David's Journal

Valerie Allen  My surgeon routinely uses wires. Unless someone is of a certain size then uses rigid fixation.  I was at the lowest end of that, but I was glad to get them as I had read about wires poking into people’s chest - not all the time but in some cases. I had also read there was less incision pain with rigid fixation. I certainly didn’t have much incision pain.

keith WALDMANN  I had wires and they became problematic from the get-go. Finally, after 18 months they were removed, and pain went away instantly. I sell devices for sternal closure ...Able Medical Sternal Plate and Montage CT settable, resorbable hemostatic bone putty! I've been in over 16,000 orthopedic surgeries and have seen everything imaginable that can go wrong. The Abel Medical Sternal plate is called the Valkyrie Thoracic fixation System . Plates are made from PEEK material which is radiolucent and contours to the patients anatomy. Easily cut for emergent re-entry..can't do that with all competitors which are made from Titanium. Montage CT is new product that is gaining market share...JB-Weld for Sternum and reduces blood loss which leads to shorter hospital stays and less pain!

Grace Mason   There are some great informational videos on Adam's blog here. I was really interested in them because of the less pain. While your sternum is healing the plates do a better job immobilizing your sternum than just wires until it begins to heal. The con is the screws may sometimes restrict blood flow and that can cause your sternum not to heal as well.
Having plates doesn't mean you don't have wires you just have less wires.
I received rigid fixation. My surgeon does not normally use this and he wasn't keen on using them but I really felt it was important to me. 
I am glad that I had it done but it may have contributed to my sternal non union. 
I began having pain upon breathing a few weeks after I started doing more with my arms (at about 10-12 weeks)but after another few weeks on sternal restrictions again that pain stopped and my sternum seems to have healed with scar tissue and is no longer painful. 
I also have a slight curve(concavity) in my sternum, so I am not sure, but that could have also contributed to my non union, as well as taking a high dose of steroids in weeks 4-7. They don't really have a definitive cause for the non union.

Robert Miller  Frankly, I am clueless about this topic. But I had a broken bone before. No plates for that incident. Cutting up your chest, I believe, isn't much different than a broken bone. Bones don't heal as well when you are older so maybe those plates help in those situation or if you have some other issues that prevents bones from healing like osteoporosis, etc. Otherwise I don't see why to use such plates. I have one bump in my chest which I believe is a wire. They nicked it when they shaved me for an ultrasound so it bled a little bit but otherwise I have no pain from it at all. I don't feel anything unless you rub your finger over that one rib where the wire seems to come out. If I could do it all over again, I would stick with not getting a plate (that was never brought up, btw). 

Carmen P  Still processing my unexpected news in January.  I'm scheduled for surgery for a reoperation of the aortic valve, aortic aneurysm and what ever they discover in the heart cath.   I'll be able to pass on some information after that.  I wish I had some info for you.  Good luck, find a great surgeon and hospital.  This is a great place for research, but you know that.

J Alexander Lassally  Hi - sounds like a full monty is being advised. Are you planning to get second and third opinions on treatment plan... I certainly would for such a big expansion of the program !  There are Mitral Valve Reference centers which should be where you are doing this.  Best of luck ! 

Larry Peterson  Hi David - definitely a complex procedure.  I would highly recommend a second opinion from one of the heart valve centers listed on this site, Mount Sinai in NY, Cleveland Clinic, Northwestern, Mayo in Minnesota, etc.  Many of them can do second opinions remotely so you don't have to travel for the initial consult.  

Rita Savelis  I'm sorry that  you have to go through this. I didn't have quite that much work but in 2015 I did have my mitral and aortic valves replaced and my tricuspid valve reinforced. I would imagine there is a reason you need this much work done in which case your surgeon should be able to explain it to you. I had radiation-induced stenosis (from cancer radiation treatment 35 years previous). Recovery is different for everyone and my surgeon was very honest and told me that I'd be tired for a long time. He didn't give me a specific time frame. I also ended up needing a pacemaker implanted a few weeks after the surgery. I was in hospital for 3 weeks and then in a live-in rehab hospital for a month. I went back to work 3 months after surgery. I never compared my recovery time with anyone else because every situation is singular. I trusted my surgeon as he was experienced with radiated hearts. Take care. 

Diane Lewis  My upcoming surgery in December is also complex. Aorta and Mitral valve or issue replacements. The mitral is a re-do from 6 years ago which also complicates the surgery. They are also recommending a MAZE procedure for A-fib. 

My biggest advice with complex surgery to find the best surgeon has done the most of what you need or someone that specializes in complex cases. I ended up going with Dr. Marc Gerdisch in Indianapolis. It will be a 8 hour drive, but Arkansas doesn’t have a valve surgeon with the kind of experience he does. It is also why his waiting list is so long. I hate waiting until December, but feel it will be worth it in the long run. I wish you the best. 

A lot of peace comes when you make the decision with someone you are really confident with. 

David Carney  Thank you all so much for your suggestions and concern.  I'll be having my surgery at Johns Hopkins and will be getting a 2nd opinion as the pre-operation tests results roll in.  I'm told Dr. James Gammie  is the best valve surgeon in my region, I sure hope so as it is the "Full Monty" of heart surgeries.

keith WALDMANN  This is a very high-risk surgery with varied outcomes. I personally would seek 2nd opinion at Cleveland Clinic. The best heart center in the world!  Hopkins is a great institution for sure ...I went there for my Prostate Cancer...but CC is in a different league in the heart arena


!

David Carney  Change of plans on my surgery, after taking the advice given by my fellow valve people, I did go for two second opinions.  In the end I decided on Dr. Gerdisch and his fine program at Franciscan Health Heart and Valve Center.  His approach and emphasis on ERAS (Enhanced Recovery After Surgery), limited use of opiods, rigid sternal fixation and other surgical innovations sealed the deal for me.  Downside was having to wait till 1/29, but I'm almost there.