So, yesterday was the second follow up CT angio on my husband’s bio aortic valve and another big improvement. The clot on the one valve leaflet has regressed to “trace”.
For a recap… in March, just over 5 years after husband’s emergency bio-Bentall procedure, he had what we’d all hoped/expected would be the last of his visits in the official “post op” period. 'Twas not to be. CTangiogram showed a pretty big clot on one leaflet. Long discussion with intervention cardiologist and it seems this isn’t a rare phenom. Not common enough to warrant permanent anticoagulation beyond the initial 3 months post op period (as with mechanical valves) but Warfarin not necessary. Eliquis was the one. Valve replacement by TAVR in the event of the valve failing.
July was angio #1. Clot already showed signs of resolution so 3 more months on anticoag. Now today’s. Along with discussion with his cardiologist, husband has decided on continuing with anticoagulation. Minimal risk of bleeding ***as compared with another clot formation *** (Google might not offer this nuance with its earnest discussion on anticoagulation therapy post HALT)
Quite a weight off both our minds. Leaves a bit more room for fretting about this albatross round our necks. Final orders hearing for the divorce first week of December…allegedly. If only that nightmare would end as well.
Thanks for the update. Wishing your husband complete resolution of this problem.
I will have an angiogram next Wednesday in preparation for my aortic bio-valve and ascending aorta replacement on Nov. 19. I asked my surgeon if this is a Bentall procedure and he said no since the Bentall involves the coronary arteries. I should have asked for more details. Next time I see him after the surgery (assuming I survive) I will ask for a diagram.
How was your husband’s clot discovered in the first place? What’s the followup after valve replacement?
For my husband, the coronary arteries were involved because of the degree of reconstruction necessary. Incidentally at the post surgery pathology scrutiny of both the dud aorta and the few coronary arteries that’d been dissected out,cwe found out that my daughter had been right…the ascending aorta was beginning to dissect (the surgeon wasn’t being overly pessimistic in amount of time for decision making…he’d already cleared his OR list on Tuesday afternoon by midmorning Monday, shortly after he’d seen my husband)…but coronary arteries clean as a whistle. No coronary artery disease noted post mortem, right?
So post surgery and discharge, he saw the surgeon again about 10 days later and another couple of times to keep a check on healing. The intervention cardiologist entered around 3 months an the first CT angio. Leap frogged with seeing the two fo about a year then, no more need for the surgeon to see him and just the intervention cardiologist every 6 months for CTangio. That’s how it was detected…on the very last appointment he expected to have before cutting the lifeline (he actually felt like that a bit) A thickening of one of the leaflets …called HALT, HypoAttenuating Leaflet Thinkening, most likely a clot, given that there were no signs or symptoms.
I imagined he might be going back on Warfarin…like the first 3 months post surgery. Not the end of the world but still a nuisance to have to go for frequent bloodwork. Nope, Eliquis was the recommendation.
The cardiologist just called to speak to him and they both decided he would be fine staying on for at least another 3 months. Husband went to great pains to point out that whatever triggered the clot formation is still there, in all probability, so he’s up for taking the stuff long term (like me). His cardiologist did point out the limited data on long term treatment but husband is capable of objective personal risk assessment, so that’s the story. Keep on doing what you’ve been doing.
P.S…my husband has the images taken over the past 5 years, I think, so I’ll see if he can transfer them to me and I’ll post a few to eyeball. It’s all quite a feat of engineering.