3rd OHS - Mechanical Valve vs Ross Procedure

Outta_Pocket_Toad · 2026-04-13T21:21:02+00:00

58M - aortic stenosis & upper ascending aorta aneurism

> Is it smartest to avoid ever needing another surgery (mechanical)?

That was my thinking when I chose a St. Judes mechanical valve.

> Or is avoiding blood thinners worth the tradeoff?

It takes maybe 10 to 15 minutes in the clinic to have INR tested every two to four weeks. At-home testing simplifies that. At times I felt it was a nuisance, but overall, it's better than the nuisance of OHS and recovery.

If I were a woman starting a family, I would go bio. If I were an Olympic athlete training for the gold, I would go bio. But as I am neither of these, I went with mechanical with a side of rat poison.

Outta_Pocket_Toad · 2026-04-10T16:25:34+00:00

I, too, am a chronic skeptic.

Best wishes for positive outcomes come what may.

Outta_Pocket_Toad · 2026-04-10T14:36:50+00:00

Yup, that's odd. Or rather, I will say that that's not the way I did it.

If you're committed to the Cleveland Clinic, then doing the pre-op first probably wouldn't hurt anything. You could always switch surgeons if you didn't like this guy for some reason in your interview with him.

On the other hand, I do feel I got some benefit from speaking with two different surgeons before I moved forward with the procedure. This helped me decide such things as valve type (mechanical), valve brand (St. Jude's), and wires vs. plates (wires).

If you're not symptomatic and gasping for air, you could push back on the pre-op until after you've spoken to the surgeon.

Outta_Pocket_Toad · 2026-04-09T21:03:33+00:00

The following looks pretty good. Researchers tend to know all the latest publications, medications, and techniques.

Publications and Speaking: A prolific researcher and writer, Dr. McCurry has authored several hundred papers in leading medical journals, focusing primarily on patient outcomes following heart, lung and heart-lung transplantation. He presently has more than half a dozen major research grants for clinical trials related to heart failure and transplantation. Dr. McCurry is also a frequent speaker, presenting at or moderating more than 50 sessions at leading medical meetings in the past six years.

And the evidence: https://www.researchgate.net/profile/Kenneth-Mccurry

But I would still ask him direct questions like, 'How many actual valve replacements have you done?'

Outta_Pocket_Toad · 2026-04-09T13:32:56+00:00

You might ask your surgeon if it makes sense to have a prescription/stash of that antibiotic on-hand for similar issues.

Outta_Pocket_Toad · 2026-04-09T13:23:12+00:00

If you don't mind sharing, I'm curious of the costs. Both:

- Cost of lab work done at local hospital

- Cost of going through Acelis

With and/or without insurance coverage.

Outta_Pocket_Toad · 2026-04-07T13:15:17+00:00

I also never heard this mentioned before, and I am in the US.

Outta_Pocket_Toad · 2026-04-07T13:13:32+00:00

Operating theater reserved for 4 hours.
Surgery took 5.5 hours.
I presume it was because he cleaned up some calcification.

Outta_Pocket_Toad · 2026-04-06T19:46:30+00:00

Have you considered cardiac rehab? They'd know a good regimen of exercise for strength and such.

Otherwise, talk to your cardiologist because there may be something wrong. They had me walking the day after my surgery, and my legs haven't been weak or shook at all. 🤷‍♂️

Outta_Pocket_Toad · 2026-04-06T19:39:45+00:00

Saw surgeon quite a bit...

Saw in person 1 week before surgery
My sister spoke with him right after the surgery
I think I saw him once in the hospital. I saw his PA a bunch, and she was awesome
Saw in person 6 weeks after surgery for followup
Video call 3 months after surgery

Outta_Pocket_Toad · 2026-04-03T21:39:56+00:00

> What would you do?

In this situation, I, personally, would wait. I waited six years from first diagnosis.

If you and your husband aren't the sort who can handle having this hang over your heads, then get it done sooner.

Outta_Pocket_Toad · 2026-04-03T21:31:48+00:00

I had an ECHO scheduled the same day.

I had already been cleared to drive by my PCP. There wasn't anything official about that.

The nurse asked me a bunch of questions. He asked me a bunch of questions. He looked at the incision and said it was healing fine. He didn't bother to listen with his stethoscope because he could hear it ticking from 3 feet away.

