Heart mitral valve surgery

[Winston001]

KB is an excellent place for sharing experiences so, knowing that one or two of you have heart problems, here is my tale.

In May 2009 my doctor detected a heart murmur which he thought was benign but worth checking. Naturally I did nothing - until he phoned asking what the cardiologist had said. Ok ok so I set up an appointment. That involved an ultrasound scan of my heart and surprise suprise, it wasn't benign. The scan showed a badly leaking mitral valve and I was able to watch the real time video in lurid colour.

The cardiologist proved to be a very decent bloke who advised urgent valve surgery. Luckily I had Southern Cross medical insurance which covered this type of problem although in hindsight I think I'd have been accepted into the public system no problem.

I'll break this all up into separate posts to avoid boring you. :D

[scumdog]

Fark Winston, maybe that's why you crashed????

[Winston001]

A little physiology is needed. I knew very little a year ago and too much now. The heart has 4 chambers and 4 valves. Three valves open to deliver fresh oxygenated blood to the brain and the body when the heart pumps. The 4th valve, (the mitral valve) opens at the opposite beat to draw in new blood from the lungs. It's sort of like the warehouse door of the heart.

The valve itself is made of two opposed leaflets which jam closed to keep the heart full of the nice new blood. Mitral valve failure is not common compared with arterial heart blockages which are the cause of your average heart attack. But at least the arteries are on the surface of the heart and can be treated with stents (steel tubes inserted from the wrist or groin). Bypass surgery is required when these are completely blocked.

Valve surgery is a different matter requiring the heart to be cut open and generally abused. So I checked my will.....

In my case the P2 lobe of the posterior leaflet was prolapsing and fluttering when the valve closed which allowed a backwash of 50% of the blood to the lungs. In other words, only half of the fresh blood was being circulated. The result was fatigue, extreme tiredness, lack of energy, loss of vigour, and vague memory. Looking back, these symptoms began 5 years ago which are classic mitral valve indicators.

[FJRider]

I gather the problem is sorted now ... and feeling much better overall. I HOPE ...

[scumdog]

The result was fatigue, extreme tiredness, lack of energy, loss of vigour, and vague memory. Looking back, these symptoms began 5 years ago which is classic mitral valve effects.

Sums up most of my days.
And I ain't crook like you!

[Winston001]

Fark Winston, maybe that's why you crashed????

Trust me SD, I pondered that at the time but no. I'd never had a blackout or sudden event from this problem, it's a gradual thing. Also the CAT and MRI scans didn't show anything apart from the concussion damage.

[Gareth51]

That's no good ,so we won't be seeing you at the cold duck tomorrow

[Winston001]

Back to the medical trail. Having accepted the cardiologists advice he set up an angiogram to be performed at Mercy Hospital Dunedin. This involved injecting a radio-opaque dye into the radial artery (or whichever artery is best) and watching the dye travel to the heart. I watched it too while lying on a nice big operating table but in truth can't remember much because he gave me some good juice to calm me down. Must get it out on DVD.

There are risks of stroke and even death with an angiogram because plaque can break off the artery walls and lodge in the brain. Indeed the cardiologist had had a death occur recently. In its own weird way that info helped. The odds are 20,000:1 of such a tragedy and since it had already happened, I figured my chances were good.

[Winston001]

That's no good ,so we won't be seeing you at the cold duck tomorrow

Err no Gareth unfortunately but some of the other guys I was with are going. Its a great rally.

[Winston001]

I left hospital that afternoon for a motel and next morning reported to Dunedin Hospital with the cardiologist for a TOE. Transoesophageal echocardiogram in case you were wondering.

Now this did not appeal to me as a lot of fun. Having a firehose shoved down your throat with an ultrasound unit on the end just to take pictures of the heart seemed....invasive. Why bother? Well, apparently they can get much better info, almost 3 dimensional images, which the heart surgeon needs to decide on a Ferrari or a Maserati which you are going to help pay for.

Private hospitals don't do TOEs (so I'm told) because the equipment is expensive and not used often.

But I digress. They assured me I had nothing to worry about and sweetened the deal with some excellent drugs so I played along. Next moment I'm waking up to a Sri Lankan student doctor offering me a cup of tea - it was all over. No pain, no discomfort, all good. I was released (no driving) after a few hours.

