Hi everyone,
It’s just been decided that I need a new valve; I’m 56 and the consultant is leaning towards a mechanical valve. Of course that means being on wharfrin, which concerns me as I don’t drink everyday, but enjoy a few when entertaining and out with friends.
There’s so much to absorb and get my head around, I’m really not yet sure how I feel about it all.
I look forward to learning from members: how to prepare for the op, recovery and getting back to life.
Hello Sax-Man
Welcome to the forum, a place you never thought you would be joining, but a place where you will get help and support.
I had Aortic valve replaced and bypass done 4 years ago, I was 68 at the time, and had a pig’s valve. Went with what my surgeon thought was right for me. Haven’t had any problems so far but my valve does have a shelf life. There are other new valves now someone will be along to talk you through those options I am sure.
Looking into the hole that is open heart surgery can be a very scary place, but believe me it’s not as bad as our imagination makes it. You are so well looked after you have no pain, and as long as you follow the instructions you are given, no arms above your head no lifting anything heavier than half a kettle of water, no pushing or pulling movements, you have to let your sternum heal 8-10 weeks. After your surgery gentle walking and carry on doing your breathing exercises that you will be given in hospital. Remember your lungs take a hit when we are on bypass they are collapsed so all the little pockets need to be filled up again.
There are lots of tips we can give you, there are lots of us that have been there and can help. Post if you have any questions. You are now a member of the Hearties family and we can lend an ear or even give you a shoulder to lean on if that’s what you need.
Best wishes Pauline
Thanks very much for your reply. Helps to hear from you. I think I need a proper conversation with my consultant to really be able to decide which way to go.
Any advice on preparing for the Op?
Anil aka Sax Man.
Hi,
You need front fastening pj tops, for while your in hospital no arms up! They gave me a rolled up towel in hospital, it’s to hold against your chest if you need to cough or sneeze, son went out and came back with a soft baby blanket, this went everywhere with me for a number of weeks after surgery, because you can’t sleep on your side I found sleeping with my arms wrapped around it pressed close to my chest really helped. I am a side sleeper and the first time I could get on my side was bliss! That blanket still lives on my bed just to remind me, my family called it Mums teddy!
A V shaped pillow is very useful, can also help sitting on the sofa😂 Don’t be surprised if you are a bit emotional after, and you can feel that your brain is a bit foggy, you will have quite a big dose of anesthetiser and it does take time for it to work it’s way out of our system, plus are brain needs to catch up with what as happened to us.
Best wishes
Pauline
Hi Sax-Man,
It is definitely a head spinner at first. I had my aortic valve replaced via open heart surgery 10 weeks ago. Having come out the other side I can say the worry about the op is far worse than the op itself. Very little pain for me to be honest, more just discomfort and weakness. Sneezes were the worst - if you press the skin between your nose and lip firmly sometimes you can make them go away. I’m now walking 3 miles easily and doing light weight (milk cartons - 😉) exercises to build up my upper body. I’m 52 and had the dilemma of warfarin as well. In the end I did some research and went for the Edwards Inspiris Resilia tissue valve. It has a special coating on it so is supposed to last for round 20 years and can have a TAVI valve inserted into it if needed in future. 🤞it will do me a job.
It’s a very personal choice as everyone is different and I hope your choice works well for you and your lifestyle.
Remember to follow all of the advice they give on what you can and can’t do after the op to give yourself the best chance of healing properly.
Take care and best of luck
Sam
Thanks. Glad to know it’s not too painful post surgery. I’m glad you’re already walking 3 miles just 10 days after surgery.
Good to hear recovery is not as bad as I might fear.
Anil. Aka Sax Man
Hi, just to be clear, the 3 mile walk is 10 weeks post surgery not 10 days 😉
Take care
Sam
Oops! Bit optimistic there wasn’t I ! Still, it’s not overly long.
