its still open heart surgery!

Anyway, anyone been here before? How did everything go, recovery times etc? Do you think the right choice of valve was made? Like i say i'm erring on the side of metal but its not me is it and who knows how simple the procedure may be in 15 years times when todays fleshy one needs replacing.
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Will there be a possibility that she could have metal now and then choose something else in say 15 years time when synthetic might be better? My kids have both had major surgery recently and I think our health system is fantastic at doing these serious operations, hope it all goes well for your wife (and you).
Matt
 
I had a quad bypass at the start of 2000 at the tender age of 46 and I'm still here despite not looking after my grafts as well as I should. I was lucky enough to be operated on at the Royal Brompton and it's one of the best possible places you could go for heart surgery. I remember that valve patients were generally released a day earlier than us bypass victims.

If she goes for pig, try asking if you can pick the donor. ;)
 
It's gopd reading all the success stries. In our lifetime we have seen amazing drugs and surgical procedures chage thr lives of so many.

In my life I remember my amazement in 1967 shen Dr Christian Barnard performed the first heart transplant on a human being. I have met 3 people in the past 12 years who have someone else's heart! The truly amazing thing is that modern diagnostics, surgical interventions and drug treatments have reduced the ratio/ number of patients that need to go for heart transplants! I was astonished at watching my angiogram on a massive flat screen - in the near on 10 years since my first I have had 2 more (because of small heart attacks) and even that technology has changed - even down to the 'plug' used to seal the cut in the femoral artery that the cather is passed through to the heart!

I know the Royal Brompton is a great hospital but all of the are when it comes to the major intervention procedures. My surgery was done in Bristol RI and since mine was done there is now a new Cardiac centre, also linked the Univerdity of Bristol. They nos do Angioplasty 24/7, as do many others around the UK, which is reducing the death rate of those suffering Cardiac Arrests. The paramedic and emergency response teams are an incredible link in the chain of survival.... as my eldest son's father in law discovered last November! Collapsed in street, paramedic on motorbike there in less than 10 minutes helicoptered to hodpital less than 15 minutes later, stabilised and in for stents and on the recovery ward 85 minuues after the 999 call. Was home in less than 2 days. Cost benefit - cheaper than the 'old' way and back at work in 2 weeks.
 
Moadib said:
https://drmalcolmkendrick.org/2012/04/13/the-joy-of-coronary-arteries-the-body-aint-that-simple/

Generally interesting blog - a doctor who has spent his career studying this stuff.
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Interesting article. As a member of the 'cabbage patch' - my.left ventrical muscle was damaged so not something Angioplasty could help, so 'stenting' is something I have observed in others. In total I have spent neary 7 months in hospital cardiac wardsand observed people kf all ages arrive grey and barely mobile, walk out 2-3 days later afted angioplasty.. My thought would be that every day that is given to them is a day they might not have had.

Gor me a CABG was the only option.

Time is on our side compared to our forebears.

An interesting study would be the follw up on the increase in MI amongst younger women. The 'Ladette' effect of increased alcohol consumption .... My last spell in hospital had the example of a 22yo woman in the Female ward who had collapsed during a hen party who had to have a CABG. Acomment was heard tbat 'numbers were increasing'.
 
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