Guestbook of David Knight

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David Knightgot a new guestbook post

2858 days ago

Jan Persico posted a note for David that says:

David, what did you decide? Had my surgery Monday, hope to be discharged either tomorrow or Friday. Hope all is well with you!

David Knightgot a new guestbook post

2878 days ago

KEVIN RYAN posted a note for David that says:

Hi, David: Like you, I have a bicuspid aortic valve with aortic stenosis...AND...I, too, am scheduled for surgery at Cleveland Clinic on Valentine's Day (2/14/17)!! ...Read more

Hi, David: Like you, I have a bicuspid aortic valve with aortic stenosis...AND...I, too, am scheduled for surgery at Cleveland Clinic on Valentine's Day (2/14/17)!! Dr. Gillinov is my scheduled surgeon. However, I am now reconsidering the Ross procedure with Dr. Paul Stelzer at Mount Sinai Hospital in New York. Have you considered the Ross? What type of valve are you considering? Thanks.

David Knight Kevin I have bicuspid aortic valve with no dilation of the root or aorta. I have not considered Ross ... Read more

David Knight Kevin I have bicuspid aortic valve with no dilation of the root or aorta. I have not considered Ross. Dr Svensson felt he could repair my valve. If not I would prefer a mechanical Onyx valve. Why are you considering a Ross?

Dave

KEVIN RYAN Dave: I have gone around and around with the following three options: mechanical; tissue; Ross. I ... Read more

KEVIN RYAN Dave: I have gone around and around with the following three options: mechanical; tissue; Ross. I have made a great case for each at one time or another. Paralysis by analysis! The easiest/simple "fix" would be conventional replacement with either On-X or bioprosthetic. I'm leaning toward Ross with Dr. Stelzer (the surgeon with probably more experience with the Ross than anyone in the U.S.) because of the hemodynamic superiority of the left ventricular outflow which is more likey to lend itself toward regression of the left ventricular hypertrophy and a more likely return to normal; it's reduced risk of endocarditis; and a return to a near-normal life expectancy curve vs. the other options which actually have a reduced life expectancy curve. (I'll elaborate more fully...late for work now) Until then.

KEVIN RYAN Part II: In addition, there are no activity restrictions; and, no balancing of coagulation/anti-coag ... Read more

KEVIN RYAN Part II: In addition, there are no activity restrictions; and, no balancing of coagulation/anti-coagulation levels/meds with the Ross procedure. However, one can find a study to support one's fears or one's hopes. It is technically much more challenging for the surgeon...as Dr. Stelzer likes to say: root replacement is a three dimensional mindset whereas conventional valve replacement is a two dimensional mindset.

The other fear I have is: taking a one valve problem and risking conflagration into a two valve issue; or increasing the risk of aortic dilation; or risk of the cadaver conduit becoming stenotic.

I guess if I had a family depending on me (besides my senior rescue dogs :-), I would be hesitant about increasing risk even if the payoff is much greater.

Good luck in your due-diligence, David. I have had the opportunity to talk with a few patients of Dr. Stelzer who have had the Ross. One recent member of this blog community and one who had it done over 10 years ago. Both highly recommend Dr. Stelzer and the Ross procedure.

All the best.