Aortic valve replacement

[Hammerboy]

Good morning , I’m now on the waiting list at Papworth for surgery following my latest echo and review with my cardiologist. I note from his letter to the hospital that he has recommended a valve replacement with LAA exclusion . I have Atrial fibrillation for which I’ve had two catheter ablations which have kept my episodes mild , short lived and pretty infrequent but I have been on anticoagulants since 2017 which I tolerate comfortably. I’m slightly concerned about the extra procedure on my left atrium as after looking up what it involves , it appears that it involves an extra risk and isn’t fully successful. I’d appreciate any feedback from anyone who has been in a similar situation.

[Survivor1952]

I had PCI in May last year followed by AVR with a single CABG in June, all at Papworth, no need for LAA though. Nothing but praise for the team there and the care I received during my 5 weeks in hospital (that's from diagnosis to discharge, it's a bit complicated as to the reason).

You're going to be in the hands of one of the best teams in the UK and a world leading research facility there. I consider myself to have been very lucky to have been treated there and fully believe I would not be here now but for them.

[Hammerboy in reply to Survivor1952]

That’s great to know and I’m not concerned about how I’ll be treated at Papworth as its reputation is first class . My post was about the reasons and need for LAA exclusion as it’s not been mentioned up to this point . I’m sure the surgical team will talk me through everything before they operate but I’ve been curious to know if anybody having this extra bit of surgery has any thoughts and personal experience post op .

[Etzel]

I'm due for AVR, MVR, LAA and ablation all in one hit, my surgeon told me that afib makes me more prone to a stroke and LAA shuts off a potential cause of that. Sorry if that sounds simplistic but but it's what I was told in initial discussions, like you I will talk it up in detail with the team when the day comes.

My opinion is they are the experts (i'm at Harefield) and they wouldn't be doing it just for fun.

[Hammerboy in reply to Etzel]

I’ve tried to research the LAA procedure and the reasons for it . From what I can tell as a layman it’s to reduce the risk of stroke after surgery through AF . I need to understand if being on anticoagulants is sufficient as they are doing that job now and that I’m not at more risk post surgery

[Robfromwales]

I had LAA as an ‘extra’ as I had open heart surgery for an ascending aortic aneurysm. My surgeon said it reduces stroke risk via AF by 60 per cent although I have also read ( I think on this site) that it may be higher. I remain on apixiban and more than happy as this reduces stroke risk and heart attack risk

[Hammerboy in reply to Robfromwales]

Does that mean that anticoagulants aren’t enough to reduce the stroke risk ? If I weren’t having surgery to replace my stenotic valve I would be on Edoxaban for life as I have PAF , although my two ablations have made the episodes infrequent and short lived