Jump to content
BANGKOK 19 June 2019 05:38
Mobi

Aortic Heart Valve Replacement Surgery – Anyone Had Any Personal Experience?

Recommended Posts

I have suffered from narrowing of my coronary arteries for more than 10 years, but never sufficiently bad enough to warrant the insertion of stents. This has always puzzled me as every time I complained of severe symptoms (arm and chest pains, high BP etc), I was given an angiogram and then effectively given an ‘all clear’.

I have been taking beta blockers and BP reducing drugs for years which generally, have succeeded in keeping my BP under control and my heart rate in the 50’s.

Then in mid-2010, I was admitted to a hospital for an operation on my wrist, and they did some stress checking on my heart and told me I had ‘moderate’ aortic stenosis.

Then towards the end of last year, I was having trouble in keeping my BP under control, despite the drugs, and I was also so unfit that even a short five minute stroll was enough to cause breathlessness, dizziness and arm and chest pains. So I went to see the heart specialist in Bangkok last December for the first time in 3 years.

She had planned to give me a stress test, but during the echocardiogram, prior to doing the stress test, they came to the conclusion that my the condition of my aortic valve deteriorated since they had last examined it and cardiologist told me that it looked like I was going to need a valve replacement. They didn’t even bother to do the stress test.

Anyway, she increased my BP drugs, told me to try to lose weight and get more exercise and see her again in early March, but warned me that if I had any repeat of the extreme symptoms (breathlessness, chest and arm pains) then I should make an immediate appointment to see her.

Since then, I have been getting myself much fitter, ( I can now walk briskly for around 50 minutes a day without any adverse reactions), I have lost about 10 kilos in weight and after a slow start, I have succeeded in getting my BP under better control.

However, I take my meds twice a day – morning and evening - what is happening is that after I take the meds, my BP comes right down (as low as 110/50) but gradually increases and by the time I come to take my next dose of meds the systolic is back up to well over 150.

When I see the doc next month, I am concerned that the she will tell me that I now need to replace the valve which will put me back around 1 million Baht – give or take - whether I have it done in Thailand or the UK.

Now I am fully aware that it is a foolish idea to get medical opinions over the internet and I fully plan to see what the doc says and then get a second medical opinion. But my fear is no one will be completely honest with me and they will all urge me to have the op, even though it may not be necessary, at least not yet.

I am 65 and a long term, insulin dependent diabetic, so major surgery will always be a risk.

So I would be grateful if anyone out there has had a similar experience to mine, (dodgy aortic valve, meds only working for a limited period ), and what was the prognosis? If nothing else, I may have some searching questions to ask the specialist when I do see her.

These days, a million Baht is a lot of money for me and I really don’t want to fork it out unless I absolutely have to, neither do I wish to subject my poor, ravaged old body to unnecessary risk.

So, anyone had any background on this sort of thing?

Thanks.

Share this post


Link to post
Share on other sites
So, anyone had any background on this sort of thing?

i can only add some layman's info Mobi which might be relevant to your concern "surgery risk". three years ago i had open heart surgery (4 cardiac and 1 aorta bypass) in Munich, Germany. after an eight day stay in the hospital i spend another two weeks in a bavarian rehab center. there i met a former famous olympic gold medal winner and during small talk we found out that we had the same surgeon. what puzzled me most was that he had one of his valves replaced by non-invasive "surgery", id est the valve was put in place through an artery the same way stents are placed. could this be perhaps an alternative for you?

Share this post


Link to post
Share on other sites

Thanks for that Nam.

Yes, I had heard about that new alternative procedure, but as far as I have been able to determine, it is at least twice as costly as the standard op in the UK, presumably because it is very new???

This may or may not be correct and I will check further and also ask the good lady Doc when I see her.

Share this post


Link to post
Share on other sites

Thanks for that Nam.

Yes, I had heard about that new alternative procedure, but as far as I have been able to determine, it is at least twice as costly as the standard op in the UK, presumably because it is very new???

This may or may not be correct and I will check further and also ask the good lady Doc when I see her.

can't imagine that it's twice as costly. no sawing up chest bone, no titanium wiring chest bone after surgery, no three days in intensive care wired and hosed up with a pump connected... and... and...

the procedure is not that new. just read that it is done since 2007.