Hi I had a mechanical valve fitted in 2005 at age 48 I have had absolutely no issues at all, yes I have to take warfarin nothing to it again no issues whatsoever, I ski ride my mountain bike as for drinking not a problem just try not to over do it
Hi Sax-man,
Its been nearly 18 months since my AVR. I was 49 when i had mine, spent my 50th in hospital! The best advice is talk to your surgeon, they know the current set up and can offer the best advice. My surgeon suggest a mechanical valve and because of my age I was happy with that. Pros and cons with everything obviously. However with regards to the warfarin I certainly wouldn't stress about that. You just take it every day like any other medication. They monitor you blood periodically, starts off weekly and the more you are in range it will stretch to two monthly. Some GPs let you do it remotely at home, although it really is only a 10 minute appointment and they are never late as it is a dedicated session. I do both, pop in to GP and my own to supplement the GP.
Yes, diet and alcohol are concerns, but no that much. Like you, I am not a big drinker, but will occasionally have half a bottle of wine and maybe a G&T on a Saturday night, no problems with the INR.
The mechanical valves can also make a little clicking noise as they close, but I rarely notice that now and even when I do it doesn't bother me.
With luck and a fair wind, I may never have to have another op.
I cycle with a friend at weekends and do up to 50km and like another poster, I was walking early on. Not just for my physical health, but also me mental health. That was probably the biggest hit.
With regards to the Op, preparation is the name of the game. Take ear plugs, eye mask, books, phone/pad, treats like chocolate etc (trust me you will need them, I lost 1.5 stone over 7 days).
Lastly, good luck and don't be afraid to post here. It's not a sign of weekness.
Regards
Pete
Hi, thanks for your response. It’s really heartening to hear it’s likely to be fine after surgery. I do wonder though, I’ve always struggled with cardio fitness: certainly compared to others, but now, I can see why.
Do you think you can get fitter with a properly working valve? I aspire to build up cycling speeds and getting back to trekking in the Himalayas, which I thought were spectacular, but crushingly tough!
A.
Sorry to hear your bad news - but it's not the end of the world.
Mechanical Valve is recommended because of your age - tissue valves have a much shorter life and at your age, you could reach an age where you needed a replacement in the future.
In respect of warfarin, they are looking to phase it out with other medication that requires less input from the user. When we looked at me having a mechanical valve fitted, because i was already on Rivaroxiban - it waa felt they could leave me on it and leave the warfarin out of the equation altogether. It does all seem to be down to your surgeon and your local Cardiology Clinic as to how the medication thing pans out post surgery.
In respect of the surgery, I was amazed at how 'production line' like it is. Operation, ICU until you a showing sings of stabilisation post anaesthetic and back to the recovery ward until you are fit to go home. Make sure you have a smartphone or computer tablet with you - or a good book to read. They do like you sitting in a chair as soon as you are awake, and like you to sit in it for as long as you can cope with it. They also like to get yo ustanding up and walking as soon as possible as well...
It's an interesting experience, but you soon dsicover you are not alone and there are plenty of people who have undergone such surgery, and between them, have experienced most outcomes and recovery best practices & medication options.
Good luck with it all.
Hi Brand,
Go any further info on it being phased out? I know there are other drugs, apixiban for example, but wasn't aware of them being even debated for mechanical valves yet. Would be great if they are.
well, the fact that they were happy to use Rivaroxiban for me shows that drug is already seen as an option. Forget the other one being considered - mainly because i ended upkeeping my AV and getting a new Aorta instead...
As mentioned, it seems ot be very down to the surgeon and the treating Cardiology Clinic... Interesting how they can all differ in which is best 🤔
Hey Sax-Man. I see you've already had some great advice here. First, good luck! Being in this situation is never easy and the whole run-up does your head in - the mental/emotional side was almost as big for me as the physical. But it is these days a very standard and straightforward operation, if still a big one, with normally great recovery and outcomes so sure you'll be in good hands and on the road to recovery.
