Hi everyone, feeling so panicked... My husband is due to go into hospital this Sunday to have open heart surgery for aortic valve replacement. He had diabetes and is a little bit in the large size. I so worried about him having the operation because of his underline health issues and the effects the operation might have in him. He is 65 years old and still walks everyday for about 30 minutes. The other issues he has is that he will be asked which valve he would prefer because they say he’s on the cusp. Can anyone through light on this.
Kind regards,
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Jewel7
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Hey Jewel7. First off, very best of luck both to you and your husband; sure he'll be in good hands. If it helps at all, I was a complete emotional wreck in the run-up to my AVR (Dec 2018) and that was without having to worry about things like coronavirus! So I feel for you.
It's only natural to be fearful and worried - there is no getting around it, it is a big operation - but if it is any help, for the surgical teams these days, AVRs are very standard, straightforward bread-and-butter procedures. Even if for us having them they are a massive deal!
I was given these by my hospital, St Thomas', which I found useful:
For me I was lucky in that I had (age 50 at the time) very few if any complications. I was in and out in a week, sore and tired, but much more "able" to do things than I had thought I would be. I had assumed I would be an invalid in bed at home for weeks, but I could go up and down stairs, dress and wash myself, make myself a plate of food (though he won't be allowed to lift anything heavy than a half-full kettle of water for the first six weeks) and essentially make a pain of myself to my family. I was also out walking quite soon, initially just around the block but gradually increasing until I was soon doing 40 minutes or more a day. I also found my heart function - and I hadn't really felt I'd had any symptoms to speak of - massively improved, even when still in hospital.
The main healing of the operation is the knitting back together of the breast bone rather than the heart, although as I say I didn't have any complications, and some people do have issues with things like atrial fibrillation. For me, the main complication, if you can call it that, was extreme tiredness for the first six weeks.
Of course, everyone is different and I was relatively fit and had few other underlying health conditions (bit of asthma) and, as I say, felt very lucky that for me it was plain sailing. Although, of course, now things are complicated by worries over coronavirus.
In terms of the valve choice, I went tissue, the Edwards Inspiris Resilia, which is a new generation of valve from the US that "should" (they say) last 20-25 years (with luck!). I had expected to have no option but to go mechanical, so I was pleasantly surprised to be given the option, as I hadn't been keen on having to take Warfarin. But a lot of people manage very well with mechanical valves and swear by them. There is no "right" choice, as there are pros and cons to each.
Basically it boils down to a choice of accepting you will need another op at some point (but as I say if he's offering the Inspiris that could be a couple of decades away) and what sort of age/health he is likely to be in at that point versus the need to take Warfarin life-long with the mechanical valve and (for some people) the ticking sound. But it will be a very personal decision. The other thing my wife advised at the time was, whichever he goes for, make it "your" choice; don't do "what ifs", whatever happens. As otherwise you'll just tear yourself up.
But I hope this helps at least a little bit and, as I say, very best of luck to him. Look after yourself too as being the helpless observer is also not easy. I'll be thinking of you both over the weekend.
The first thing to remember is they would only carry out the operation if they felt the benefits outweigh the risks. Delaying would only increase the risks and ultimately surgery may longer be an option.
I had a quadruple bypass nearly two years ago. They are used to handling diabetes - I have been Type I most of my life. The best thing he can do is relax and try and keep his BGs in range. Remember this is their day job and they are very good at it. Your husband should find the sheer professionalism quite calming.
As regards the valve my feeling would be mechanical as there are members who have had them for 40 years. Having further surgery in 10, 15 or 25 years has little appeal. Doubtless others will have an opinion on this.
Hey Jewel, sending good wishes to you and your husband. I'm 45 and had my aortic valve replaced last year. I went with the mechanical one, because tissue valves don't usually last a lifetime. I didn't want to have to have open heart surgery again, especially when I'm older. If I was 65, I'd have done exactly the same. In fact if I was 65, I'd be even less keen on getting a tissue valve that might need replacing. If a tissue valve was guaranteed to last a full 25 years, I might, as I'd feel it would probably outlive me. But since they can quite often need replacing sooner, I'd worry too much about the risk of needing more surgery in my 70s or 80s.
