TIA after Heart Valve Replacement

[Beanlover]

My husband had an aortic valve replacement by open heart surgery 2 wks ago, at the age of 79. They diagnosed atrial fibrillation before his discharge and prescribed blood thinners. He has been very tired since discharge, but has been unable to take his RA medication for two wks post op. Yesterday he had what we thought initially was a stroke, but only lasted 10 mins, and then went away.. Ambulance came and took us to A&E and after 5 hrs sitting in a wheelchair decided he had had a TIA., they spoke to neurology, and got advice, and said they would probably want to see him, and gave him statins, to take along with his thinners.Does anyone have any experience of this happening. It was pretty scary, and reading that it can be a warning before a full stroke means we almost daren't take our eyes off him. He is due to see GP in 5 days. He did have a long chat with cardio rehab team before it happened. We have no idea how long it will take for neurology to see him.

Just wondered if anyone else has experienced this, and any advice.

[K1955]

I’ve had heart failure since 2012. In 2020 I had a tia and was taken to a&e where they arranged for me to have a scan on my neck in a week's time. The day before the scan I had a second tia and ended up being admitted to hospital. An artery in my neck was found to be partially blocked and I ended up having a carotid endarterectomy which is removal of fatty plaque from the artery. Apparently this can be a common cause of a tia and can be treated without the need for surgery depending on how bad the blockage is. I've had no issues since and was able to carry on as usual.

It helps if going forward your husband has a healthy and balanced diet, stops drinking alcohol and smoking, and does any regular exercise that he's able to.

I hope this helps, please ask if you have any questions.

[Beanlover in reply to K1955]

Thank you for your reply. My husband doesn't smoke, hasn't drunk alcohol since the op. He is struggling a bit moving around because of his Rheumatoid Arthritis, and the Open Heart Surgery. He just feels very tired all the time, but that will hopefully improve.I think our issue will be how long he has to wait for a neurology appt to do all the tests on the neck. I've suggested he ring the cardiac rehab team to see if they can find out more, and the GP on Friday who is very good.

He did have an angiogram before the surgery where they said all his arteries were clear. His only problem was the leaky aortic valve, which has now been replaced. We assumed the TIA might relate to the Atrial Fibrillation which started following his surgery.

Thank you for the information.

[K1955 in reply to Beanlover]

It is a worrying time for family, mine were watching me like a hawk at the time. It will be good to talk through his concerns with the GP.

[Beanlover in reply to K1955]

Indeed. My daughter who was staying was the first to notice something was wrong. She lives some distance away and my other daughter is an hour away. They were both very upset.Fortunately we have a retired district nurse living next door who came round and did some checks before the ambulance arrived.

We have very good GPs and the one he is seeing Friday knows him well.

I feel now I know better what to look for.,He had had some double vision the night before but didn't think it was anything important. We now know it probably was.I am glad you are now well. I know we have some way to go because of the surgery, but hoping he can concentrate on recuperation soon.

[Beanlover in reply to K1955]

Thank you for all your helpful and supportive comments.A neurologist rang this morning and spoke to my husband for about half an hour. He has reviewed his records and tests etc. Says A& E did exactly the right thing, he is on the right medication, and as his pre op angiogram showed his other arteries were clear, he is happy that they don't need to see him at this point. Husband reassured, and hopefully can concentrate on recuperation from heart surgery. We will of course still be keeping a close eye on him.

[K1955 in reply to Beanlover]

I'm glad your husband is reassured after speaking to the neurologist. It's hard enough coming to terms with a heart operation without throwing a tia into the mix. I wish him well in his recovery.

[Beanlover in reply to K1955]

Thanks for your good wishes.

[DodgyTickerMum]

Hi, I’m so sorry your poor Husband has been through all this and has now gone into A.F and had a T.I.A as well. I too went into A.F post valve replacement but fortunately mine was short lived and had corrected itself by the time I was discharged from hospital 2 weeks later. As I had a mechanical valve fitted, I will now be taking Warfarin for life - but it is very unsettling to hear that despite your Husband being on an anti-coagulant medication - a T.I.A still occurred.

Did the hospital not perform a Carotid Doppler scan prior to his surgery? I had that, a lung function test and an angiogram before my op - as the surgeon said they didn’t want any ‘surprises’ once in theatre.