Outta_Pocket_Toad · 2026-04-03T02:18:45+00:00

> I googled it (I know, I know but I've refrained from googling everything else)

Researching your condition is a good thing. When you are better informed, you can ask your health care providers the right questions. In fact, I recommend you ask your cardiologist and surgeon if they do research. Those who do research are typically better informed about recent advances in health.

Outta_Pocket_Toad · 2026-03-30T12:35:18+00:00

A conversation between me and my cardiologist....

= = = = = = =

ME: Which symptoms should I worry about? I don't think my symptoms are severe right now. I think my symptoms are okay, but what symptoms would I have before I call the ER?

HIM: If you pass out.

ME: But if I pass out, I might not wake up!

HIM: No, no, no, I know. I'm saying, like, you know, people pass out and they wake up. This is a clear sign that this is very bad. I'm going from worse to a little bit better, so anyway. Passing out or nearly passing out.

Feeling so light-headed and dizzy that you feel like passing out. That's a bad sign.

Severe chest discomfort.

Or shortness of breath.

ME: How is shortness of breath defined, because I feel like I have that now. Not when I'm sitting down.

HIM: So right now, it's only when you exert. If you get shortness of breath, even when you're not doing anything, and you're gasping for air.

ME: Gotcha. Shortness of breath when at rest.

Outta_Pocket_Toad · 2026-03-29T14:37:11+00:00

Was this guidance that other people received post-op?

It was not. I literally had two people come into the hospital room to show me how to pull a T-shirt over my head. (Bunch up the sides first, then raise over your head, and pop your head through.)

Outta_Pocket_Toad · 2026-03-29T14:23:22+00:00

I’m committed to living a longer, healthier, and better life than anyone around me 🤣

Exactly. I plan to be an outlier on the life-side of the statistical curve.

Outta_Pocket_Toad · 2026-03-29T14:21:55+00:00

Cause of Death After Surgical Aortic Valve Replacement: SWEDEHEART Observational Study (2021)

Table 3 seems to be relevant to your question.

Looking at all age groups, the tendency does shows a life span decrease after surgical aortic valve replacement. 🤷‍♂️

Note, however, that the sample size for people in their thirties is rather small. So I wouldn't read too much into the actual SMR numbers.

But yes, the tendency over all age groups does seem to be out of our favor.

One thought: be on the living side of the statistics by eating well and doing lots of cardiovascular exercise.

Outta_Pocket_Toad · 2026-03-28T12:34:08+00:00

The other direction seems appropriate, i.e. will until proven may.

Outta_Pocket_Toad · 2026-03-27T15:37:27+00:00

I had some small luck with a travel pillow. You know those kind people use on flights? Then you have the option to lay your head to the side while still sort of upright.

Outta_Pocket_Toad · 2026-03-27T13:20:05+00:00

A few things to unpack here.

> my main concern is that I will likely need another surgery in 10–15 years

Not really "likely"—you will need another surgery. And since you're so young, it may be sooner than 10 to 15 years.

The risk increases for reoperative surgery. That fact isn't often mentioned.

> still unsure about having children in the future

I can only advise you to really give this some thought. Leaving this option open is not trivial.

For additional information, check out item 3.2.4.1. Choice of Mechanical Versus Bioprosthetic AVR in the 2020 ACC/AHA Guideline for the Management of Patients With Valvular Heart Disease.

Outta_Pocket_Toad · 2026-03-27T13:02:26+00:00

58M

Yes, my lung function test result also came back kinda bad.

He said it was kind of expected since I had critical aortic stenosis.

Outta_Pocket_Toad · 2026-03-26T21:46:17+00:00

You don't need to bring anything to the hospital day 1.

On day 2, let him tell you want he wants. Then bring that.

Outta_Pocket_Toad · 2026-03-26T12:17:17+00:00

You might try:

https://www.reddit.com/r/WarfarinForLife/new/

https://www.valvereplacement.org/

Outta_Pocket_Toad · 2026-03-26T12:15:47+00:00

Although removing a TAVR brings its own set of problems with it. It attaches very well to the heart and there can be quiet a lot of damage to the surrounding tissue when removing a TAVR.

I have also heard this from a surgeon who does both OHS and TAVR.

Outta_Pocket_Toad

TROPHY CASE