This all happened in early September 2009. On 20 September 2009 coming home from the Pissed Penguin Rally my beautiful Ducati and I parted company on a corner in the Catlins. :shit:

[Winston001]

Recovering from the bike accident took precedence over the heart problem and frankly I was in no condition to undergo major surgery for quite a long time. The concussion is still with me today. By January I felt up to facing surgery and a date of 5th March at Mercy Hospital was arranged. However you can't just go and have heart surgery, there are various tests beforehand. A complete dental checkup with my dentist, then a special 360 degree X-ray of my teeth was done at Southland Hospital. Finally comprehensive blood tests a week out from surgery. Those blood tests were repeated when I was admitted for the operation. There is a purpose in telling you this - the guy in the next bed had his surgery delayed a month because his blood showed an infection.

[Headbanger]

wtf?

This is what you were referring to when you said you had to pop back into hospital to get a few loose ends tidied up?

Do they give out medals for understatement of the century?

Stay healthy my friend.






I'm fucking hoping this has a positive ending.

[Winston001]

wtf?

This is what you were referring to when you said you had to pop back into hospital to get a few loose ends tidied up?

Do they give out medals for understatement of the century?

Stay healthy my friend.






I'm fucking hoping this has a positive ending.

Cheers mate, more description to come and yes, all good now. My purpose is to describe the experience from a patient's point of view because most of the stuff on the net is from the medical perspective.

[scumdog]

Cheers mate, more description to come and yes, all good now. My purpose is to describe the experience from a patient's point of view because most of the stuff on the net is from the medical perspective.

So nice to hear it from that perspective Winston, not very often is an op put so clear and understandably.

[mashman]

Cheers mate, more description to come and yes, all good now. My purpose is to describe the experience from a patient's point of view because most of the stuff on the net is from the medical perspective.

Post the vid on youtube and do your own voiceover???? take it easy Winston.

[Winston001]

Post the vid on youtube and do your own voiceover???? take it easy Winston.

Funny you should say that MM, there are videos on the net showing the operation and I studied them beforehand. If anyone wants to know more the Cleveland Clinic and the Mayo Clinic are the world leading heart specialists and have good info on their sites.

Anyway, open heart surgery is not a cakewalk. I may have appeared cheerful and no worries but underneath I was exceedingly nervous. So I fronted the surgeon. I pointed out to him that he proposed to crack my sternum, then crank it wide open with retractors which you can imagine comes as a bit of a shock to the ribs. After that he'd plunge his hands into my chest shoving aside the lungs and anything else in the way and grab my heart, at which point I was a dead man.

Not only that but the aeorta and vena cava would then be pierced so the perfusionist could artificially run my blood supply, while the anaethesist kept the body as close to death as he could manage. And to top it off the body would be cooled to slow metabolism down. The butcher....er surgeon then intended to cut my heart open, fiddle about with the mitral valve, cut pieces out of it, or if things were in a parlous state, replace it with a mechanical valve. After which he'd have a scotch, put in a few stitches, run some lacing wire through the sternum, hook me up to an electric fence and Voila - the Tui Moment - back to life.

Yeah right.....

He just grinned at me and said restarting the heart was the least of my worries. As it turned out, he was right.

[FJRider]

He just grinned at me and said restarting the heart was the least of my worries. As it turned out, he was right.

It's called "putting things into perspective" ... some butchers have a way with words ... eh !!!!

[Nasty]

He just grinned at me and said restarting the heart was the least of my worries. As it turned out, he was right.

I loved it when they told me for the SVT radio frequency ablation that signing the forms for a pacemaker were only a "precaution" in case something went wrong when they burned the electrical fault I had .... that gave me huge confidence ;)

[Okey Dokey]

Geez, winston, this is riveting stuff. So very glad you are here to tell us yourself!

[Winston001]

So the big day arrived. I was admitted the night before and woken at 6:00 am for a shower with a special anti-bacterial sponge and instructed to shave my chest. I perked up when they offered a nurse to help but when I saw it was a guy.....never mind. So after that they stated putting lines into my veins with some happy juice and really everything following is vague. I said goodbye to my wife.

She tells me that later in recovery I would blurt out Monty Python lines while people were talking although I wasn't conscious. Its a 4-5 hour operation and everything went well. By the next morning I was awake and chipper, even managing a few steps around the recovery ward. In fact I felt pretty damn good.

