Update - TAVR

I saw the Interventional Cardiologist the other day. He is concerned that my left coronary artery could get occluded by my current valve leaflet when they are pushed aside by the new valve. He said I would have a heart attack on the table - OUCH! He said it is too close for him to decide alone so he is putting it out to other cardiologists as well as Carpentier Edwards as he is looking at the Sapien Valve. The surgeon doesn't think it is an issue. However, I'm glad for this doctor's caution. He mentioned coronary stents and chimneys, but from what I've read, they usually require lifetime warfarin and more future complications. If that's the case, I'll just request a redo surgery (SAVR)! I'll keep yall posted!

1 Comments

Lots to consider

by Gemita - 2023-05-13 03:16:51

USMC-Pacer,

Thank you so much for your update.  I can see this is far from straightforward or an easy decision to make.  It does seem that the SAVR procedure, however invasive, is still quite rightly on the table.  I found the attached link on chimney stenting of interest, although I expect you have seen it, or read similar articles.  Of course you would be extremely unlucky to suffer a coronary artery obstruction during any TAVR  procedure but of course the risk is always there.

My husband has several stents (but no major valve disease).  Following his stents, he had to stay on triple therapy initially, this being Antiplatelets:   Aspirin/Clopidogrel + an anticoagulant for 3 months, followed by Aspirin only + anticoagulant for another 12 months, before being able to drop the Aspirin and remaining only on an anticoagulant for life, so stent care to prevent thrombosis/re-stenosis could be quite challenging.

All you can do is to be guided by your excellent team and your own gut instinct as to which way to go.  I wish you lots of strength to make the right decision.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7376538/

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