Art's Journal

Darlene Smith  I had pleural effusion that raised my pulse to the 80s-90s, and my HR to about 129. That got me 3 trips to the ER and a hospital stay where they inserted a chest tube for 24 hours to drain the fluid. My elevated HR and pulse was temporary and eventually settled down. And the pain was in my left shoulder and radiated down my back, and it hurt (a lot) to breath, not just deep breaths, but normal too. Unfortunately it took me a couple months to get over it, but after that, its all been good.

Art Jackson  Thanks Darlene, sounds quite similar. I am back on the take it very easy train until I get over this. I was just about to get rid of the reclining chair too! Skiing 12 weeks post op may have been a little ambitious anyways :-).

Darlene Smith  Don't get rid of the recliner!!! Its been a lifesaver. I just got back from skiing but I'm a little ahead of you in recovery time. You may be ok for some good spring skiing!!! Good luck.

Shannon Gray  Thinking of you! My story is long, so I'll spare you the history lesson, but I can relate to the frustration and challenges with pericardial effusion and then pericarditis. It was long and drawn out, but I did baby myself and kept from high endurance type activities,, and I was still on metoprolol which helped keep the heart rate lower. Thinking of you and if you have any questions, please let me know. Wishing you the best!

Corey Sines  I would always give repair shot if a surgeon, who has a good track record, says he likely could repair it. Repair, at the very least will give you some number years (just a bovine valve would) but possibly last the rest of your life, with no trade-offs (e.g. Blood thinners). No other prosthetic valve choice can give you that chance.

Adam Pick  I agree with Corey. If you can get a repair from a very skilled surgeon, that could be a great long-term solution. I'll post a few videos for you about this now.

Doran Herritt  Dr. Bavaria did my replacement. The plan was to repair first, if he felt he couldn't then to replace with a tissue valve (Edwards anti calcification test valve). When he got in there my valve leaflet was torn and perforated. He didn't feel the repair would last so he replaced with a tissue valve. So all went according to plan and that's the important part. Have a plan with your surgeon. Thoughts and prayers to you. Drn

Billy G  I had my aortic valve repaired almost one year ago. The surgeon said he would not repair it unless he got in there, saw the problem, and thought he could do a repair that would last at least 10 years, with the potential of lasting the rest of my life. He actually repaired it, tested it, wasn't happy, and then repaired it further before being satisfied it was the best course of action.

I was 34, and although I would have been happy with any course of action that resolved the issue, I am happy repair was an option, even though I know there is a possibility the repair may not last the rest of my life.

I'm more than happy to talk or share any additional thoughts if it helps.

Darlene Smith  Repair over replacement always!!!!! There are many aortic repair surgeons who specialize in your valve. I would never replace over repair.

Art Jackson  Thank you all for reaching out. After my consult I have found out it is actually a root replacment valve sparing procedure they will do. I wasn't prepared to discuss root replacment. Repair my Bicuspid valve and replace the root at the same time (I do not have an aneurism currently). When you all speak of repair did you have the root replaced as well? Do you think that repair with the extra work of doing the root as well is still the best option? The surgeon believes not replacing the root as well will not lead to extended durability. Very nervous after last nights meeting.

Corey Sines  This is newer territory, Most cases if the root needs replaced, in the past, the valve was replaced with it. I have heard of valve sparing procedures with a root replacement. I don't know if I have seen any on this site at the moment. Ask some questions of how many of these your surgeon is done? Other Aortic valve ops?

Art Jackson  Thanks Corey, my surgeon says he does about one a week, has been doing this for about 15 years and he will not do It without replacing the root as well as he says that just repairing the valve alone will not last or last as long, because the bicuspid will eventually lead to the valve leaking agin in the absence of a new supported root. All very confusing and with added time to the surgery and risk rather than the straight valve replacement or straight repair. The added risk would appear less than what the Ross procedure would be.

Billy G  My root was not replaced. I do recall reading about replacing the root during a repair and started digging into it just over a year ago. I don't recall exactly what it was, but at some point, I determined it likely did not apply to my case. And since no surgeon brought it up, I shifted my focus towards other research.

After endlessly researching many things and becoming very comfortable with what I was facing, I felt like I knew what needed to be done but was also fully trusting that my surgeon would do whatever was best, even if that meant doing something I somehow never came across. In the end, he ended up repairing the valve as we hoped (although he actually repaired it, tested it, wasn't happy, and then further repaired it before being satisfied that the repair was better than a replacement).

Steven Dean  Art - this is an area of reasonable dispute. Some surgeons really believe in it and others do not. The reasons I have heard against it are that you are taking a person with one valve disease and giving them two, it is a harder and longer surgery, and it is not clear that it will last longer than current generation bioprosthetic valves. Of course it has worked out very well for some people. That is to say there is not a consensus in the medical community on the procedure.