I’m not sure of your financial circumstances but if you are able, you could obtain a private referral for a Carotid scan. (I required a second one since my surgery - due to my neck pulsating, which ruled out an aneurysm). Alternatively, if he has the contact info of his Cardiac Rehab Nurse - they can also arrange scans - if they’re not happy with your progress. Mine was able to organise an Echo for me, when my recovery wasn’t going so well.

I hope you manage to get this resolved swiftly. Your Husband has been through such a lot already - he really doesn’t need this as well. Bless Him. ❤️‍🩹

[Beanlover in reply to DodgyTickerMum]

Thankyou for your reply. He did have an angiogram before surgery which said other arteries were fine.. not sure about lung function, certainly don't think he had a carotoid doppler. He had a biological based valve, The AF started when he was in hospital. He was discharged after 6 days. He did realise he had forgotten to take his anti coagulant the previous day, before the TIA, but it seems unclear as to whether that could have such a fast effect. He will be talking to the cardiac rehab team today hopefully. He is just so tired at present that everything seems an effort. Thanks for your good wishes.

[Wingnutty in reply to Beanlover]

You will never know whether forgetting to take his anti-coagulant contributed to his TIA, but what you want to make sure of is that he doesn't forget again. I have a mechanical aortic valve and I am on warfarin and I have forgotten a few times in the past to take my meds. I usually take them at 7:00pm and I have now set an alarm on my watch to go off at 7:05PM to remind me to take them and it probably reminds me at least once a week that I haven't taken them. Every time this happens, I always say thank you for saving my life to my watch. As belt and braces, I also set a daily reminder for 7:00pm on my google calendar which I tend to look at a couple of times per day, so if I missed the watch reminder, I have a backup reminder. If he doesn't have a watch with an alarm, then it is worth thinking about getting one.

[Beanlover in reply to Wingnutty]

Thanks for that. I now have an alarm on my phone for 6pm which was when they suggest he takes it. . It's easy to remember the morning ones, but 6 for the thinners and 10 for the statin are inbetween times. He doesn't have a watch but his mobile has an alarm and I have it aswell .

[Cliff_G]

I can assure you, being tired after an AV replacement by OHS is entirely normal. AV replacement is also one of the things which usually qualify someone for a cardiac rehab class. The RA and TIA may modify that, as well as age on top of it all, but it's worth considering and asking about. I found cardiac rehab class was excellent after my big dissection and AV operation. At age 65, I took 5 months to do the 8 week class 😂 and the youngsters (30s) very obviously managed a lot better, but we had several folk much older than me.

[PadThaiNoodles]

I had a TIA in my retina about 2 weeks post-op (mitral valve repair and aortic valve replacement). I went to A&E and was kept in for 6 days while they did head CTs, a head MRI, two different eye scans, blood tests, etc. In the end they decided it was just one of those things and added aspirin to go along with my warfarin. I haven't had any repeat issues (it's been about 4 months now).

(They did start me on a statin in the A&E, but after reviewing all my pre-op records decided it wasn't a plaque rupture and took me back off the statin.)

(FWIW, I'd be fairly certain your husband had a carotid scan before OHS. I was told they do it to see if they need to set the pressure on the cardio-pulmonary bypass machine a bit higher.)

[Beanlover in reply to PadThaiNoodles]

Interesting. Would the carotid scan be done as a separate procedure that he would be aware of, could it be done once he was under for the op.The blood thinners were prescribed because he had developed atrial fibrillation I am making the assumption that the angiogram which shows his other arteries were clear would affect what kind of tests they needed to do, or medication. He had a head CT scan, and blood tests in A&E which showed nothing. All they have done really is added the statin. I think they have decided it was just one of those things for him. I'm glad you have had no further problems. How long did it take before you or your family were able to relax and not worry about it happen again. My daughters feel very anxious I know. I am trying not to keep looking at him, or asking him if he's ok.

[PadThaiNoodles in reply to Beanlover]

Not sure on the carotid scan. Mine was done the night before my surgery (along with a chest X-Ray). It was a quick 5 minute procedure with an ultrasound machine.

By the time I got home I was so happy to be out of hospital that I don't really remember worrying about a repeat incident. (One of my chest drain wounds had also come unstuck, so I was more worried about that. That ended up taking another 4 weeks to heal.)