If this is your first visit, be sure to check out the FAQ in HCMA Announcements. You may have to register before you can post: click the register link above to proceed. To start viewing messages, select the forum that you want to visit from the selection below. Your Participation in this message board is strictly voluntary. Information and comments on the message board do not necessarily reflect the feelings, opinions, or positions of the Hypertrophic Cardiomyopathy Association. At no time should participants to this board substitute information within for individual medical advice. The Hypertrophic Cardiomyopathy Association shall not be liable for any information provided herein. All participants in this board should conduct themselves in a professional and respectful manner. Failure to do so will result in suspension or termination. The moderators of the message board working with the HCMA will be responsible for notifying participants if they have violated the rules of conduct for the board. Moderators or HCMA staff may edit any post to ensure it conforms with the rules of the board or may delete it. This community is welcoming to all those with HCM we ask that you remember each user comes to the board with information and a point of view that may differ from that which you hold, respect is critical, please post respectfully. Thank you

Announcement

Collapse
No announcement yet.

15 days post papillary muscle relocation/reorientation and myectomy

Collapse

About the Author

Collapse

joepgh DX w/ HOCM April 2015 Symptomatic a few years before DX Obstruction due to elongated MV /papillary muscle Find out more about joepgh
X
  • Filter
  • Time
  • Show
Clear All
new posts

  • 15 days post papillary muscle relocation/reorientation and myectomy

    I am 15 days post surgery at Cleveland Clinic and doing well.

    My operative report says..... we inspected the subvalvular apparatus and then what I did was detach the most anterior head from the anterolateral wall of the left ventricle and from its middle components of the anterolateral papillary muscle head and then keeping the orientation of the chordae intact, I reattached with pledgeted mattress sutures through the fibrous head to the most posterior aspect of the anterolateral papillary muscle complex. We then reoriented the posteromedial papillary muscle head, performed our simple myectomy, taking out 3 g of muscle and then we irrigated, closed the aortotomy, easily separated from bypass.

    So as the cardio and surgeon told me pre op the primary issue causing SAM/LVOTO was papillary muscle/mitral valve complex and not so much thickness of the septum.

    The whole experience looking back now was not that bad. Not painful but more an uncomfortable experience at times. I had never spent a day in the hospital before this surgery.

    Monday- Blood work, chest xray, ekg, catheterization. They were pros at the Cath and it did not hurt at all. Just a long day.

    Tuesday- Met with Anesthesia and surgeon.

    Wed – Surgery was only 3 hours. Woke up with tube down throat but I calmed down and it was out not too long after I awoke. I am a gagger and it was not bad.

    Thursday- My one day in the ICU. They had me sitting for a good part of the day with two suitcases. One for blood and the other for urine. I never looked down to see the tubes coming out of my upper abdomen. I felt no reason to look at these tubes. Moved to regular room later in the afternoon.

    Care in the ICU is first rate. Even though you are beat up you are aware that the staff is extremely competent and caring. Never been in the hospital before but cannot imaging better care than the CCF ICU.

    Friday- Felt pretty good and was walking a bit after they removed chest tubes and catheter. Maybe a little cocky and figured if I did not feel so bad after just 48 from surgery then my recovery would be a breeze, however, I kind of hit a wall on Friday night (worst night) and continued into Saturday.

    Saturday- I was miserable this day and felt better the day before. Constipation was an issue for me. I think days 2 through 4 you kinda just gotta grind through as time goes slow. I did not like the bed in the step down. I was uncomfortable and never really got much sleep as you are interrupted every 2 hours for some sort of test such as vitals (BP, TEMP, O2SAT), glucose, heparin shots in the stomach (not painful), daily weigh in, meds, meals. All this stuff is annoying but necessary.

    Sunday – Still miserable but much relief after I finally went #2 in the afternoon. Watched my Steelers lose to Denver Broncos on Sunday night and went to bed. Was really starting to dread spending another evening in that hospital bed.

    Monday- Had an echo with amyl nitrate (first time with amyl nitrate) in the AM. Had a headache most of the rest of the day due to the amly nitrate, however, the results were satisfactory for my release from hospital. Took my first shower, put on new sweats and waited for wheelchair down to my ride home to Pittsburgh at about 5pm. Stopped halfway home to walk at a panera and a eat half a sandwich. I was quite tired and just wanted to go home (my sister’s house as she is totally caring for and spoiling me). Was totally drained when we got home around 8pm and I went straight to bed and slept no problem at all for 12 hours straight.

    No real pain since just a sore back from having to sleep on my back. I am a side sleeper. So far so good and hoping this progress continues. Still have constipation issues even though I have cut back on pain pill to just 1 before bed time. Hopefully this improves. I had my first post op check up at CCF on Tuesday and everything ok just some minor inflammation around the heart which they say is normal and should continue to dissipate.

