Monday, June 5, 2017

OHS or TAVR?

Now that my open heart surgery is scheduled for June 27, I am trying to mentally prepare myself for both the surgery itself and the recovery that will follow.  I am comfortable with the procedure that I will have, which is an aortic valve replacement and bypass of a partially blocked artery.  Also, I am comfortable with the surgeon, Dr. Richard Stahl, who will perform the operation.
But I still wonder if it would be better to have a TAVR procedure, in which the diseased valve is replaced through a catheter inserted into my groin, rather than having the full open heart procedure.
The advantage is a shorter recovery period and a shorter stay in the hospital; the disadvantage is that the TAVR procedure has less of a track record than OHS, and higher risk of some complications, such as valve leakage.  Also, for a patient considered "low risk," such as myself, the TAVR procedure (which stands for transcatheter aortic valve replacement) is not approved by the FDA.
That means my only option, as I understand it, would be to enroll in a clinical trial, which is designed to determine the effectiveness and safety of the TAVR method for low-risk patients.  Because the clinical trial is randomized, that means I would have a 50-50 chance of having either the TAVR or OHS.
With all this going through my head, I am scheduled to meet with an interventional cardiologist who is part of the clinical trial tomorrow.  Right now, I feel it is likely I will go forward with the open heart operation, but I wanted to at least explore this other option before making a final decision.
When I talked about this with my primary care doctor a couple of weeks ago, she agreed it would make sense to learn more about the TAVR procedure.  To that end, she found a doctor for me to talk to, and put in a referral.
While this is a big decision, I'm also still wrestling with the question of whether to get a tissue or mechanical valve.
As I have written about before, the tissue valve (from a cow or pig), does not require the patient to be on blood-thinners for life.  However, for someone of my age (56), it would last 10-15 years, and I'm not crazy about the thought of a potential second operation when the tissue valve wears out.
A mechanical valve lasts much longer, 20-30 years, but patients must take blood thinners, which could impact my diet and activity level and would require regular blood tests to make sure the dosage is correct.
A lot to think about...

1 comment:

  1. how can I contact you? Interested in quoting you in my surgery book.

    ReplyDelete

Success!

Today (Friday, Aug. 11) I am home after a successful TAVR procedure at Scripps Hospital in La Jolla.  My procedure was on Tuesday morning, a...