Heart Valve Replacement

Long time forum member, lurker and occasional poster. Had a bit of a shock this week as I have been diagnosed with severe aortic stenosis following a fainting episode whilst out on an early morning ride. Felt myself starting to go light headed so slowed down to dismount but next thing I remember is that I’m lying across the bridlepath with the bike trapped between my legs. I recovered well enough to walk approx 2.5 miles back home. Contacted my GP and following a visit to her I ended up in hospital where following various tests and a chat with the cardiologist etc. They diagnosed that I have a bicuspid aortic valve and suffering from severe aortic stenosis.  So at the age of 63 I am now on the waiting list for aortic valve replacement surgery.

I had a TIA in 2011 where a heart murmur was identified but nothing was ever said or done to identify the cause and it was never followed up.

Searching back through the forum I have noted that there are a number of forum users that have mentioned that they also have a bicuspid aortic valve and or suffered from a heart murmur.

Has anyone had a valve replacement operation? If so, what was the recovery and rehab like? How long until you could get back on the bike again? I know every one is different and some may recover quicker than others but looking for feedback or advice.

Nothing of real value to add other than a mate has one, and has had it about 35 yrs now and it’s still working well

His is metal and you can hear him ticking. He has suffered from mental health issues related partially to that as he says he can never escape the ticking

A friend has a replacement valve, not sure what type. It was 20 odd years ago and he’s been competing in sport at a high level ever since.

Yes. 

Forty-one years clicking (1982).

Technology has moved on massively so don’t listen to us old-timers.  I’ve sent you a DM.

PS: This is not justification for an ebike. Steel hardtail yes, but not e-.

Nearly 10 years clicking.  I too recovery steady with gentle workouts on the turbo and then gradually working back to fitness out on the bike, about 3 months in all.

After the op make sure you take the laxatives offered and have some all bran for breakfast. Morphine tends to clog you up and you don’t want to be straining with your chest freshly stitched up………….

Morphine tends to clog you up

LOL. And some. 

Happy days 🙂

i was in for open heart surgery a few years ago ( not a valve replacement ).  the other 3 blokes in our ward all had 3 valves replaced IIRC. all seemed loads better by the end of a weeks recovery, and the talk from the medical staff was, that is is a daily bread and butter operation now, with great outcomes.

so i reckon you will be all good mate……….and good luck.

MIL had a pig valve repacement – outlasted her (over 15 years) but she wasn’t fit and healthy when the valve was done, but it worked well for the 15 years.

Obviously your consultant should be your first port of call for advice but for another good source: there’s a load of good info available from the BHF including their heart helpline if you want to chat to someone else about it.

https://www.bhf.org.uk/informationsupport/treatments/valve-heart-surgery

I had my aortic valve replace with a metal and carbon prosthetic 4.5 years ago.
The ticking drives me mad.  I have non-congestive heart failure caused by the failure to perfuse my heart properly with oxygenated blood during surgery.

Two TIA’s, a stroke, a subarachnoid haemorrhage and a subdural haematoma later, all caused by Warfarin and a failure to properly advise me of medications I should no longer take – sumatriptan.
When it comes down to it – actually death as an alternative would be better.  Today, as on most days I’m sick of life.

I don’t want sympathy, or advising of the value of life.  I live an existence being less than half the person I was – and I don’t want it.

My dad had it done at 76 due to aortic valve stenosis and his recovery was remarkable. As the cardiac nurse told him, ‘mechanical problem, mechanical fix’. His first proper walk after the op was the same as his last one before it but without any of the rests he’d got used to taking on the hills.

My Dad had an aortic valve about 6 years ago (he was 73), was done open-chest as they wanted to make sure they got it right due to other medical issues (he had a whipple procedure 2 months later)

When i visited him in hospital straight after the Op he looked like crap – had a breathing tube down his throat etc. Went back the following eve and he was in the armchair having just been for a walk to the bathroom.

Out of hospital a couple of days later – and has had no issues with it ever since. He also noticed an immediate improvement in his stamina – able to walk upstairs without getting out of breath, etc.

As others have said – routine procedure these days.