  • #2
    Congratulations on an uneventful post-op course! Sorry about the Steelers ( Not really, I live in Denver LOL). Your day by day matches a lot of what I remember and I'm sure others too! Papillary muscle reimplantation is an art.... And CCF has one of the worlds best artists....I assume it was Dr. Smedira... Try a glass of prune juice in the evening for the slow intestines.....Walking also helps things get moving. Be sure to post us about how your HCM symptoms improve over the next few months.
    Again Congratulations!
    After years of symptoms:
    Officially Diagnosed HOCM 2006
    Myectomy 3/11/13 at non-COE
    Extended Myectomy 7/23/14
    At Mayo with Dr. Joseph Dearani

    Comment


    • #3
      Hi Jill. Yes, it was Dr Smedira. I quit the pain meds and constipation has resolved. Yes, prune juice is good. They gave it to me at CCF. CCF was going to take more drastic measures if it did not work. Hard to tell how much better I feel yet. Hopefully still early in recovery and more improvement to come. I will be rooting for Broncos tonight. Hopefully a good game. Peyton Manning has a chance to ride off into the sunset a champ. Hard not to root for that but up against a very tough opponent.

      Comment


      • #4
        Glad to hear your progress.... There will be inevitable ups and downs, and each recovery is different. I agree about the super bowl.... Carolina is young, they can always come back next year.... I'd like to see Peyton win and retire with the honor he deserves for a great career. GO BRONCOS!
        After years of symptoms:
        Officially Diagnosed HOCM 2006
        Myectomy 3/11/13 at non-COE
        Extended Myectomy 7/23/14
        At Mayo with Dr. Joseph Dearani

        Comment


        • #5
          Hi Joe,

          Hope you're doing well.

          Your post caught my eye because we have a lot in common. First, I am scheduled for septal myectomy with Dr. Smedira at CCF on Oct. 19th. Second, we share a lot of characteristics pre-surgery. My septum is not too thick, around 1.2-1.4 cm before 2015, but more recently 1.5-1.9 cm. My resting gradient, like yours, used to be low--single digits--but has now shot up to 65 mmHg. My exercise gradient has gone from 100 to 170 mmHg. Also, am an avid exerciser, but have seen a gradual decline in fitness--now find jogging impossible, a slow 5 mile bike ride is my new limit.

          I see that you haven't posted since Feb 2016, so am wondering how your recovery's going.

          I would welcome any advice regarding surgery with the CCF team.

          Thanks!

          Comment


          • #6
            The CCF surgical team is one of the best in the world for HCM surgery.....You will be in good hands.
            After years of symptoms:
            Officially Diagnosed HOCM 2006
            Myectomy 3/11/13 at non-COE
            Extended Myectomy 7/23/14
            At Mayo with Dr. Joseph Dearani

            Comment


            • #7
              Jill,

              Thanks for your reassurance.

              Has anybody heard from Joe? Hope his symptoms have long since resolved.

              Comment


              • #8
                Hi CatCyclist33,

                I see you have surgery coming up in a couple weeks. That is good. The obstruction will not go away on its own. I wish I would have been diagnosed sooner and had the surgery done earlier. I am better than I was going into surgery but not as well as I was before the whole HCM discovery process began. I still have HCM and have aged a bit too but I do walk 2 to 3 miles 2 to 3 times a week and grateful for that.

                No advice regarding surgery with CCF team really except just let them handle it. They were great and know what to do. I agree with JillC that they are one of the best teams in the world. Not sure if there are any surgeons out there who have performed more myectomies than Smedira. That is what you want. Someone who when they go in there has seen many different HCM anatomies and can determine the best surgical procedure to perform.

                Good luck and I have no doubt you will do well.

                Joe

                Comment


                • #9
                  Hi Joe,

                  It's really great to hear from you. You had quite a detailed description a couple years ago, and I was wondering where you are now. It seems like fewer people are on this board now, so it's good to see people return.

                  It seems like most people here seem to fall into two main camps, the "still have HCM", but doing better group, and the completely forgotten they have HCM, the sky's the limit group. Probably the first group--people like you--is larger. A third group, those who didn't see much benefit, or maybe got even worse, seems to be smaller. I don't know where I'll be after surgery. I guess the key is to set realistic expectations. It is easy to get carried away and dream of doing 30-40 mile bike rides again. Gratitude for what we have, including access to the best HCM centers in the world, is most important.

                  One of the things I am hoping for is being weaned off beta blockers, metropolol in my case. I believe it exacerbates my fatigue and depression. Did they make any adjustments n your dosage?

                  Thanks again for you encouragement, and hope to hear from you again.

                  Udayan (aka CatCyclist)

                  Comment

                  Today's Birthdays

                  Collapse

                  There are no members with birthdays today.

                  Working...
                  X