Aortic valve replacement

[aussie63]

Hi there

I have been reading all the AVR posts and thought I would share mine. Like a lot of forum members I was completely unaware of my condition until a GP remarked to me that "do you know you have a heart murmur". This was in 2016 when I was diagnosed as having "moderate/severe" aortic stenosis. A year later I had some breathlessness while warming up in the gym and following a CT angiogram and a stress-echo I was now a clear "severe" diagnosis. Following a 15 month wait I finally had valve replacement surgery at the Royal Brompton on May 14. As I am (relatively) young at 55 and active I chose a biological valve rather than a mechanical valve. This was a tough decision but my surgeon sold me on the Edwards Inspiris valve and the promise of a less invasive surgery when it needs replacing - hopefully in a very long time! The open heart surgery went as well as could be expected. I still have a higher heart rate than before the surgery and a left branch bundle block which I didn't have pre-operation. Also, I now have a nice collection of new medications! Aspirin, Atorvastatin (40mg) and Bisoprolol (2.5mg). I seem to be tolerating them OK at the moment and my heart rate is down since being on the Bisprolol.

Once back in Cardiff I recovered pretty well. My wound healed without any issues and I was walking as much as the weather allowed. Sleeping was a real pain for the first 6 weeks until I could get back to sleeping on my side! I was off work for 7 weeks and am finishing up a phased return this week. This was one of the hardest aspects to gauge as I was feeling OK at home but that was without the day to day stress of work. Since I have been back in the office I notice I tend to be quite tired in the mid-afternoon. I would advise anyone to think carefully about rushing back to work - the surgery takes it out of you and you have no idea how the healing is going on "underneath".

I am in the middle of an 8 week cardiac rehab programme which has been really useful. I know other forum members haven't always been impressed but I really like the education and monitored nature of the exercises. I am really looking forward to getting back to the gym and my old routines but still anxious about how "fixed" I am. This is brand new territory for a lot us!

At the moment my only physical reminders are the impressive scar and the changing feelings in my chest as the healing goes on. I don't know if other folks on the forum still have the "tightness" in the top of the chest? This seems to come and go with me but I feel it pretty strongly at the moment. Possibly this is because I am trying to do more things with my upper body - not sure but I do wonder how long it will last.

Well that's my story and I want to thank all of you who contribute to the forum. I have learnt so much and I would love to share some of my experiences if they are useful.

Best wishes

Con

[Nic25]

Hi Con. Great to hear you're doing so well. I had my AVR (also tissue Inspiris) in December at age 50. I was in a fog of tiredness for the first six weeks which only gradually eased so I think you're doing really well to be back at work at all! I was lucky in that I mostly work from home so didn't have to factor in an exhausting commute. But it does take it out of you. I did a three-day work in March and really felt the tiredness I remember. The mental/emotional side is also a big thing, so don't try to bury it - it's normal to feel worried about how 'fixed' you are and what the future holds after this massive upheaval.

My scar has healed well - I found bio oil helped. We're off on first post-op holiday in two days so I'll need to be careful in the sun with it. I'm only on aspirin and candesartan so hopefully all manageable. I also found cardiac rehab very helpful but be careful not to overdo it.

Can't help I'm afraid with your tightness question. For me if anything my issue is the other end as I have a bit of a lump at the bottom of my scar! But it is just a cosmetic thing really. And you are still quite early days yet for lifting and what have you.

Good luck with your recovery. Hope it continues to go well for you and welcome to the zipper club!

Nic x

[Nic25 in reply to Nic25]

three-day work trip meant to say...

[aussie63 in reply to Nic25]

Thanks Nic. Your posts have really helped me - much appreciated. I totally agree with you on the mental/emotional side. people see that you are getting out and about and look like your old self but don't see the tiredness and fogginess from the surgery. Your mind also goes to places like "will I be the same person". Its all very odd and unsettling.

Thanks for tip on the bio oil. Take care in the holiday sun! My rehab nurses reckon the "tightness" is from the nerves healing after their trauma so I will hang in there on this one. It doesn't affect my mobility and is a pretty minor discomfort.

Enjoy you post-op holiday - it will be a lovely reward!

Best wishes

Con

[BicuspidBob]

Excellent write-up, Con and very helpful to me. Thank you.

I have the same AVR surgery coming up next week in London. And am having the same valve implanted – Inspiris Resilia tissue. I have a bicuspid valve with severe stenosis which needs replacing.

This is my second attempt, as my first surgery date 10 days ago was cancelled about half an hour before my op. The previous patient’s surgery had become complicated in theatre, so there wasn’t time for me that day so I was sent home with a new date. More than glad to make room for the previous patient and only hope things turned out Ok for her.

Did you have a full sternotomy? My surgeon’s an expert in mini sternotomy, so he’ll attempt a smaller cut in the sternum – about four inches or so – rather than the full cut.

I wish you good healing and great health as the days pass.

Very best to you.

[aussie63 in reply to BicuspidBob]

Thanks for the lovely comments. I also had a last minute cancellation for the same reason. My wife and I had traveled to London on the Thursday for a Friday surgery. I was admitted, had all the tests and was nervously waiting in my bed when we were told that my surgery would not take place until the following week. Cue panic as we just made the last train from London to spend the weekend in Cardiff! Strangely the false start calmed my nerves a bit as I saw other patients walking around and realising, that while it is a very big deal, folks like myself get through it. I felt just that little bit less anxious the following week.

I did have a full sternotomy - as Nic says a member of the zipper club! I have been lucky and had no issues with the wound healing and I am getting used to it now. Some days I just stare in the mirror and think "did this really happen".

Good luck with your surgery. You will be in good hands and I wish you a speedy and healthy recovery.

Best wishes

Con