Thank you for all the comments and feedback. I’ll have a chat with the consultants regarding the clicking…

@jamj1974 I am truely sorry to hear that your experience and outcome wasn’t what you were expecting.

My 9 year old son is on the waiting list for valve and conduit replacement due to an issue diagnosed pre-birth and medicated for since. He had open heart surgery at 14 weeks old and those bits now need replacing.

Anyway, spoke to the surgeon last week and he said roughly 10 days in hospital, 6 weeks off school. Good luck mate.

JamJ, really sorry to hear about your troubles, hopefully you can get the warfarin under control.  The ticking does reduce with time, a small comfort I know but hopefully a glimmer of light for you.  Feel free to DM me if you need a listening ear.

Hey Keando

Exclusive group we are.

I’ve been told I will need a new valve at some point and having regular echocardiograms to monitor at the moment.

I think your doc will put you on ACE inhibitors to lower blood pressure. Note if Ramipril makes you cough lots (tickly) ask for a change to another.

As above it seems common and above all fixable and return to normal – still a head funk though.

I had myocarditis post vaccine which swelled the heart massively and made me pretty ill, this lead to diagnosis.

I get the feeling my surgery will be a while off as still physically active. Unsure how much to push training now though and warning signs to push for the op.

From limited research, the pig valve lasts c 15 years whilst the metal is for life with warfarin. The latter, depending on geographical location can be injection or tablets and takes time to balance out and I’ve heard good and bad things on it. I’m weary as bike / back pack solo often and dont fancy bleeding out anywhere.

I understand there is a possibility to insert the new valve via your leg but tends to be US based, otherwise open heart surgery.

@SterlingCrispin if you have any new tech news do ping over, it would be greatly appreciated. And any fact check on the above!

Renton had the op this year and we spoke last year, so plenty of info about.

Good luck and if you want to talk, ping me.

can be injection or tablets

Never heard of warfarin being injected, always thought it was by tablets.  Heparin is injected though.

My 9 year old son

I’ve got a lot of respect for the paediatric cardiologists, my surgeon was taken ill before my valve op and so the team from the nearby childrens hospital (Bristol) came over and did the op. In my fifties I was a lot different to what they were used to.

They will probably tell you about ‘pump head’ . This is where your brain is affected by being on the heart-lung machine and memory and eyesight can be affected, thankfully it tends to be temporary but allow a good 6 months or so before going to the opticians.

Hey Ruddy,

Mine looks as though the op’s going to be in the next 2-3 months… No blood pressure medication involved. BP lower in the mornings and getting higher during the day but not excessively high.

Due to my ‘young’ age it is going to be open heart surgery rather than a replacement through the veins as this type of replacment lasts longer. Their surprise was that there were no prior indications of anything wrong. No aches, no pains etc.

Good Luck too.

@Natrix Thanks for the additional info.

@Ruddy

I’m weary as bike / back pack solo often and dont fancy bleeding out anywhere.

I am on warfarin and have bikepacked (including a 4-month, 6000 mile ride round Britain).

Biggest issue I’ve had over the years is thigh haematomas – bleeding into the thigh muscle following a fall.  Off-road I now wear crash pants with thigh protection (Endura MT500 Protector Undershorts II – or equivalent). Knee pads too.  Took a massive crash at Comrie on Tuesday and walked away with minimal bruising so that cheered me up 🙂

With warfarin small cuts can bleed forever – or so it seems. So I carry plasters with clotting agents, and at home have haemostatic bleed control bandages. Designed for severed limbs but you can never be too careful.

Go ride !

Holy Thread Resurrection !!

How are you getting on Keando

Hi Renton,
Thank you for asking.
Things are moving along but I’m still waiting for a date for the operation. Have noticed that I can breathless quicker an more easily than when I was first diagnosed.
Not had to take any other meds part from those I was already on following the TIA. I’ve spoken with the Cardiologist and had a pre-assessment meeting at Harefield Hospital so hoping that it won’t be too long now. Made a decision on the valve I’m going to have. This will be the tissue valve so there should be no need for Warfarin going forward. The concern for the consultant was the potential for internal bleeding rather than an external bleed which can be controlled by applying pressure to the wound.
Next up is a CT scan after which I am hoping I’ll be given an indication of the date.
Getting a bit fustrated as I have done some form of sport all my life and now I’m not allowed to anything strenuous. The last ride on the bike was the day I ‘fainted’ at the begining of October. Been walking occasionally but not so as to put any strain on the heart, so a lot of sitting around – not good after Christmas…
The good thing is that my wife wont let me do anything strenuous around the house – so no lifting boxes , cleaning, gardening etc.

