What questions should we ask when my mom goes to talk the surgeon about getting a heart valve replacement?

Question

If this is too much to read skip to the bottom my question is there. But the following story gives some background.

Okay 4 years ago my mom went to the cardiologist to find out why she has a heart murmor. They did and ECG and discovered she had a "bi cuspid aeortic valve". We were told its not a big deal that she would just have to take an antibiotic before going to the dentist and really didnt have any other effect on her life.
Now 2 months ago she had the flu. After she recovered from that she realized how much weaker, and easily out of breath she was getting. She also started feeling her heart "go flip flop". I told her to go to the doctor because of her heart.
They did and EKG and imediately sent her to the cardiologist for and ECG. He told her that her valve was "thickened" and needed replaceing soon. So she now has an appt with a cardiovasculer surgeon in 2 weeks.

My question is : What things she we ask or make sure we are aware of before the surgery?

Answer 1

I had my mitral valve replaced in April 2003. I was 37 at the time. I am talking from personal experience. I will share some personal experience and some questions to ask. It is rather long, but I think it will help you and your mother.

1. Make sure to ask if the valve can be repaired or does it have to be replaced. Some valves can be repaired and not replaced. The cardiovascular surgeon will probably check during surgery to see if it can be repaired before they replace it. That is what they did with me, but in the end I had to have it replaced.

2. Depending upon how old your mother is, this is a very important thing to ask and think about. Some doctors suggest pig valves. Pig valves only last for about 15 years, so if she is young, she should consider a mechanical valve, they last 60-70 years. Go with the kind of valve that lasts the longest time period (trust me, she does not want to go through this surgery but once if at all possible, not trying to scare you or her). I had a St. Jude Mechanical Valve and it is also MRI compatible so she can have MRI's in the future if need be, etc.

3. Be prepared for EXTREME soreness in the chest. They actually cut open the sternum (break the chest bone). The surgeon will discuss this in more detail with you and her.

4. More than likely she will have to be on Coumadin for the rest of her life if she gets a mechanical valve. This is a blood thinner and keeps things from sticking to the valve. She will have to have monthly visits with her cardiologist every month for the rest of her life so they can check her Coumadin level and keep it where it should be. This is very imporant. Talk with the doctor about Coumadin.

5. Ask the surgeon to explain step by step (and most do without you even having to ask) what will be done during the procedure. I won't go into detail about that.

6. Ask about post-op. (I am sure the surgeon will discuss this in detail also). From my personal experience, I was in intensive care after the surgery for 24 hours. They wean you off the ventilator as quickly as possible. She will not remember any of this time because she will be heavily sedated, so don't let that scare you. Also she will have many IV's and tubes when you see her in intensive care, again, don't let this scare you, it is normal. After 24 hours they will "bring her around" a little more and move her to a regular room. She will have a heart monitor and a temporary pacemaker and it will be painful for her to lie flat down. She will still have some IV's but not as many as she had in intensive care. She will be more alert once she is moved from intensive care. I had to sleep in a recliner for about 2 months as your sternum is broken and if you lay flat down someone has to help you get up, etc. She will be uncomfortable for a while, but pain medication does help. I really did not have pain, it is just a soreness that is so sore you can't describe that makes it hurt. They will begin making her walk with a pillow that she will hold across her chest. That pillow will be her buddy. If she has to cough or sneeze she will hold that pillow over her chest with both arms to help ease the pain when she coughs or sneezes and also to help with stitches not coming out. Again, they will make her walk so clots will not form in her legs. She will have tight stockings on each leg that she will have to wear for a while after the surgery.

7. Ask about recovery time. I could not drive for 12 weeks. This gives your sternum bone time to heal. She will not be able to sweep, vacuum, or do many other things doing her recovery time. The doctor let me return to work 3 months after my surgery. The doctor will encourage much walking and other gentle exercises to strengthen her heart and strengthen her body.

8. I can tell you this, it was a tough recovery time, but it was tolerable. The result for me is that I feel better than I have in a long time. It took me approximately 6-12 months to totally feel good and back to normal. But I do get tired easily sometimes still to this day. There are good days and bad days.

9. Please tell her this one important thing. When I went in for my surgery I was not scared at all. When the surgery was over and I started to know what was going on (getting over the heavy sedation) around me, that is when I became very scared. I think that is when it hit me. Also if she gets a mechanical valve she will hear a ticking noise in her chest, that is the valve. That was the hardest thing to get use to. Now, I barely notice it all. After the surgery I would get very emotional because I would feel that I would never feel better again, but it does get better. Trust me, it does. I was also told by my cardiologist and surgeon that it is normal for open heart patients to become emotional after surgery. I was very emotional and cried at nothing. It is a combination of just being scared that something will happen. It does get better and that feeling does go away. It is something you just can't describe unless you go through it. However, it may not affect her in this way at all. Everyone goes through things differently!!

