Hello folks, is there anyone who s had aov replacement procedure who can give me a run down of what to expect?I'm a 57 yr old male, v fit and active, diagnosed with bicuspid defect which is now serious. I ve v few symptoms,.
Any advice on what valve choice should be? What prospects are for each? Things to watch for during the process...any unseen or undisclosed side effects , what the recovery entails? Many thanks
Dear Nugen
Bicuspid isn’t likely to be a problem, but it can speed up stenosis. It means your aortic valve has two propellers rather than three. I lived active life for 70 years without even knowing my valve was bicuspid.
If your problem is stenosis, which is medic speak for blocked valve or artery, you will likely have symptoms of being tired and dazed. In the meantime your cardiac consultant will monitor your progress by having scans taken periodically. Often just annually. You will be classified as mild then moderate then severe. At that stage you will be booked for the replacement valve. I went for five years of mild then one year of moderate before getting severe. My main symptom was excessive exhaustion and stumbling forward when exercising.
When you get nearer the need for a new valve then you can consider whether a synthetic or metal valve will suit you better. I went for synthetic but I was 72 so the lifespan of the valve should see me through my lifetime. Since being fitted, my valve is brilliant. I don’t know it’s there. I get an annual outpatient check up (scans).
The op went very well. My surgeon said he had a success rate better than 99%. By far the worst bit was waiting for the op.
The recovery is long. For me about 12 weeks. And you really are required to be in rehab at home for months.
My biggest recommendation is to not ask Dr Google. And that especially includes Facebook. Stick to the BHF or NHS sites.
Best wishes
Sooty
Thanks for the info much appreciated. What was the procedure like?
The procedure is two scans and a lung function. I had these three as an inpatient but majority have them as outpatients. Then admission to the cardiac ward, which is fabulous. Single rooms. Staff wonderful. Nurse ensures you have a proper shower then off to the theatre. I walked in to theatre, which surprised me. Anaesthetic for half a minute then I woke up two days later. A day in ICU then a day in HDU then a week in my lovely single room. Ambulance home. You can not do the rehab alone, you must have someone to care for you at home or you must go in a respite home. You can not lie down for a few weeks. And no lifting etc.
I had the more common OHS. There are also TAVi and less invasive options, but OHS is most likely. It really helps if the patient is fit and not overweight.
I didn’t know anything about the procedure. The anaesthetic is huge. I found HDU quite horrid because I was half awake and half zonked out. You get a big scar down your chest but I didn’t notice that for a few days. You are encouraged to get moving a little ASAP. It helped a lot that I was fit before hand. Unusually my op was observed by a small group of students. They couldn’t wait to tell me about the op, but I politely said I don’t want the gory details.the students were not youngsters.
The op takes several hours. But you won’t know anything.
Sooty
Thanks for the info, sounds like you had a reasonable experience there. How is it all progressing now? Back to normality?
yes the op went really well and by week 13 I felt wonderful and strong. I can hardly find the scar. I use the phrase “I got given my life back”. I have fond memories of the lovely staff in the hospital. It was covid time so strictly no visitors, which in fact was a boon.
A lot later I did have a bit of a problem with my shoulder and neck, but physio has sorted that. I couldn’t get any cardiac rehab, again due to covid, so maybe they would have helped me with my shoulder. The hospital rang me weekly to monitor progress. My GP came to my home Eg to remove the stitches.
Sooty
Hi I had a mechanical aortic valve back in 2005 ,at age 48 it’s been fantastic. I do have to take warfarin which presents no problem whatsoever, don’t listen to the fairy tales about taking it.
Hospital visits for INR testing can be cut down to twice a year by buying your own tester you give the results by phone to the hospital and they will dose you. As for lifestyle after you’ve recovered to give you some idea I go skiing and mountain biking.
I'm also bicuspid and just had the pre-op tests for my provisional date of 1st Feb so can't comment yet on the actual op. What I was told is that at 61 and being relatively fit (gym until Feb this year) they would expect my recovery to be in the 6 weeks area (but of course could take longer). Again my surgeon recommended metal valve based on my age/activity level and whilst I don't fancy the warfarin I fancy even less the thought of a 2nd potential op in my 70's!
I am bicuspid aswell but my consultant is very happy with me so I won't need the valve replaced for another 15 to 20 years. I will continue to have scans every year to make sure nothing has changed in the mean time. Hope your operation goes well x
Thanks mate, I ve had weird stuff going on since I was ten! Only now it's become a problem. Love long and prosper.
can I throw another Penny worth
Doctors aim to have five years of experience regarding anything new. In the five years, the production of valves advances a lot. So I belive the shelf life of a synthetic valve is longer. And a major improvement to the valves is they will now take a TAVi if needed.
Sooty
TAVi being thf method by which they implant?
TAVi is an operation whereby the get at your heart via blood vessels rather than opening up your breastplate. Thus, if you have a failing synthetic valve they can get a further valve tacked on.
TAVi is an option to avoid the big op., ideal if you have other impediments. But not always successful. So you might start with a failed TAVi and they then have to do the full OHS.
I was privileged to have an OHS surgeon and a TAVi surgeon to advise me beforehand. I guessed at OHS and have not regretted it.