When a medical expert tells you there is only a 2% risk factor with a procedure you tend to feel reassured. What it means is 98 people out of 100 recover and there are no complications. Risk however means that 2 people face death (at the extreme), damage to the heart, collapsed lung, stroke, infection etc. What you the patient don't realise is someone has to make up the 2%. :sick:

Suffice to say, I took one for the team. 99 of you reading this can relax. :yes:

[Winston001]

Later in the day the surgeon turned up and explained there had been a surprise. Not a surgical problem as such but a medical complication. In other words his job was completed and it was up to others to keep me alive.....:bye: Actually that's a bit harsh because he was certainly concerned.

The good news was the valve could be repaired instead of a mechanical valve being inserted. The bad news was that upon opening my heart he discovered evidence of bacterial inflamation and activity on the posterior mitral valve lobe. Exactly where he needed to operate. Oh dear....

There are two non-technical terms for this - a BAD THING and MEDICALLY INTERESTING. Trust me, you do not want to hear these words. Endocarditis is the proper name. The surgeon had only seen it once before in 20 years.

[Mom]

Endocarditis is the proper name. The surgeon had only seen it once before in 20 years.

I trained as a nurse at Greenlane Hospital when I left school. That once was the leading Heart hospital. Sir Brian Barret Boyes operated there and I can remember ward rounds with him :D

Endocarditis is no laughing matter, have nursed many cases of it. Gets on your heart valves apparently :pinch: Not very nice either.

[Winston001]

I trained as a nurse at Greenlane Hospital when I left school. That once was the leading Heart hospital. Sir Brian Barret-Boyes operated there and I can remember ward rounds with him :D

Endocarditis is no laughing matter, have nursed many cases of it. Gets on your heart valves apparently :pinch: Not very nice either.

I can second that. I have a couple of friends who are GPs and they have never seen endocarditis in a patient here although its not so unusual in poor countries. I should be accurate and explain the heart surgeon had certainly encountered endocarditis on the operating table but normally he already knew about it and was prepared. That was the reason for all the preliminary blood tests.

[Mom]

I can second that. I have a couple of friends who are GPs and they have never seen endocarditis in a patient here although its not so unusual in poor countries.

Once you have todl your story I will share one about a bloke I nursed.

[Winston001]

At this point I want to say that the heart surgery itself was far less painful than I ever expected. Modern medicine really is miraculous. The fact that I was feeling good and very much alive only 24 hours later says a lot. All things being equal I would have gone home after 5 days and it was all a surprisingly easy experience.

[Winston001]

Anyway I ended up with a staphylococci infection in my heart. Harmful bacteria have no business being in the pericardium (heart space) so science is interested in how they got there. 10% of infections can be traced to dental disease but 90% is not understood. Thus I found myself under the curious gaze of an infectious diseases expert some days later. This type of thing is meat and veg for research papers and I should have felt honoured to contribute but somehow......:shutup:

After 2 days being stabilised in Mercy Hospital I was moved to Dunedin Public Hospital for intensive anti-biotic treatment and was starting to feel really sick. The medicine was 5 million units of penicillin 4 hours intravenously day and night plus 60mg of Gentamicin every 8 hours. That is a powerful lot of poison. Plus blood tests every 12 hours to check inflammatory markers and other things I lost track of. Gentamicin for example can cause hearing and liver damage.

6 days after the operation I was ready to say goodbye because I felt like I'd be in a coma next day. Guess that was the low point because strangely I was a lot better next morning. Crisis averted but it was a chillingly mortal moment.

[Winston001]

After a few days they put in a PICC line which is a semi-permanent IV tube running close to the heart so that the anti-biotics were delivered on site. The good thing about this was that I could walk away from the IV drip stand for 3 hours at a time. Initially I was told I'd be on a 6 week course in hospital which was a bummer piece of news. To be tied to 4 hourly treatments when I was beginning to feel well and just wanted to go home felt so frustrating.

You have to make your own fun to pass the time. As a teaching hospital there were a lot of trainee nurses and doctors so when a new one turned up to take blood I would scream at the crucial moment. This was guaranteed to produce panic. Ahhh the laughs we had......

You can't assess your own state of health in hospital. Its warm and safe and you feel better than you are. Once the PICC line was in I was free of the IV stand so naturally I escaped. Walked a block down the street to a mall and supermarket which sounds easy enough eh. Not. It was 5pm with a cold southerly wind blowing and I could see the hospital from the supermarket.....and wondered if I could make it back. One block. Farrrgggg! Imagine having to call an ambulance.

