Open Heart for PFO/ASD?

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Dejaboo
Regular Member


Date Joined Nov 2008
Total Posts : 55
   Posted 11/19/2008 9:16 AM (GMT -6)   
I had my Tee Test yesterday.
It was way worse then I expected.

My sedation was minimal. I was Wide Awake.  The probe down my throat was very painful-It Hurt Alot- During the whole Echo.  Maybe I wasnt numbed enough?  I already wasnt numb not even 5 minutes after the end of the test.

Also my Hole in my heart is in a different place then thought & there is a small chance I will need open heart surgery.  I am freaking out & totally Bummed.  He said something like to close to the edge- I already forget.

My Cardio- Must be very good ( I hope)- because Both Nurses said if anyone can fix this with a Catheter procedure he can. 

I need to set up an Appt to discuss my test Results with my Cardio(a Different Dr did the test)...Although he called My Dr. with the results & thats when he told me he thinks he can still fix it.

I feel like I am always unlucky & I will end opn not being a Candidate for The Transcathetor  closure.

How many of you had had to have open Heart Surgery for your PFO/ASD?

Can you share your experience.

 

Also- this Dr asked me who my Neurologist was...I dont have one.   Should I ?

No one ever sent me to see one.

Thanks,

Dejaboo


Miss Helen
Regular Member


Date Joined Aug 2008
Total Posts : 56
   Posted 11/19/2008 1:29 PM (GMT -6)   
I've had two TEEs and they were the worst tests I've ever had. The numbing did very little for me, and the sedation never kicked in for me either.  I feel for you.
 
Although I've not had surgery for a PFO I've had open heart surgery twice, once to replace an aortic valve and the second time to repair an aneurysm of my ascending aorta and replace the valve again.   It's amazing how quick the recovery period is.   They have you up and out of the hospital in most instances within 5 days!  Hopefully you'll be able to have yours repaired without open heart surgery.
 
Your doctor probably wants you to see a neurologist because of the incidence of stroke with PFO.
 
Good luck.

greenhope
Regular Member


Date Joined Oct 2008
Total Posts : 113
   Posted 11/20/2008 10:38 AM (GMT -6)   

Hi, Dejaboo, I'm so sorry to hear you had a bad experience with the TEE test.  I think for most of us the TEE was quite uneventful.  It does sound as if you were not sedated enough.  When I had mine done I did not fall asleep but felt quite drowsy;  I did not feel a thing.  Did they also spray your throat to numb it?

With regards to the neurologist, you may not need one if you no longer have neurological symptoms (I know you mentioned you had a TIA at one point).  However, your doctor MAY need a supporting second opinion before going ahead with the procedure.  I say MAY because it might depend on the facility where the procedure will be performed, the doctor, etc.  I'm not sure what the current protocol is since this is emerging science (PFO closure through catherer) so it seems to change frequently.  Each facility, doctor, state, etc. may have its way of doing things.  Check with your cardio to see if he needs the supporting opinion of the neuro before going ahead with the procedure.

I hope all goes well for you.  You have been through a lot already and it would be easier on your body if they could perform the less invasive procedure with catherer closure.  You sound like you have a good cardio who will take great care of you!  We are all sending lots of positive thoughts your way.

Greenhope

 

 


CatMom5
Regular Member


Date Joined Apr 2008
Total Posts : 88
   Posted 11/20/2008 2:25 PM (GMT -6)   
Dejaboo,

I only needed a neurologist in the very beginning when they were diagnosing my TIA and PFO/ASA. As a matter of fact it was the neurologist that suspected a PFO and asked for a TEE to be done. I guess I was lucky because I slept through my entire TEE. I remember having my throat sprayed then they must have given me something in my IV because the next thing I knew I was being woken up and told that I had a hole in my heart. I'm so sorry that you were awake and in pain during your test.
 
ETA: I had the catheter procedure done with the Gore-Helix device. In retrospect with the issues I had with the procedure and afterwards I think I might have made a different decision and gone with the open heart procedure.

