u/Macholegend

Hello all, my father (80/m) had the TAVR procedure done on Friday at a highly reputable university hospital. The doctor performing the procedure has done over 700 of such procedures per year successfully. The original plan was for my dad to stay one night after the procedure for observation and I could pick him up today (Sunday).

In my dad’s case the procedure lasted double the amount of time anticipated (4 hours instead of 2 or less). I come to find out his femoral artery was pierced somehow to a point that a vascular surgeon needed to be called-in to hand-stitch the wound closed. My dad lost 2 pints of blood. We were told afterwards that this is extremely rare but does happen and that he needed to stay another day to make sure the stitching heals properly.

While he’s there recovering his heartbeat is also being monitored. It was determined my dad had a lower-than-normal heartbeat and that he was experiencing “heart block”. Heart block is a delay or interruption in the electrical signals traveling from the heart’s upper chambers to its lower. It is essentially an electrical malfunction that can cause a lower heart rate or skipped beats. So a temporary pacemaker was hooked up. They are now recommending a permanent pacemaker if his conduction system does not improve - there is still hope that it does. A determination will be made tomorrow (Monday).

In reading up on the pacemaker’s effectiveness after TAVR I’m seeing that in the short term it is effective. Long term effects are more questionable. According to studies I’ve researched some cases of permanent pacemakers inserted after TAVR increase the possibility of heart failure over time. I’m assuming because the heart depends on the pacer to beat and doesn’t rely on its own strength alone to beat, which would promote a strengthened heart.

If my dad’s heart conduction system does improve a bit and given a choice he is leaning towards asking for a heart monitor he can go home with and have constant monitoring instead of having a permanent pacemaker. If the monitor shows worsened heart block he can always go back to have the pacemaker installed. On the other hand perhaps his conduction system improves as his heart adjusts to the new valve and never looks back. The question I have is this too risky? I don’t want him going for a walk and feeling like he’s going to faint, or even sudden death. Any advice one can lend with experience would be greatly appreciated.

Off subject but for those in this sub who happen to be cardiologists could this heart block have been avoidable? I’m reading that the type of valve (balloon expanding vs self-expanding) and the surgeon’s ability to position the new valve the correct way (not interfering with the branch controlling heartbeat) could greatly impact the need for a post-TAVR permanent pacemaker. Again this is one of the nation’s best university hospitals and a very experienced surgeon. However between the heart block and the wound that was so severe that it needed to be closed by a specialist it leaves me wondering how “top-notch” this place really is.

Hello all, my father (80/m) had the TAVR procedure done on Friday at a highly reputable university hospital. The doctor performing the procedure has done over 700 of such procedures per year successfully. The original plan was for my dad to stay one night after the procedure for observation and I could pick him up today (Sunday).

In my dad’s case the procedure lasted double the amount of time anticipated (4 hours instead of 2 or less). I come to find out his femoral artery was pierced somehow to a point that a vascular surgeon needed to be called-in to hand-stitch the wound closed. My dad lost 2 pints of blood. We were told afterwards that this is extremely rare but does happen and that he needed to stay another day to make sure the stitching heals properly.

While he’s there recovering his heartbeat is also being monitored. It was determined my dad had a lower-than-normal heartbeat and that he was experiencing “heart block”. Heart block is a delay or interruption in the electrical signals traveling from the heart’s upper chambers to its lower. It is essentially an electrical malfunction that can cause a lower heart rate or skipped beats. So a temporary pacemaker was hooked up. They are now recommending a permanent pacemaker if his conduction system does not improve - there is still hope that it does. A determination will be made tomorrow (Monday).

In reading up on the pacemaker’s effectiveness after TAVR I’m seeing that in the short term it is effective. Long term effects are more questionable. According to studies I’ve researched some cases of permanent pacemakers inserted after TAVR increase the possibility of heart failure over time. I’m assuming because the heart depends on the pacer to beat and doesn’t rely on its own strength alone to beat, which would promote a strengthened heart.

If my dad’s heart conduction system does improve a bit and given a choice he is leaning towards asking for a heart monitor he can go home with and have constant monitoring instead of having a permanent pacemaker. If the monitor shows worsened heart block he can always go back to have the pacemaker installed. On the other hand perhaps his conduction system improves as his heart adjusts to the new valve and never looks back. The question I have is this too risky? I don’t want him going for a walk and feeling like he’s going to faint, or even sudden death. Any advice one can lend with experience would be greatly appreciated.

Off subject but for those in this sub who happen to be cardiologists could this heart block have been avoidable? I’m reading that the type of valve (balloon expanding vs self-expanding) and the surgeon’s ability to position the new valve the correct way (not interfering with the branch controlling heartbeat) could greatly impact the need for a post-TAVR permanent pacemaker. Again this is one of the nation’s best university hospitals and a very experienced surgeon. However between the heart block and the wound that was so severe that it needed to be closed by a specialist it leaves me wondering how “top-notch” this place really is.

Hello all, my father (80/m) had the TAVR procedure done on Friday at a highly reputable university hospital. The doctor performing the procedure has done over 700 of such procedures per year successfully. The original plan was for my dad to stay one night after the procedure for observation and I could pick him up today (Sunday).

In my dad’s case the procedure lasted double the amount of time anticipated (4 hours instead of 2 or less). I come to find out his femoral artery was pierced somehow to a point that a vascular surgeon needed to be called-in to hand-stitch the wound closed. My dad lost 2 pints of blood. We were told afterwards that this is extremely rare but does happen and that he needed to stay another day to make sure the stitching heals properly.

While he’s there recovering his heartbeat is also being monitored. It was determined my dad had a lower-than-normal heartbeat and that he was experiencing “heart block”. Heart block is a delay or interruption in the electrical signals traveling from the heart’s upper chambers to its lower. It is essentially an electrical malfunction that can cause a lower heart rate or skipped beats. So a temporary pacemaker was hooked up. They are now recommending a permanent pacemaker if his conduction system does not improve - there is still hope that it does. A determination will be made tomorrow (Monday).

In reading up on the pacemaker’s effectiveness after TAVR I’m seeing that in the short term it is effective. Long term effects are more questionable. According to studies I’ve researched some cases of permanent pacemakers inserted after TAVR increase the possibility of heart failure over time. I’m assuming because the heart depends on the pacer to beat and doesn’t rely on its own strength alone to beat, which would promote a strengthened heart.

If my dad’s heart conduction system does improve a bit and given a choice he is leaning towards asking for a heart monitor he can go home with and have constant monitoring instead of having a permanent pacemaker. If the monitor shows worsened heart block he can always go back to have the pacemaker installed. On the other hand perhaps his conduction system improves as his heart adjusts to the new valve and never looks back. The question I have is this too risky? I don’t want him going for a walk and feeling like he’s going to faint, or even sudden death. Any thoughts one can lend with experience would be greatly appreciated.

Off subject but for those in this sub who happen to be cardiologists could this heart block have been avoidable? I’m reading that the type of valve (balloon expanding vs self-expanding) and the surgeon’s ability to position the new valve the correct way (not interfering with the branch controlling heartbeat) could greatly impact the need for a post-TAVR permanent pacemaker. Again this is one of the nation’s best university hospitals and a very experienced surgeon. However between the heart block and the wound that was so severe that it needed to be closed by a specialist it leaves me wondering how “top-notch” this place really is.