Lisa Heinen  Art - message Jeff Shebovsky - he personally visited with me several times with any questions I had - and will put you in touch with several others willing to give you their personal stories with the Ross as well. They will all go above and beyond in answering any questions, concerns, or fears you might have. I struggled with the decision - but have not once questioned if it was the right choice since surgery! I was 47 at the time and am hoping to never have to have OHS again! And Dr. Paul Stelzer is an Amazing Human Being and the Best of the Best for the Ross.

Art Jackson  Thanks you for your time and for the comments. I will be following up. They seem pretty convinced that the mechanical is the right choice for me and my activity level however I wiped out on the rocks this weekend during a walk on the beach and realise that I'd probably be black and blue, or worse, if that happened while on blood thinners.

Regan Runnalls  Hi Art,
Going through the same dilemma right now at age 39. At the moment I'm going with the bovine valve. It is such a personal decision. Some people seem to live life with Warfarin seamlessly, whilst others I know have endless complications. Both options have positives and negatives, so go with your gut!

Corey Sines  I am about the same age (40) and faced with a similar decision however in the Mitral position not the Aortic. A mechanical valve doesn't preclude you from continuing any activities you list above. They do recommend stopping contact sports (didn't see those on your list). I would recommend an On-X valve, as it requires less anti-coagulation that others in the market currently. Check out : http://www.cryolife.com/patients/

In the end its a personal decision of what you can live with, anyone at age 39 getting a tissue valve is hanging their hopes on medical advances to improve or limit the number of Heart Surgeries (statistically your bad odds go up with each subsequent Heart Surgery, about the 4/5th surgery they start getting more risky, couple that with increased age and issues around that too). Additionally TAVR is great and groundbreaking, but it is unknown how many times the procedure to can be repeated, but there is a theoretical limit to it, as they don't remove the previous valve, so they just squeeze in over the top of the previous valve So while valve-in-valve is possible, valve-in-valve-in-valve (or valve-in-valve-in-valve, etc) is a bit unknown and current TAVR valve life manufacturers are only estimating 5-7 years.

Ted Miko  Hi Art. I'm 50 and very active in weight training and I also own a service company and am always work with my hands on heavy equipment. So cuts, scraps and bangs are almost a daily thing. So I too am trying to decide ona valve. I'm thinking alot like you... who knows what they'll have acomplished in 10-15 yrs as regarding OHS and valve tech. It's probably the only real stress I feel about my upcoming surgery.

Lisa Heinen  Hi Art- after reading Adams book, I did extensive research for available options- have you looked into whether or not you are a candidate for Ross Procedure? There are several people on this site that are more than willing to talk to about their personal experience with the Ross. I am 100% convinced I made the right decision for me with the Ross- I'm almost 1 year out and have not had any problems or restrictions ❤️

Mary Wagner  I got a mechanical valve at age 39 and it is going strong at year 27. I recently had aneurysm surgery and the surgeon checked out the valve and said it looked great. I have been on coumadin for that many years and have had really no problems with it. I am active. After having 2 OHS - I don't want another one!

  I don't have a mechanical, but at age 40 received a tissue valve (Dec of last year). My surgeon implanted a larger tissue valve with the plan to have a TAVR replacement that will not require OHS next replacement, so it can ideally buy me more time for technology to catch up. I am crossing fingers for a human DNA grown valve in 20 years. Best wishes to you and your choice!

Chris Vereb  Hi Art. I am older than you, 51. I chose mechanical. I work a heavy manual labor job at UPS. I am doing great. The Chicago Bulls coach is more your age 42. He has mechanical. https://www.youtube.com/watch?v=C88mpgQJ_n0

Rita Savelis  Hey Art, Sorry you have to make this difficult decision. We've all been there. It's all very personal and no decision is wrong or right. Plenty of active guys your age get mechanical valves. For a "young" patient (especially male) mechanical can be a good choice.
I got 2 mechanical valves last year at age 54, no problems (yet)....

Art Jackson  Everyone! thank you so much for reaching out to me. This really helps to hear your opinion and or your story. I may be a candidate for the Ross but I will not know until after the Cardiac Cath and CT apparently. Numerous OHS cant be good for anyone so I am weighing my options. Was just a little caught off guard by the mechanical valve.

Denise Campbell  I'm 51. 6 months post up with mechanical valve. You'll need to keep in mind your on coumadin, but life goes on. I work with preschoolers.

Priscila Marino  I had my Aortic valve repaired but it was not 100% cerntain they would be able to fix it. I don't think there is right or wrong when choosing it.... It is personal, for me I choose tissue, I didn't want to be in blood thinners, I am 34.
I choose it in hopes that in 12 years from now it would be changed through cath.
I did not need to have replacement, thank God, but if I had, now that I have gone through the operation I would be freaking out about the remote chance of having to do it again.....

Hope you can make the choice that you will be more confortable with.