Briana's Guestbook

Briana Morgan  I researched this about two years in advance to needing my surgery. At the time I didn't realize I would need it so soon, but I'm glad I did the research when I did. There is a lot of research out there which shows that there is a greater risk for reoperation with the Ross procedure. I think that is where you have to really research what surgeon you want to go with and find out what his/her statistics look like. Having a physician that does this procedure all the time makes a lot of difference on how your outcome may be. The Ross is a very specialized procedure. There is risk of the aortic valve enlarging and becoming leaky if not reinforced, if the aorta is not replaced there is still the risk of it dilating if that is a risk factor for you, and if the pulmonary valve is not large enough it could become stenotic. Dr. Stelzer addressed all of those concerns with me. He also replaced my already dilated aorta while he was doing the Ross, so I don't have to worry about that later either. After talking with Dr. Stelzer, I decided that for me the benefits outweighed the possible risks. If you are considering the Ross, you can definitely talk with him even years in advance. My brother is already discussing this option with him, and most likely he will not have to have surgery at least another five years. This is how I was able to get in contact with Dr. Stelzer. I just requested an appointment on the website, and the office helped me get in contact with him.
http://www.mountsinai.org/profiles/paul-stelzer

Briana Morgan  Yes, I emailed and he didn't know why they would want me to do the stress test right now. I haven't scheduled the stress test, because I didn't feel it was in my best interest to stress my heart right now. I am feeling great and would rather just keep working at improving. Thanks for the input. I'm off blood pressure meds now and my blood pressure maintains about 100/60s. When I'm exercising it increases appropriately. Sorry, I didn't see your note till today. I have been working a lot lately. We look forward to hearing from you following surgery!

Briana Morgan  So, this is a pretty complicated topic. I had to do a lot of research in order to decide what kind of valve replacement I wanted for myself. I am only in my early 30s and I'm not sure I want to be done with chidbearing, so that played a minor part in the decision. However, if I had thought that a mechanical valve would have been the best choice for my health, I would have done that without the consideration of future childbearing. I did not want to be on anticoagulant for the rest of my life which is necessary with a mechanical valve. A tissue valve was out of the question for me, because of how quickly they tend to degenerate in younger patients. Therefore, I looked into a Ross. My cardiologist was against this because of the complication of replacing my acsending aorta at the same time. Knowing that the surgeons he was recommending did not have as much experience with the Ross, I looked to see who had the most experience and ended up contacting Dr. Stelzer.
Other reasons why I decided to do the Ross; I have epilepsy and if for any reason I end up having a grand Mal seizure again, I would rather not be on anticoagulants. I also looked at life expectancy and possible mortality and morbitity rates with the mechanical valve. With the research I did, I was more comfortable with the Ross. I know the Ross can overall get a bad reputation for reoperation, but that is including all surgeons that do it. Dr, Stelzer's statistics that I was quoted were very good. And his mortality rate during operation was less than 1%. That was better than any other surgeon for any other operation that I had spoken with. I definitely wanted to make it out alive. If you are going to have a Ross procedure done, you need to have a very experienced surgeon. I hope that helps!
We did have a backup plan, if for some reason a Ross was not possible. My second option was a mechanical valve. Occasionally, a pulmonary valve can be bicuspid and you may not want to use that to replace a bicuspid aortic valve.

KEVIN RYAN  Briana: how's recovery from your Ross going? I am getting close to having to commit on which type of valve/procedure/surgeon. In the past two weeks, I have received two calls from Dr. Stelzer re Ross. I really connect with him as a person; and his experience with the Ross is comforting...but two valves when only one is failing...tough bridge to cross. I am much older than you (59) and so a tissue valve would be appropriate with a strategy to plan replacement then TAVI , if needed after that. I really like the reported hemodynamics and life-expectancy from the ross...but the long-term data is somewhat limited...and there is such variability depending on surgeons experience. Anyway, will have to make a decision in next day or two. Would love to talk to a fellow Washingtonian. I am on FB Kevin Ryan Mill Creek. Take care.

Briana Morgan  Hi Kevin, my recovery is going really well! I am very happy with my choice, even though it did involve two valves. I just started cardiac rehab this last week to make sure I will be ready to go back to work and they seem to think I can go back any time. We will see how I do this week. It really felt great to exercise, and I am not at all short of breath anymore. The other medication o am still on is the aspirin. It is a real blessing to not be on coumadin. I never really considered a tissue valve an option for me, because of my age. I didn't want to consider that it may fail within ten years. I will only know with time how this procedure is for me, but for now I feel great.

Briana Morgan  I highly recommend Dr. Stelzer if you decide on the Ross or any other valve surgery for that matter. He also was great to talk to the phone prior to my surgery. In the hospital he was informative to me and my family. He stopped by the bedside everyday. After we left the hospital his nurse practitioner was available and,if needed, he also was available to speak with. He even emailed back and forth a few times with me and when I got sick six weeks after surgery, he was prompt to call me personally. He cares about his work and his patients.

KEVIN RYAN  Thanks, Briana! Did Mount Sinai send you sufficient packet of info re preparations i.e. hotels, pre-op requirements/schedules, etc?

Briana Morgan  Mount Sinai always provided any information we needed. I don't remember actually receiving a packet, but we were scheduled pretty quickly. As for hotel, we found our own accomadations, but I do believe they can provide that information for you. Even possible accomadations at the hospital I believe. Preop was all done the day before surgery, and that was a full day of activities. They pretty much told me where to be and when and we went from there. I made sure dinner was already cooked the day before preop. I'm glad I did, because I got home late and dinner was waiting for me. Which, of course was my last meal before surgery. I wanted it to be a good meal. Just ask them for any information you need, they will provide it. My major concern was who would be doing my surgery and that and what I would be having done. After that, we just got the rest figured out. Mt Sinai took great care of me.