Share this post


Link to post
Share on other sites
the good lady Doc

are you referring to a lady cardiologist in PIH or BPH?

Share this post


Link to post
Share on other sites
the good lady Doc

are you referring to a lady cardiologist in PIH or BPH?

Neither: Bumrungrad.

I don't have much confidence in any hopsital in Thailand, as fas I am concerned, all Pattaya hospitals are no go areas. Not sure I would trust them with an ingrown toe nail.

Share this post


Link to post
Share on other sites

Thanks for that Nam.

Yes, I had heard about that new alternative procedure, but as far as I have been able to determine, it is at least twice as costly as the standard op in the UK, presumably because it is very new???

This may or may not be correct and I will check further and also ask the good lady Doc when I see her.

can't imagine that it's twice as costly. no sawing up chest bone, no titanium wiring chest bone after surgery, no three days in intensive care wired and hosed up with a pump connected... and... and...

the procedure is not that new. just read that it is done since 2007.

I assume you are referring to Transcatheter Aortic-Valve Implantation (TAVI) .

One of the top Heart hospitals in the UK quoted me GBP36K for this as compared to GBP23K for a standard valve replacement. Another wanted a deposit of GBP 60kfor a TAVI as against 30K deposit for a standard op.

I think the valve (which sort of inflates) they insert is very Hi tech - hence the high cost.

Apparently it is for patients with severe aortic stenosis who are not candidates for surgery, due to extreme frailty and other illnesses, and I am not sure I quite qualify for that. I also read that the traditional op is still considered to be more effective for those fit enough to stand the operation.

Share this post


Link to post
Share on other sites

Its a difficult area to judge Mobi. Do get a second opinion for sure. One thing to also consider is that the valves may need replacing at a later stage, say 15 years down the line.

If you are reasonably well I would be looking at leaving it as long as possible. Of course that carries its own risks.

Best wishes whatever your decision. jap.gif

Share this post


Link to post
Share on other sites
the good lady Doc

are you referring to a lady cardiologist in PIH or BPH?

Neither: Bumrungrad.

I don't have much confidence in any hopsital in Thailand, as fas I am concerned, all Pattaya hospitals are no go areas. Not sure I would trust them with an ingrown toe nail.

heart surgery in Pattaya is done by BPH's Bangkok team. by the way, according to what my German surgeon told me Phyathai Hospital in BKK beats Bumrungrad hands down in heart surgery.

Share this post


Link to post
Share on other sites

hi mobi i have sent y a pm.as y see my posting is working.anyone else wants some info on aotic valve replacement i had surgery 2007.depending on your age y have a choice of animal flesh or a mechanical one.

Share this post


Link to post
Share on other sites

hi mobi i have sent y a pm.as y see my posting is working.anyone else wants some info on aotic valve replacement i had surgery 2007.depending on your age y have a choice of animal flesh or a mechanical one.

Hi meatboy, yes, I have read your PM and replied to it. Thank you.

Share this post


Link to post
Share on other sites
the good lady Doc

are you referring to a lady cardiologist in PIH or BPH?

Neither: Bumrungrad.

I don't have much confidence in any hopsital in Thailand, as fas I am concerned, all Pattaya hospitals are no go areas. Not sure I would trust them with an ingrown toe nail.

heart surgery in Pattaya is done by BPH's Bangkok team. by the way, according to what my German surgeon told me Phyathai Hospital in BKK beats Bumrungrad hands down in heart surgery.

I have no doubt the some of surgeons at BPH are eminently qualified - and yes I do know that many travel down from Bangkok - but unfortunately as soon as they hit the Pattaya environs they seem to see dollar signs on the faces of every patient. I just have a mega problem with the ethos of that hospital which has had so many adverse reports of 'screwing'; patients that they simply cannot all be false, and indeed I can relate several of my own experiences to add to the collection.

Of course all this is vehemently denied, and so desperate are they to neutralise this bad publicity that they have had, (and possibly still do have), farang members of staff writing re -joiners and defending the hospital on this and other forums.

