Aortic Valve Replacement with known CAA

Posted by bforbes @bforbes, Jan 15, 2020

Seeking information regarding having Aortic Valve replacement with known CAA. My mom needs to have this done. Her cardiologist is concerned about the increased risk of another cerebral hemorrhage since she will have to have large doses of blood thinners during the surgery. Any insight/experiences would be much appreciated.

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Hi, @bforbes - welcome to Mayo Clinic Connect, and apologies on my tardiness in doing so. Sounds wise that you are looking into any potential risks for your mom prior to the aortic valve replacement.

A few members who have talked about CAA and who may have some input on potential increased risk of another cerebral hemorrhage with having large doses of blood thinners during surgery include @shedwina @coloradogirl @bortner @thomaslmason @gbiffart @sistertwo. @hopeful33250 also may have some thoughts for you.

Is the surgeon willing to take on her surgery at this point, with some risk mitigation, or is she or he not recommending going forward with the surgery? Have you looked into the option of getting a second opinion?

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Hello @bforbes,

I can certainly understand your concern for your mom regarding the possible surgery to replace her heart valve. I would be concerned as well. You do not mention your mom's age nor when she had the CAA. How is she doing since the stroke?

Do you know what type of aortic valve replacement the doctor is planning? There is a non-invasive type of surgery that can be done on elderly folks or others who are at risk for open-heart surgery. It is called TAVR and is done with a catheter (rather than by opening the chest). You would probably need to talk with a specialist about the need for blood thinners with this type of procedure. Most likely blood thinners would still be required. Here is a link with information about this procedure,

https://www.mayoclinic.org/tests-procedures/transcatheter-aortic-valve-replacement/care-at-mayo-clinic/pcc-20384700?

If you and your mom decide on having this valve replacement I would certainly recommend a second opinion at a well-known heart institute such as a Mayo facility or a university medical center that has a good reputation for heart surgery and specifically valve replacement.

How long has your mom had an aortic valve problem?

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@hopeful33250

Hello @bforbes,

I can certainly understand your concern for your mom regarding the possible surgery to replace her heart valve. I would be concerned as well. You do not mention your mom's age nor when she had the CAA. How is she doing since the stroke?

Do you know what type of aortic valve replacement the doctor is planning? There is a non-invasive type of surgery that can be done on elderly folks or others who are at risk for open-heart surgery. It is called TAVR and is done with a catheter (rather than by opening the chest). You would probably need to talk with a specialist about the need for blood thinners with this type of procedure. Most likely blood thinners would still be required. Here is a link with information about this procedure,

https://www.mayoclinic.org/tests-procedures/transcatheter-aortic-valve-replacement/care-at-mayo-clinic/pcc-20384700?

If you and your mom decide on having this valve replacement I would certainly recommend a second opinion at a well-known heart institute such as a Mayo facility or a university medical center that has a good reputation for heart surgery and specifically valve replacement.

How long has your mom had an aortic valve problem?

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Thanks for your response. My Mom initially had the valve replaced in 2012 & it has narrowed again. After speaking at length with her cardiologist again, she's decided to take a "wait & see" approach. Since she's not having any major symptoms, mainly just fatigue, her cardiologist felt this was a reasonable choice. At age 82, quality is more important than quantity when risk of surgical complications are likely very high.

Her cardiologist had mentioned TAVR which also would require mega doses of blood thinners.

REPLY
@lisalucier

Hi, @bforbes - welcome to Mayo Clinic Connect, and apologies on my tardiness in doing so. Sounds wise that you are looking into any potential risks for your mom prior to the aortic valve replacement.

A few members who have talked about CAA and who may have some input on potential increased risk of another cerebral hemorrhage with having large doses of blood thinners during surgery include @shedwina @coloradogirl @bortner @thomaslmason @gbiffart @sistertwo. @hopeful33250 also may have some thoughts for you.

Is the surgeon willing to take on her surgery at this point, with some risk mitigation, or is she or he not recommending going forward with the surgery? Have you looked into the option of getting a second opinion?

Jump to this post

Thanks for your response. See my reply to Teresa below.

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@bforbes

Thanks for your response. My Mom initially had the valve replaced in 2012 & it has narrowed again. After speaking at length with her cardiologist again, she's decided to take a "wait & see" approach. Since she's not having any major symptoms, mainly just fatigue, her cardiologist felt this was a reasonable choice. At age 82, quality is more important than quantity when risk of surgical complications are likely very high.

Her cardiologist had mentioned TAVR which also would require mega doses of blood thinners.

Jump to this post

Hi, @bforbes - wondering how your mom is doing?

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