Post Edited (CatMom5) : 11/20/2008 12:28:32 PM (GMT-7)


Dejaboo
Regular Member


Date Joined Nov 2008
Total Posts : 55
   Posted 11/21/2008 8:50 AM (GMT -6)   
Miss Helen- Sorry your TEES were terrible too! But glad it wasn't just me.
I cant imagine recovering quick from open heart surgery & you have had it twice- wow.

greenhope- They did numb my throat- I had to gargle with that terrible 'novacain like' gel & swallow it & then they sprayed my throat about 5 times. My mouth was pretty numb- but not my throat. if I have to have the test again I will speak up & also ask if I can be more sedated. The Dr pushed on my stomach when they ran the saline bubble. I did that 4 times & was like a normal person- no Sleepiness at all- I even watched the Monitor

I so hope it is just the Cathetor procedure. I will let you know what I hear. Still waiting for my Dr to call back : (

CatMom5- Im sorry you have had so many problems after your Procedure. I hope things take a turn for the better & improve each day.
I did have an IV drug & I felt it when they 1st gave it to me. But it only seemed to last for about 2 minutes really.

Thanks for all your replies.
Dejaboo

mlm50
New Member


Date Joined Dec 2008
Total Posts : 3
   Posted 12/1/2008 9:37 PM (GMT -6)   
I would like to know if anyone had a pfo and didn't heal in 6 months and doctor wants to go back in .Is it safe and successful?

CatMom5
Regular Member


Date Joined Apr 2008
Total Posts : 88
   Posted 12/1/2008 11:35 PM (GMT -6)   
Hi mim50,
 
I had my PFO/ASA closure done on April 29th. At my 6 month echo with bubble studdy it was determined that my PFO was still somewhat open. Both the echo technician and my Doctor said that this was normal and that most PFO's take at least one year before they are totally closed by the scar tissue. The technician said that she rarely sees one closed at 6 months. My Doctor does not want to see me again for another 6 months and we'll do another bubble study. He did keep me on the Plavix and 325mg aspirin though. Does your doctor want to go in after only 6 months?

mlm50
New Member


Date Joined Dec 2008
Total Posts : 3
   Posted 12/2/2008 3:26 PM (GMT -6)   
Hello Catmom5,Thank you for responding to my letter so quickly.The person I am writing about is a 68 year old male family member  and he was told by a doctor in Atlanta Ga.that he would like to go back in and yes it was only 6 months .Your note sounds encouraging.I would like to ask you  if you know of anyone a doctor performed a second procedure on and was it successful and perhaps the state it was done in as well as the doctor and hospital . Anything you can find out would help so much .He sees the Doctor again in January 09.Thank you,MLM50

CatMom5
Regular Member


Date Joined Apr 2008
Total Posts : 88
   Posted 12/3/2008 9:55 AM (GMT -6)   

Mim50,

I'm sorry to hear about your family member. I haven't personally heard of anyone needing a second device and in my discussions with my doctor the possibility was never even mentioned. I was curious though after your response so I did some research and apparently this is done in certain cases where a large shunt remains after the first device is implanted and it is done at the 6 month mark. Here is an excerpt from an article I found on the internet. The title of the article is:

Treatment of Residual Shunt After Percutaneous Closure of Patent Foramen Ovale With a Second CardioSEAL® Device

author: 
Raghunandan Kamineni, MD, Richard R. Heuser, MD
 

Case Report
A 58-year-old female with a history of stroke and PFO detected by agitated saline contrast on a transesophageal echocardiography underwent percutaneous closure of PFO with a 23mm CardioSEAL device. She was noted to have a small residual shunt after the PFO-closure device deployment. She was discharged on aspirin and clopidogrel. A follow-up transesophageal echocardiography performed 6 months after the initial device deployment showed a moderate-sized persistent residual shunt at the inferior border of the CardioSEAL device (Figure 1). The patient experienced an episode of transient ischemia attack (TIA), manifested as slurred speech and facial numbness, that resolved completely within several hours of onset. She was then taken to the catheterization laboratory for closure of the residual shunt with a second CardioSEAL device.

Discussion
Persistent right-to-left shunt is seen, on occasion, several months after the initial percutaneous PFO closure. Meier et al. reported a persistent minimal residual shunt in 11% of patients, and moderate-to-large persistent residual shunts in up to 10% of patients following the initial transcatheter closure of PFO.9 Patients with minimal residual shunt might have complete shunt elimination over time,21-22 but patients with moderate to large residual shunts after a percutaneous PFO closure rarely show spontaneous regression of the shunt during follow-up. Unfortunately, such residual shunts are not benign. Patients with residual shunt appear to have a four-fold increased risk for recurrent embolic events compared to patients with complete PFO occlusion.8 Although the best therapeutic approach to treat the residual shunt is unclear, anecdotal reports of second closure with transcatheter closure technique are described in the literature.9 The implantation of a second closure device is similar to and no more technically challenging than the initial procedure.