Sooty
Understood thankyou for your relaying your experience..very valuable. Can I ask where you were treated? I've been referred to our regional centre at Liverpool who I believe are pretty decent from what I know.
I was due to go to Basildon (Essex). However it closed due to covid. I ended up in the fabulous Cromwell hospital, west central London. Most Cardiac wards are well above the standards on other wards. It’s another (delightful) aspect of heart surgery. My initial contact was Colchester and the cardiac stuff there is good. My cardiologist was Colchester and she really went the extra mile. As soon as I became seriously ill everything moved fast. Very fast. Up till then slow results meant no problem.
Sooty
Hi, I would suggest for you to be open-minded and consider the modern valve options carefully. Valve technology and Surgical procedures has advanced significantly in recent years, so the straightforward option of either (a) Tissue or (b) Mechanical are no longer the only options available. I'm 3x OHS with multiple valves replaced going back to the early 1990's with the most recent 10 years ago, so the boat has long past sailed for me, unless it's decided to pull the trigger on a fourth surgery.
My first AV was a a bog standard Tissue that lasted nigh on 19 years, whereas I now have Mechanical Aortic and Mitral Valves. Both were my choices, and the right one's in the circumstances at the time. Having had both, I've seen first-hand the pros and cons of each type, and to be honest, I've found the Mechanical require more maintenance as I call it. That said, I've been unfortunate to have one of the lesser known side-effects of acquiring Haemolytic Anaemia where the valves destroy my red-blood cells too early in their life which has had a knock-on effect.
Try and give yourself as normal a life as possible without relying on medical intervention or attention as time goes by.
Good luck.
I had a TAVI in mid-July and made a very good recovery, only to start feeling tired early in September. Tests showed noticeable dips in my various blood counts compared with January 2023 and I'm now anaemic (though I've been close for at least ten years). Haemolytic anaemia was one possible self-diagnosis I came up with. My surgeon said my heart was fine and referred me to a gastroenterologist at a private hospital, whom I saw last Tuesday. I'm awaiting the result of another blood test, mainly to assess my iron levels.
HiYour surgeon will probably guide you as to which valve would be the best for you.
I went for mechanical because I really don't want to have to stay in hospital again if I can help it. The ON-X should hopefully not need replacing.
Everyone's experience will be different. I know that some here were lucky enough to be able to go private and therefore their experience may be a lot different to others.
If you are on Facebook then maybe consider joining UK Aortic and Heart Defects Pre and Post surgery group. Everyone is going through the same thing and can offer support and reassurance.
Joanne
😊
Thankyou Joanne , very reassuring, appreciate your comments. Took the liberty of viewing your profile and You seem to have overcome some pretty big problems , that's a hell of an achievement. Your condition sounds very similar to mine . Richard
Yes, very similar Richard, right up to 2 weeks before surgery I was asking my medical team if they were sure that they hadn't made a mistake with my diagnosis. I was oblivious to my heart defect until I was 52, I thought my breathlessness was just that I was unfit even then or asthma at worst.I'm still really anxious every time I'm contacted my the hospital, next visit is 29th December following an Echocardiogram in November. I had great care from my medical team though they are keeping a close eye on me post surgery and I know that not everyone has been lucky enough to have had this
Joanne
hi, I was diagnosed and operated on within 3.5 months aft yrs of my symptoms being blamed on my diabetes, weight, hormones anxiety, NO I had severe aortic stenosis !
Op was 3 was ago, went well but as I also have rhthym issues had a few blips, a night in a corridor at AE, but med tweaks have settled that touch wood
there is pain and discomfort not to be denied but these are controllable, also have a cough from the tubes etc put down throat, and visual disturbances migraine headaches caused by the bypass process but this also lessening now
The tiredness cannot be put into words it is so strong and strange but its bodies way of making you take things slowly
as I'm only 3 wks In all this will improve and I will be a new woman
Good luck
Im 67 yo male and had an aortic valve (due to severe stenosis) and a dual bypass almost 3 weeks ago. I chose animal tissue valve as did not want to be on Warfarin for the rest of my life. Plus some say it’s quieter (it’s silent) compared to artificial valves. Pre admin tests are Echo cardiogramme, Angiogramme, Carotid artery scan and Lung capacity test. Operation took 130 minutes and was full sternotomy. That mean rib cage separation. By day 5 after op, I could get out of bed without great pain. After seven days in hospital, now back home recovering well. Still on paracaetemol, for sternum and leg ache (when they take the vein for the bypass) by breathing is better and can walk for 35 mins without getting breathless. Excercise gets easier every day and is why you need to stay on painkillers. I was not looking forward to a scar in the middle of my chest, but it’s only 6” long and already a mere shadow compare to after the op. . I think after 6 months it will be near invisible and will continue to improve. I’m still bringing up phlegm from the op but think that’s part of the healing process. Make sure you feel comfortable and confident with your surgeon and check that he will be there afterwards if you have issues. That’s the best advice I would have given myself.
Thankyou for message, it's v reassuring to hear . I'm very pleased for you, great news. Have a great Xmas. richard
Approximately 6 weeks
Aortic valve replacement 
Aortic valve replacement 
Aortic Valve Replacement
bicuspid aortic valve replacement 