Somehow I got back to the ward where I was spotted by the nurses and my card was marked. Next morning the cardiologist whom I'd developed a good rapport with called on his rounds. He talked about releasing me to Southland Hospital but then mused that could be a problem because there were no supermarkets nearby......bastard. :D

[Winston001]

This is pretty much the end of my tale. Shrek came to visit me which was damned decent of him because he lives in Central Otago. I was sent to Invercargill then discharged home for daily doses administered by a District Nuse. After 6 weeks the line was taken out and life has returned to normal. I'm on Warfarin for a couple of months and still get pain in my chest if I try anything physical but that isn't surprising. It takes the sternum about a year to completely heal and the baling wire stays inside.

I hope this story will be of reassurance to anyone facing heart surgery. The medical care was simply excellent and pollyanna as it sounds, I feel really fortunate to have been looked after so well.

[jim.cox]

I hope this story will be of reassurance to anyone facing heart surgery. The medical care was simply excellent and pollyanna as it sounds, I feel really fortunate to have been looked after so well.

Yeah right

Stay away from Hospitals and Butchers...

[Mom]

I hope this story will be of reassurance to anyone facing heart surgery. The medical care was simply excellent and pollyanna as it sounds, I feel really fortunate to have been looked after so well.

The advances that have been made in medicine in a few short years is amazing.

Like I said I trained in NZs heart hospital, some of the most pioneering surgery was performed there, it was a world leading hospital for the treatment of heart disease. Probably still is before I get told off :D

I saw some truely incredible things during my time there and a few have stuck in my mind. One is a man I nursed with Endocarditis, it is a story I have retold many times over the years. My children benefited from it more times than strictly required for the message to sink in, but you can't be too careful when raising babies I think.

This was 1977, the years of long hair and loud music, and Bob* was admitted to my ward. He was one very, very sick puppy. Tall and thin, on the methadone programe, long hair, a once attractive man who had obviously lived a bit. He had these most incredible track marks on his arms and legs. Honestly I had read about them, and seen pictures but to actually see them and feel them was a truely shocking thing for a young gal out of school. He was in his mid 30's and not expected to live much past the next few months.

He was philosophic about how his life had panned out and was full of advice and sage words of wisdom gleaned from the lofty position of "dying from his lifestyle choices" hindsight. His heart was giving up, his mitral valve was completely stuffed, and he was not eligible for surgery as he was too sick. There was not enough time to get him well enough for surgery, before his body gave up. Mind you we still tried.

He had endocarditis on his mitral valve. He likened the growths to cauliflowers that were preventing his valve from closing properly. The reason for his? Injected drugs of the illegal variety. He was a heroin addict who would inject about anything into his veins to get his fix. He told of dealers cutting the stuff with talcum powder, cornflour, you name it they used it, and he just shot it up his arms and legs. Powerful thing meeting Bob. Over 30 years and I can recall him to my mind as if I saw him yesterday.

Back then it was weeks and weeks of hospital and IV antibiotics and a very long slow and often futile excercise to get rid of. Amazing they found yours and were able to treat it sucessfully. There is the advances for you. I reckon it will have come from your teeth, or a really bad throat (not that I have any idea really :D)

May your recovery be unremarkable and your repaired valve perform better than the original.

Thank you for sharing your story.

* not his real name

[GOONR]

.....Anyway, open heart surgery is not a cakewalk...

Ain't that the truth! My daughter had open heart surgery when she was 4 weeks old then again at 6 months. Me and the missus know way more about heart function than I care to mention.

[Mom]

Ain't that the truth! My daughter had open heart surgery when she was 4 weeks old then again at 6 months. Me and the missus know way more about heart function than I care to mention.

We used to call them button kids as the surgeons would sew a button on the bottom of their wounds as a finish to the internal stitches.

[GOONR]

This is pretty much the end of my tale. Shrek came to visit me which was damned decent of him because he lives in Central Otago. I was sent to Invercargill then discharged home for daily doses administered by a District Nuse. After 6 weeks the line was taken out and life has returned to normal. I'm on Warfarin for a couple of months and still get pain in my chest if I try anything physical but that isn't surprising. It takes the sternum about a year to completely heal and the baling wire stays inside.