It’s a piece of cake these days!  My missus has just had an aortic valve replaced with a bit of bacon. A long (12 hour) operation and she felt like shit for a week or so, was out in 10 days and no ongoing meds! She’s on Bisoprolol temporarily but the Co-codomol hasn’t been bothered. Now getting restless and bored, waiting for re-hab physio work.

You’ll walk it!

@Suburbanreuben Thank you for the feedback, glad to hear that your missus is making a good recovery.

@Renton How are things going following your op?

@Ruddy Has there been any developments/progress for you too?

@keando so far so good. I had my op in July 2022 and had a metallic aortic valve (called on-x) and an aortic root graft to remove an aneurysm.

I had a complication in my operation that when they removed my aortic valve they damaged the electrical pathway between top and bottom of my head which meant I needed a pacemaker

as my heart was pretty tired from having to pump so hard I’ve ended up with a low ejection fraction since coming out of hospital and so they decided to fit a different pacemaker this year called a CRT-P which is basically a 3 wire PM that makes your heart work much better

meds wise I’m on warfarin and a few other things like bisoprolol and entresto to try and protect my heart function now.

i don’t feel to bad to be honest, still get breathless walking up stairs which is bizarre but they maybe down to a fitness level thing.

I had conflicting advice from the consultant to the surgeon about exercising one told me stop and then the other told me to crack on. Advice on here was to listen to the surgeon over the doctor or consultant.

happy to have a chat offline if you want mate.

@Renton Good to hear that you are making progress following your complication.

Thank you for the offer.

Holy thread resurrection time Part 2.

An update for those that had asked previously and responded to my initial request for info.

Had the Aortic valve replaced on the 16th April at Harefield Hospital. Was discharged from hospital 5 days after the operation.  I am now 4 weeks post op. Wound healing nicely, chest still sore as the sternum is still sorting itself out.

Following discussions with the surgeon I had the Edwards INSPIRIS RESILIA Aortic Valve – Bovine tissue. So no need for Warfarin etc. Expected life of the valve is 15 -20 years, the valve has been designed so that a TAVI replacement valve can be used in the future should this one start failing.

When they removed the old valve they could see that it wasn’t a congenital defect as originally thought and that two of the leaflets had stuck together causing the valve to become bicuspid.

It feels strange as when things are quiet I can feel my heart beat, which is something I had not noticed prior to the operation. My wife says she can hear the beat rather than the wooshing sound that my heart made prior to the operation.

Slowly get getting back to some resemblance of normality. Did one of the Cardiac rehab exercise sessions last week – that was fun as I hadn’t done any strenuous exercise since I was diagnosed 7 months ago.

Doing regular walks up to 4 miles at a time at a comfortable pace, but not yet allowed to get on a bike / turbo trainer. Hopefully this won’t be too much longer but listening to the advice from the rehab team.

Thank you to all that had provided feedback and messages of support etc.

Keando – great to hear things are going well.

A TAVI (Transcatheter Aortic Valve Intervention) replacement valve sounds like a massive improvement for the replacement – and you’ll not miss being on warfarin.

Improvements in medical device technology are ace 🙂

Good luck with it all Keando.
My wife got a mechanical valve job in 2005, but in the end a transplant was the best option for her in 2018.
She has never been stronger in her whole life than she is now.
It’s amazing what the doctors can do these days.

It sounds like you’re doing what you should be and getting plenty of exercise which I found really helped me. I had my aortic valve replaced about 4 years ago with a mechanical one and although it took me a while to get over the op, I’ve had a really positive experience over all. My scar can be sore or itchy at times (it feels like sunburn so I guess it’s still nerve damage) and I can hear my ticking most of the time but I’ve learnt to zone it out mostly.

Good luck with your recovery.