Affairs of My Heart
Our plans for the fourth quarter took a sudden and eventful turn.
Our plans for the fourth quarter took a sudden and eventful turn.
There are several approaches to the problem she told us. You can take the TAVR route with the advantage of a speedy recovery, or you can go the SAVR route which is more invasive and impactful up front, but we won’t have this conversation again in ten or twelve years.
TAVR? SAVR? Yeah, I was learning too. TAVR is short for Transcatheter Aortic Valve Replacement. SAVR is short for Surgical Aortic Valve Replacement. The commonality is of course the Aortic Valve Replacement bit.
In case you don’t know, the Aortic Valve is one of four valves in your heart. Without one, your heart can’t move your blood around your body. The Aortic Valve is one of those key body components for which failure is not an option.
Some weeks before this conversation about TAVR and SAVR I had been informed that my very own aortic valve was in a state where it was about to fail. Acute Atrial Stenosis was the line item on the echocardiogram report. Turned my world upside down it did. A true WTF or OMG moment that was.
Turns out that calcified aortic valves are not uncommon amongst those of us lucky enough to reach our 70s. Not so long ago, this would have been a death sentence. Fifteen years ago the only answer was the surgical replacement of the valve through open heart surgery, SAVR. Today, we have the option of having a new valve pushed up through our leg arteries and positioned over top of the defective one. This is the TAVR method.
Let me think about this … crack open a perfectly good chest bone, slice into a reasonably working heart and sew in a new valve or … deliver one in place simply by snaking a tube up from my groin to my aorta. Mild sedation, maybe out the same day, where is the debate here? Sign me up.
Which brings us back to our conversation with the cardiac surgeon. That spunky smiling surgeon remarked that she was not planning for the TAVR that she could perform next week. Nope, that one was easy. She was thinking about the second one that would need to take place in 10- to-12 years. It seems these new porcine or bovine valves are very good but their life expectancy … well, it’s not forever.
My surgeon laid out the options. Yes, she told us, there are fewer complications with TAVR if you don’t consider the future. The outcome is great especially if you have some chronic conditions which make open heart surgery risky. But for a fit young man of 72 years, wouldn’t you rather a one-and-done solution? Sure it’s a wee bit more invasive, but it’s done all the time now. We crack open your sternum. Hook you up to a heart-lung machine. Pop in a mechanical valve in place of the defective original. Sew you back together and you’re done. Good for thirty years.
As an additional bonus, you will enjoy intensive care for a day or two then a few more days in the cardiac care ward. We provide a walker and make sure you are ready when you leave the hospital. You will be chauffeured about for a month. This means you can practice your backseat driving and honestly tell your wife where to go.
What can go wrong here?
My wife June and I left the appointment a bit stunned. The drive home was quiet. When we got around to discussing the options, we found we were both on the same page. It was a short discussion. When my surgeon called the next day, I was able to say that we agreed the SAVR procedure was the path to follow.
I had a chance to talk to my daughter and son together about our decision before the surgery. They were very supportive. While my daughter and her family would be returning to Germany before I went under the knife, my son would be there with his mother while I was out.
So, here we are. Several weeks after the event. My chest has a nice neat zipper scar down the sternum. It hurts less each day.
In the morning now, I wake to a new soft sound echoing in my head, a flip-flub kind of sound made by the replacement mechanical valve pushing blood out to my body.
It will be Christmas before I can get behind the wheel of a car again. On the other hand, I will be able to get behind the wheel of a car again.
Thanksgiving was last week and I have a long list of things to be thankful for. The important ones are the amazing support from my family, the great work by the MultiCare surgeons and caregivers — again amazing — and the fact that I will continue to be able to meet wonderful people and visit beautiful places. Gotta love it!
This is my story. My aortic stenosis was diagnosed because I was under care for atrial fibrillation. We didn’t know how far the condition had advanced. Aside from some fatigue, I didn’t feel any different. I was planning a 500+ mile bicycle tour in France during October. I can only imagine what a kerfuffle it would have been had I collapsed during my ride along the Rhône River.
New plan for 2024. Get fit. Get out. Enjoy life.
What about you? What’s your story? Do you have any surprises lurking in the closet? Don’t wait to get them checked out.
The world is a beautiful place. Share the beauty. Leave only footsteps.