You have to take Warfarin every day with a mechanical valve, but I'm on other daily meds anyway so it doesn't really bother me, and your husband's probably used to taking meds for his diabetes. You have to have regular blood tests (just a fingerprick) to check the Warfarin's working, ie. to make sure that your blood clots more slowly than the average person's. Once you're stable though, you can actually do this at home, and I expect he's used to testing his blood sugar levels himself, so he'd probably cope really well with doing that.
If he's having difficulty deciding on the type of valve and they're not giving him enough info on the pros and cons of each, he could phone the BHF helpline for a chat about it with an experienced nurse, and as his carer, you could probably talk to them too.
It will make a huge difference that he walks for 30 minutes every day! He's probably fitter than me, despite his weight. That will help him recover well.
They give you fantastic painkillers afterwards in hospital and to take home.
And the most important thing is that he's got you. It made such a difference to me that my partner was there, waiting on me hand and foot and making sure I had everything I needed by way of food, drinks, meds, and emotional comfort! Be prepared for some mood swings, I was elated to be alive half the time and grumpy or scared the other half of the time, and it is taking me longer to recover emotionally than physically. Antidepressants and counselling have helped me a lot, and if your husband feels traumatised afterwards too, he needs to know it's very natural to feel that way and that there's no shame in asking for medical help with it. But he might feel ok emotionally, and that's normal too.
I think I have posted before about my AVR, I want to wish you lots of luck, believe me he will be fine he will be in safe hands. Be there for him, someone he can talk to after the op when his thoughts will be all over the place.
He will soon be on this mended heart road we are travelling on.
I had my avr 3 months ago today on Feb 14. Now feeling so much better than before my op - less tired and far less breathlessness.
Initial recovery is painful and tiredness. But every day got easier.
I was only in hospital for 5 days and by the time I was discharged the only painkiller was paracetamol.
Regarding the type of valve my surgeon left the decision to me. As a 68 year old woman I decided on a tissue valve because I do not want to take blood thinners. I know there’s a chance I may need another op in future but this could be done as a tavi not ohs. This is very much a personal choice and I agree that a BHF nurse may be able to give you more info.
Best wishes to you and your husband. I’m sure that in a few weeks you’ll both feel much better!
Hi Jewel, I just wanted to send my best wishes. I am a 62 year old male and had an aortic mechanical valve and hemiarch root done at Wythenshawe hospital on 3rd December 2019. The service I received from the moment I entered the hospital was exemplary throughout. I opted for a mechanical valve as I didn’t relish the thought of another operation in years to come. Naturally every case is different, and everyone’s recovery rate will vary. I was back home within 7 days and the only painkiller I needed was paracetamol. All I will say is within reason and with the blessing of your surgeon and GP your husband will benefit from gentle exercise once he is able. Although they have ceased for the moment due to Covid, I found the cardiac rehabilitation very helpful. In my own case, I found gentle walking and then gradually increasing the walking had major benefits. Good luck.
One of the side effects of this op is that he will probably lose weight while he is in there. If you can make diet changes to knock out the cakes/biscuits/white bread he might find that his weight loss can be maintained or improved upon.
Diabetes 2 can be stopped by a mixture of diet and exercise. Exercise becomes easier if you are not carrying so many 2 llb bags of sugar around. Every extra stone = 7 bags of sugar. His Knees will thank him as well.
A whole new world will open up and he will reduce his risk factors for corvid as well.
The first month of recovery is painful but the rewards are massive. See if you can scrounge a V shaped pillow to help with sleeping as his breast bone has a lot of knitting together to do Before my operation it got to the stage where I could barely walk 4 paces. Now I get withdrawal symptoms if I don't get at least 8000 steps in every day. All the best.
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Mechanical v Tissue valve
