aortic valve replacement

[Beattyann]

My husband, 64, diagnosed with critical aortic stenosis underwent valve (tissue) replacement this January 15. A TEE revealed two leaks (mild to moderate) 8 days after surgery. The cardiologist has heard of only one case in which the valve stopped leaking. Does anyone have any knowledge regarding the above? Thank you.

[Nancy]

First of all, welcome to the site. It's a great place for support and information. You will love it here, you have many friends already.

My husband is the patient and has had 3 heart valve surgeries. He has 2 mechanical valves, an aortic and a mitral. His aortic valve is 25 years old and he had a mitral valve replaced in 1999. It did develop a leak which sometimes happens, and this was repaired in July of 2001.

It's my understanding that there are sometimes leaks that happen right after surgery, in the mild range, and these heal up in short order when the scar tissue starts to form. My husband's leak showed up later on.

When was the TEE done? If it was right after surgery, then the above might apply. If not have they suggested taking another look at the valve? Does he have any symptoms right now?

[RobThatsMe]

Hi Beatyann,

Glad you found my post on WebMD and came to the site. Welcome. I hope that you find some answers to your questions from the wonderful folks on this site.

Visit often, and again... Welcome,

rob

[RobThatsMe]

Hi Everyone,

I'm trying to keep this thread going for input.

Just wanted to try to help a friend here. Have any of you tissue valve folks had any problems like the one Beatyann has mentioned about her husband?

Nancy, thanks for helping with your exeriences. Guess I was wondering if there are some other possible causes.

I always thought that this type of problem should not be occuring with a new tissue valves.

Thanks,
Rob

[Beattyann]

Nancy, Rob:

Thank you so very much for your reply. The TEE was done 10 days after the original surgery and the cardiologist stated the same thing you did, that since it is so soon after surgery (1/15/02) - it could still heal. However, a recent echo showed that it was leaking "mild to moderate," in two places and she hated to tell us, but he would be looking at having the surgery over again within two years, if not sooner. Of course, we were very upset.

He still tires very easily and is short of breath after any exertion.

Unfortunately, he developed severe pain in his lower left back and into his hip about 2 weeks ago and has not been able to start cardiac rehap and even walk like he was doing.

I am afraid he is getting depressed and frustrated.

I am thankful I found this site - it truly helps to know others have been here and understand. Thank you again.

[RobThatsMe]

Hi Beattyann,

Please tell him that he can talk about it with us here. If he justs wants to vent or ask some questions from others that may have had the same experience, he is very welcome to.

I hope that maybe the valve will heal somemore and that his health will improve. I can understand the frustration you both must feel. You would think that after surgery, the problems would go away, not magnify. Is there any possibility of a surgical error? Seems there must be some recourse that you can take for this.

Please keep us posted,

Rob

[Beattyann]

Hi Rob,

Unfortunately, my husband (Dick) is not one to share his feelings and that is why it is me who is writing. I know if he could, it would help.

My first thought was "surgical error" since from what I understand it is very rare for a tissue replacement to leak. But, our concern is "what now?" Our cardiologist knows of only one case in which the valve stopped leaking. Of course, miracles happen and I believe in them. That is why I was wondering if anyone out there had this experience and the outcome.

I have not been able to gather any data on outcomes wherein the tissue replacement valve leaked. Will keep checking. Glad you are all there.

[Nancy]

Hi Beattyann-

I think this surgery is pretty well technically perfected. Unfortunately, our bodies sometimes don't cooperate. Healing could have been imperfect, so many things can happen when you implant a foreign part, even a tissue valve, into living tissue.

My husband was very breathless and tired when his valve started leaking. In his case I think his leak was caused by one of several faints he had because of Afib. He fell like a rock, and partially dislocated his jaw one time. Two other faints were just as hard. It was after these that the leak developed. He also had CHF which became more and more difficult to control. His TEE also showed that the leak was in the mild to moderate range, however, his symptoms were quite severe. The decision was finally made to do a replacement, but fortunately the surgeon was able to repair it. It was a very, very small leak, only took two stitches to close. Heartwise he feels much better now.

He also has a pacemaker which controls the Afib now.

Sometimes they can control symptoms with medication and put off another surgery for a while, and sometimes it has to be surgically corrected.

I'm sure your cardiologist will follow him closely. I wish him the best. Take care.

[Jack]

Hi Beatyann,

Ask your surgeon if the leak can be fixed by using the Port-Access minimally invasive techniques and not a full conventional open-chest surgery. This may help reduce the trauma and recovery time for husband.

Keep us posted and take care,

Jack.

[Nancy]

Good suggestion Jack. That's exactly how they did Joe's repair. Port access was a "good thing". :)

[Mb]

If I could add a comment.......my husband also had back pain/leg pain, post op.

We both think it was from the long period of bed rest post surgery, and
then spending so much time in a new recliner. (He loves the recliner,
uses it all of the time)]

He decided to get to rehab anyway, and do what he could. He was amazed
how much muscle tone he had lost all over (and he is NOT built like Rob)
not an excercise prone person....never had to be as he is a General
Contractor and his work always gave him enough of a work-out.

So, nudge your busband a bit to get up and move about. It REALLY helped my
husband, even though he could not tolerate the cardiac rehab, due to
a high heart rate. They had him on very very low program. But, it really
did help with muscles etc. and his back and leg only bother him occasionally
now.

Best wishes......I hope he doesn;'t have to have the surgery again soon,
and that the leak repairs itself. We will include him in our prayers.

Marybeth

[martha]

Hi Beattyann,

Sorry to hear of the problem. Had a AVR on 12-15-2000 choose a homograph.Many months after surgery, had an appointment with the cardio. He noticed a mild leak in the tricuspid, that was not there before. I see him every 6 months, to keep an eye on it. Was told that if it got worse, they would go in from the side, and put a ring around it. No change has been noticed, thank goodness. The reason for this is unknown. Know several who have homograph's with no problem. martha

[Beattyann]

Nancy, Jack, Martha and MaryBeth,

Thank you all for taking the time to respond. Any and all information is of help.

Mary Beth - I too feel perhaps the recliner is contributing to Dick's leg and back pain. Today it is worse than ever although he is taking a muscle relaxant and vicodin. We see his family dr tomorrow.

The cardiologist has said that we will monitor the leaks and proceed from there. It is still our hope it will stop leaking.

Will keep you all posted and wish you all peace and well-being.

Bea

[deborahj]

I sincerely hope that your husband's leak resolves itself, if not ,that the repair will be minimally invasive.I wish you both the best of luck.....