You will always get people favouring one hopsital over another, and I am sure Phyathai does good work and I will be investigating that possibility in due course. I very much doubt whether I will have it done at Bumrungrad as - like BPH - they are extremely expensive. But I have been seeing the cardiologist there for a number of years and as she has my full history, including the results of previous stress tests, angiograms etc and their outpatient charges will not break the bank.

Anyway, she is quite cute....that's gotta be worth something.licklips.gif

I am also looking at the possibility of going to Chiang Mai, as I have had good reports about a couple of heart surgeons up there, and it will definitely be cheaper.

But right now, I am trying to determine if I actually need the op, and was hoping to hear from anyone about their symptoms and their BP record during the period leading up to the decision to operate.

Maybe I'll just see what the doc says when I see her next month and take it from there.

Share this post


Link to post
Share on other sites

hi mobi,it all started with high bp.then a cholestral check,high bp,colestral,and feeling out of breath,trouble walking,worst after food,left arm feeling as if a ton weight was hanging on it,so it was keeping me awke all night.i was overweight,used to eat all the wrong foods this i had done for 50years,so i was lucky i have 2daughters that work for surgeons,so i got a private appointment with a consultant.i wrote everything down what i was experiancing,and without any tests he was spot on,blocked arteries and a leaking valve.then followed 2years of testing,echo grams will find any abnormalities with the heart,stress tests on a treadmill,and a cardiogram where they insert a tube[groin]and pump floresant liquid through your veins to see if there are any blockages,in my case i also had a double by-pass[that explains the cost]one thing i didnt get was servere pains in the chest just tightness.i was made to loose 20kilo's before they would operate and this for me was the worst part,i have always been frightned of the dentist,my teeth were in a right mess had to have 13out.for 5years in total that i suffered umpteen tabs,but since the surgery i feel like a new man.mobi if you had to have surgery couldnt you go back to the uk.mine was done at the universaty hospital of wales[cardiff]

Share this post


Link to post
Share on other sites

sorry mobi its an angiogram that is done to look at your blood vessals.

Share this post


Link to post
Share on other sites

With aortic stenosis, surgical valve replacement is basically unavoidable. How urgently it needs to be done depends on the severity. Leaving it too long risks permanent damage to the heart muscle i.e. you could end up needing more than just a valve replacement (or dead).

See http://www.mayoclini...tenosis/DS00418

You do not have to pay a million baht if you are willing to put up with the red tape and inconveniences of a government hospital. The best one for this -- and the one that has bene doing open heart surgery the longest in Thailand -- is Rajawithi Hospital, right at Victory Monument. I helped a Cambodian friend through a valve replacement there and not only checked it out thoroughly but was with her throughout pre and post op period. The mortality rate their for this procedure is around 1% (excellent by international standards), the surgical care impecable. Nursing care is good for what really matters but of course low on amenities and speed of response for non-urgent things can be very slow. (This is for the ward -- last 2 things probably far better in a "hing piset" but at least the 1st 24 hrs you are safer in the ward.

Burearocratic hurdles to jump to get on the schedule there - h=no matter what paperwork you have in hand from other hospitals you have to start at square one: register, be seen by a GP intern, then sent to the cardiologist, then sent for various tests, each of these steps involving long waits and needing a Thai speaker to help you navigate.Took us about 4 days (of daily visits) to get to face to face with the cardiac surgeon and then a couple weeks wait to get an echocardiogram done (wouldn't take report from elsewhere - surgeon who will operate wants to see for himself) then more wait to get in the OR schedule.

Once admitted, smooth sailing all the way and as long as one views it in medical rather than hotel terms, nothing to fault in the care. And being as she was in an open ward I saw not just the care she got but what all the patients got, how the nurses responded to emergencies etc...and my standards are high.

In exchange for putting up with the initial aggravations and red tape, you'll save many hundreds of thousands of baht. Prices will have gone up since then (this was 10 years ago) but at the time my friend had this done, cost at the big private hosps was around 500,000 baht (without complications) and cost at Rajawithi (paying full fee) was around 100,000...so 5 fold difference.

Whether the savings are worth it, only you can decide.

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

  • Recently Browsing   0 members

    No registered users viewing this page.

×
×
  • Create New...