In terms of practical advice for now the only one thing I'd offer is before the op practise standing up from sitting without using your arms (it's harder than you think). It'll come in handy in the first few days/weeks after the op as you initially can't/shouldn't push up on your sternum with your arms. Very happy however to try and answer any other specific questions you may have! Btw I had my AVR age 50 in Dec 2018 with a tissue valve, Edwards Inspiris Resilia, just if that helps. Look after yourself and best of luck again. Nic x
Thanks so much! That’s. Top tip snd one I’ll start to practice in the coming weeks.
I really appreciate you sharing your experience.
A. Aka Sax Man
Oh yes Sax-Man. Don't automatically assume at your age mechanical is the only option. It may be, and it may be the right decision. But I'd assumed just that before I saw my surgeon, was resigned to it even though I wasn't that keen on the Warfarin issue, so I was pleasantly surprised to be given the option and choice, even if that then meant I had to go away and make a choice!
I'm personally very happy with the Edwards Inspiris Resilia. It is a new generation tissue valve from the US that is supposed to last 20-25 years (I've even read suggestions of 30) so we'll see. Obviously by going tissue you make the decision that you accept you'll probably need another operation at some point but, for me, if I can put it off for 10-15 even, let alone 20-25, and see where all the technology is by then that'd be good. Having said that, many who have gone mechanical too swear by that and manage perfectly well. And that's an important point itself - own and accept your choice and it'll be the right one! But there are genuine pros and cons to both, so there is no right answer and ultimately it's a very personal decision. Good luck with it all again! Cheers Nic
Thanks fir your thoughts. The surgeon said over the phone that with a tissue valve, I’d be looking at surgery again in 10-15 years. I’ll discuss the inspiris one with him.
My instinct is to only have this surgery once. But I’ll take the information and weigh it up.
Cheers, A
Good call. Yes there does seem to be some confusion out there. I'm obviously not a surgeon but my understanding is, yes, conventional tissue valves last 10-15 years but this one last 20-25? It is coated in a special anti-calcificant that means it calcifies more slowly. Definitely one to speak to your surgeon about! But good luck whichever way you go. Nic x
Hi sax man. On now 9 week post op via ohs and am same age as you. Opted for a Resillia biological valve so no warfarin are clicking noise. My op was cancelled twice at the very last minute ( gowned up and waiting to be wheeled down!) third time lucky.
Am now back running (20mins) and light weights routine 4 times a week with long dog walks thrown in. Can’t say i did anything specific to prepare for op, just trusted my surgeon and the team at Wythenshaw.
Good luck with yours, you’ll be fine and feeling much better.
That's magnificent progress - so encouraging - thanks very much!
Hi Sax-Man
You have already been given such good advice on here from the top team❤️
They helped me from the very start when I found this amazing forum and cried out for help.
I’m now 6 weeks post AVR OHS and had a tissue valve. I was totally shocked at my diagnosis as I thought I was quite a fit healthy 67 yrs old.
The wait for surgery is the worst time. Everyone seems to agree on that. Lockdown didn’t help but hopefully that will end soon. Keep yourself safe and healthy though. Do not take any chances. There is still a pandemic 😷
So that I don’t fill your feed with a list of to do’s, I suggest you read my posts back to the beginning of my journey. The advice I was given then by these amazing, supportive and caring people was spot on and helped me so much. I am recovering well and have just started walking over 2miles weather permitting. Going slowly I will try for a 3 mile walk this week.
I hope it helps you too.
The consultant will give the best advice for your valve replacement. They are the experts and only have your future wellbeing in mind. It may not be what you had in mind but one thing is for sure, wouldn’t want to go through this again if given the choice.
Best of luck and please let us know how things are going. We genuinely want to know and feel for you all the way.
Welcome to the Hearties ❤️ Club
❤️Maisie ❤️
Thanks ever so much maisie - really appreciate your reply: I already feel much less alone on this journey. I'll be sure to lookup your previous posts.
Can't thank you all enough,
S-M (aka Anil!)
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