I hope this story will be of reassurance to anyone facing heart surgery. The medical care was simply excellent and pollyanna as it sounds, I feel really fortunate to have been looked after so well.

What a ride, really hope that you mend up well. Take it easy fella.

Every time you see a new doctor now they will want to listen to your heart cause it sounds weird now!!

[GOONR]

I trained as a nurse at Greenlane Hospital when I left school. That once was the leading Heart hospital. Sir Brian Barret Boyes operated there and I can remember ward rounds with him

Fancy a babysitting job? :laugh:

[SPman]

Got me worried now. I had a whole lot of tests 2 yrs ago and they said I had a minor leak in one of the valves - like Winston, I could see it on the scanner.......
then they sent me home and I have heard zip since.
Should I worry?

[Mom]

Heyup.
Roll on Friday and the TOE (and another three-day weekend! )

Fear is healthy, but drugs are good too I hear :D

Chances are you really will be much better once you have your valve repaired. I will come and make you laugh the day after you get back to a ward if you like :love:

[Bass]

So much of what Winston has written touches a chord with me.
My Dad died in the Dunedin cardiac unit. He had never properly recovered from his first heart attack and was going into the unit for some investigatory work. He had his second attack climbing the stairs up to the unit and that was the finish.
It being a teaching hospital and making your own fun also rings a bell.
My Dad was P & T overseer northern district Southland for years which meant that he travelled a lot in the area. He would pick up hitch hikers if they were making some effort on their own behalf and so, one afternoon he gave a couple of nurses from Dunedin a lift through to Te Anau.
They told him a story about one old bloke that they had recently had on their ward.
I don't know what he was hospitalised for but I surmise it was some sort of colonic surgery because the post operative treatment included a "flush out" every day or two. It seems he was getting a bit pissed off with this and one afternoon he asked one of the nurses for a bit of rubber hose.
She asked "what sort of hose?"
He responded that he just wanted some of the stuff they used all round the ward.
She asked how much he wanted and he indicated about 100 mm.
She thought it extremely odd, but he was an old fellow and would say no more about it and so she went and cut him his bit of rubber hose.
The following day, the ward sister went in to flush him out again and came out almost paralysed with laughter.
Aparently, she had rolled him over in bed and was feeding the hose in when he had suddenly arched his back, said "oh, oh, too far" and popped this bit of hose out of his mouth.

[Winston001]

Got me worried now. I had a whole lot of tests 2 yrs ago and they said I had a minor leak in one of the valves - like Winston, I could see it on the scanner.......then they sent me home and I have heard zip since.

Should I worry?

No but keep it at the back of your mind and ask your doctor to listen to your heart the next time you see them.

A small amount of heart valve leakage is not uncommon and is sometimes congenital. Been there from a very young age. Problems arise when the leakage gets worse and it tends to show up in our 50s.

[sels1]

Winston - ( just found this thread) Best wishes mate, sorry to hear of your troubles and hope it all works out in the end. Thanks for sharing your tale.

My Dad had this problem too, discovered after he collapsed one day while he and I were walking up the hill to Athetic Park to watch Wgtn beat Scotland. (I watched it the hosp. waiting room, it was on TV1 in those days!) He was in his 60s then and ended up having a plastic valve fitted. He ticked like a clock thereafter. However he lead an active and healthy life and passed away last year at 91 (from gall bladder operation compications, the heart was going fine)

[Edbear]

Sums up most of my days.
And I ain't crook like you!

Ain't old age a bummer.... :innocent:


So nice to hear it from that perspective Winston, not very often is an op put so clear and understandably.

Wot he sed! :yes:


Fear is healthy, but drugs are good too I hear :D

Chances are you really will be much better once you have your valve repaired. I will come and make you laugh the day after you get back to a ward if you like :love:

With friends like you... :shit:


No but keep it at the back of your mind and ask your doctor to listen to your heart the next time you see them.

A small amount of heart valve leakage is not uncommon and is sometimes congenital. Been there from a very young age. Problems arise when the leakage gets worse and it tends to show up in our 50s.

Hmmm... I'm 52 this month, may be time for a check up of my murmer. My youngest daughter has a congenital heart condition and the Specialist said ti would probably not be serious until she was a lot older, but meantime if she gets pregnant she will be monitored through it and have to have the baby in a hospital.