10. Ask the surgeon about success rates, how many he/she has performed, etc.

11. The surgeon will ask what medications your mother is on currently and tell her what to take or what not to take before surgery. They may also want to do a catherization before the surgery to ensure there are no blocks (they did this with me). After the surgery the surgeon and her cardiologist will decide what medications she will take etc.

12. I hope the above helps and all goes well for your mother.

Answer 2

I needed to make a identical option. Mine used to be did I desire a 3rd stent and threat having an extra stent in a couple of years, or did I desire a pass that might final a couple of years. I selected the pass. Then I needed to make a decision if I desired a consistent pass or the brand new much less evasive pass. I selected the fewer evasive. Turned out I used to be the primary girl on this the city to have a double process. I had a stent installed one of the most much less clogged arteries and the following day went in for the pass. I used to be best sixty one on the time. At sixty five and no longer having every other well being disorders, you'll anticipate to are living for a while. My mom used to be 88, and I've recognized humans to are living into their 100s. So even as this can be a complex determination to make, I might in general move with the only with the longest existence time and wish for the great. I would not love to must face the operation once more. This pass is ample middle surgical procedure for me, I do not desire to any extent further. Of path I did have an extra competencies, might be you do additionally. I had a blessing earlier than surgical procedure. I credit score it for treatment so rapidly. My healthcare professional published me to force myself three wks earlier than he almost always might, and the final time I noticed him, he instructed me I recovered over a month quicker than his different sufferers. I do not know wherein I might be had I no longer had the blessing.

Answer 3

There are four heart valves and they all behave differently, are subject to differing ailments and can be treated differently. The two most common heart valves which cause problems in adults are the aortic and mitral.

The aortic valve is subject to high pressures and has a relatively limited size. When this valve fails the only real option is to replace it. But this may be done with either a mechanical or tissue replacement valve. More on the difference between the two in just a minute.

The mitral valve is subject to lower pressure and has a relatively larger diameter. This equates to there being more options. A failed mitral valve can be dealt with in a number of ways. If the valve has a specific, one spot lesion it may be possible to repair the valve. This is commonly a focal redundancy of the tissue of the valve that can be trimmed back or stitched. Alternatively, some times the valve is just fine, but the outer diameter is being stretched apart causing the leaflets not to come together and creating a gap. In this case reinforcing the outer ring of the valve can help bring everything baclk together. Lastly, sometimes the valve is just eaten away from infection or age related degeneration and it has to be replaced. Again it can be replaced with a wide variety of tissue or mechanical valves.

Tissue valves have more natural flow but wear down over time (ten to fifteen years). Mechanical valves have more disrupted flow but last a long, long time. If you choose a tissue valve you should expect needing another operation in about 13 yrs to replace it. If you choose a mechanical valve you should expect to stay on blood thinners every day of the rest of your life. A second operation when your a decade older is risky as it can be difficult to recover from this operation. Being on blood thinners puts you at risk of bleeding complications. And if you stop taking the blood thinners you'll be at risk of stroke and blood clots. The choice as to which kind of valve to have installed is what most of the conversation with the surgeon should be about.

Questions to ask, ...
Can the valve be repaired?
or does it have to be replaced?
What kind of valve does he/she reccomend?
How many of these replacements or repairs have they done?
What is their personal success rate with repair?
Does your mom also need bypass?
Would your mom benefit from having a pacemaker or defibrillator placed?

God bless.

Answer 4

Ask about a typical post op period, ICU length, chest tubes, ventilator, pacemaker {usually temporary}, activity. any pre-op education needed to prepare for the surgery. Any current medication, what to continue to take, and what needs to stop prior to surgery. This includes over the counter meds as well as herbal meds!
Ask about procedures needed to prep for surgery.
Ask about cardiac rehab after surgery. It is a good program, which teaches life changes to promote a healthy recovery.
If I remember anything else I will edit it in. Good luck

Answer 5

Regarding your questions, there are multiple questions to be asked, this link will help you:

http://www.sjm.com/procedures/procedure.aspx?name=Heart+Valve+Replacement§ion=ExpectBefore

Answer 6

Ask your physician about less invasive techniques such as endoscopical surgery.