Conclusion
Persistent moderate to large residual shunts after initial implantation of PFO closure device carry a significant risk of recurrent embolic events. Despite the lack of long-term data, a second transcatheter closure of the residual PFO appears to be technically feasible and safe, circumventing the need for surgical approach.

The authors can be contacted at *link-1endlink**

 

It would seem that your family member still has moderate to large shunting of his PFO. Perhaps you could contact the authors of this article for further information. There were several other discussions I found on this topic. I did a google search on "second PFO closure device" and they came up. Good luck!


mlm50
New Member


Date Joined Dec 2008
Total Posts : 3
   Posted 12/3/2008 11:03 PM (GMT -6)   
Thank you so much for all the much needed research you found .Reading and hearing of others that have walked in your shoes is very comforting.Anything else on this procedure you or anyone out there runs across and would like to send me will be appreciated as well.MLM50

lthree5
New Member


Date Joined Dec 2005
Total Posts : 11
   Posted 4/23/2010 10:12 AM (GMT -6)   
mlm50 - did your family member ever get the second device?  I just had one done last week (second one).

CatMom5
Regular Member


Date Joined Apr 2008
Total Posts : 88
   Posted 4/27/2010 10:40 AM (GMT -6)   
mim50 - how did your second procedure go? Any different than the first? Did you have a large shunting remaining that caused them to do a second device? I'm two years out my closure and still have some small shunting[just had another TEE yesterday] but they don't think they will do anything other than keep an eye on it by doing anual TEEs.

lthree5
New Member


Date Joined Dec 2005
Total Posts : 11
   Posted 4/27/2010 11:58 AM (GMT -6)   
CatMom5 - I had a second device put in on 4/12/2010.  Four years after the first one was placed.  A large residual shunt on valsalva was there with first device, so, they decided to put a second one in.  Just had my 2wk follow up echo and everything is still in place.  I will have a bubble study done in June to see if things are closed up.  They wanted to do bubbles today but I didn't want to do valsalva test (bearing down) because I want it to heal nice and tight first before I bear down.  That is my choice, nothing from the doctor indicating it would do any harm.  Anyway, so far, so good.  I can sleep on my sides again -- was having a hard time breathing when lying on my side for a few months prior to second device.

onehotsauna
New Member


Date Joined May 2010
Total Posts : 1
   Posted 5/15/2010 12:52 PM (GMT -6)   
For those of you who are thinking about having your ASD/PFO closed, have you researched the Helex septal occluder? It has the the safest history.

stkitt
Elite Member


Date Joined Apr 2007
Total Posts : 32602
   Posted 5/15/2010 5:48 PM (GMT -6)   
For those looking for mlm, the last time this member was online was 12/01/2008. I do not know if they are still reading or not.


Sorry.



Kitt

rmil
New Member


Date Joined Jun 2010
Total Posts : 16
   Posted 8/7/2010 11:44 AM (GMT -6)   
lthree5- How are you doing since your second procedure? I am curious because at my 1 year appointment yesterday they found fairly significant shunting (right to left) with valsalva. That hadn't been a problem at my 6 month appointment...only a few bubbles then. I should know more Monday.

Are you feeling well? Can you tell a difference? I have been having pains, dizziness and fatigue...

Thanks! I hope you are recovering well!

bpw
New Member


Date Joined Nov 2011
Total Posts : 3
   Posted 11/9/2011 9:20 PM (GMT -6)   
CatMom5, just wondering what your doctor's reasoning was not to give you another device. After 2 years, I have slight residual shunting across the device. Has your doctor told you that there is no added risk of another stroke?
Thanks in advance for your reply

stkitt
Elite Member


Date Joined Apr 2007
Total Posts : 32602
   Posted 11/10/2011 8:02 PM (GMT -6)   
bpw,
 
I am sorry but you have posted to a thread that is 2 years old. CatMom has not posted is well over a year.  Would you like to start a thread of your own on this topic ?   Feel comfortable starting your own thread.
 
Kindly,
 
Kitt
~~Kitt~~
Moderator: Anxiety, Osteoarthritis,
GERD/Heartburn and Heart/Cardiovascular Disease.

www.healingwell.com

"only as high as I reach can I grow, only as far as I seek can I go, only as deep as I look can I see, only as much as I dream can I be"

Post Edited (stkitt) : 11/10/2011 6:05:53 PM (GMT-7)

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