Ascending Aortic Aneurysm and Aortic Valve Replacement

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Ernie Seckinger

Ernie Seckinger

The email address is ernie.seckinger@zebra.net The occupation is archeologist (of the mostly desk-bound bureaucratic type). Born in 1950. Proud to say I am an alum of West Georgia, where this fine website is hosted.

Interests: Reading, book collecting, fountain pen use and collection, and writing. My writing has 4 forms: journal, letters, creative, and reading notes. I deal with matters of reading and Transcendentalism as well as the obligatory section on genealogy at www.zebra.net/~ernie.seckinger.

Each morning, I stumble to the table for breakfast and the day's more substantial reading. I use there a pen and a particular ink until used up or my mood changes. Abbreviated—hopeful refined—versions of these notes become reading notes on my website.

I live in Daphne, Alabama which is in the Mobile metro area. It is a true struggle each day to drive to work (starting back to work on August 23^rd!) across the head of Mobile Bay (or the lower end of the Mobile River Delta depending on which way you look) seeing along the way pelicans—both brown and white in the fall and winter, ibis, gulls by the gezillion, the Battleship Alabama, through the 1941 Bankhead Tunnel (named for Tallulah's father) on to park in a downtown Mobile historic district within 100 feet of a live oak tree.

Due to the recent events outlined below, I am adding a bit more physical exercise to my regime. For too long, I have gotten my exercise jumping to conclusions!

Ascending Aortic Aneurysm and Aortic Valve Replacement

9 August 2004

I am a 54 year old male. I suppose my problem began at birth since the doctors frequently used the term congenital. I did find myself often at Emory when I was young for a VSD (Ventricular Septal Defect). A couple of years ago I began having too many PVCs (Preventricular Contractions} and other heartbeat irregularities.

The exact date escapes me but within the last 2-3 years I had my first echocardiogram. Somehow I managed to crook my neck around so I could see the screen. For me it was nearly a metaphysical experience to watch my own heart beat. But to the point of this writing, even I could see the leaking VSD. That I expected. I was surprised though to see my aortic valve leaking. I immediately wondered if the one bottle of Redux I took caused that problem. I went through the sequence of stress tests including the IMHO worthless but expensive thallium stress test then onto a heart catherization in 2003.

That showed only a little plaque and, as the cardiologist said, an enlarged aorta. This simply didn't register with me which I find odd since I usually ferret out the least medical subtlety particularly when it pertains to me. Call it denial, I suppose.

I had a regularly scheduled appointment with the cardiologist in mid June of this year. I happened to ask him, "Just what do you mean by an enlarged aorta?" He said he had been thinking about that so we should do a CT scan to use as a measurement baseline so we could monitor it in the future. That done the next day, I thought no more about it assuming it would be filed away for reference.

Imagine then my surprise about 10 days later when the doctor's nurse called to ask if anyone had discussed my CT results. Apparently the cardiologist had consulted a vascular surgeon. Then on July 1, the cardiologist called to say certain characteristics of my case could bear waiting in that the enlargement, now identified to me with the scary word aneurysm, was at 5.0 cm and was in my ascending aorta. However, given that prediction would suggest the surgery would be needed within a year and that my aortic valve wasn't in the best of shape, we should go ahead now.

Over the next day or so I got set up with a vascular surgeon. Then my wife, who is in the medical profession, said no way was I going with that surgeon. She had heard just too much about him. So we called up the vascular surgeon with the best reputation in the Mobile area. He scheduled me for another cath on the 12th and the surgery on the 13th. Up to this point, the only positive point I remember was the doctor saying I would need a mechanical rather than a tissue (pig) valve. When I asked why, he said, "Because you are too young." I liked the sound of that.

In short, the surgery went well but what actually occurred was more complex than anticipated. Practically all of my ascending aorta and my aortic valve were replaced. While the door was open, they went in and patched shut the small VSD I was born with. My hospital stay after surgery lasted another 5 days. I was not a good hospital sleeper, so I was ready to go when they sprung me.

For the first couple of days my atrial fibrillation continued but since my heart rate was not high and I was on Coumadin due to the artificial valve, no one seemed concerned. Then by the forth day home I felt I was in the midst of a remarkable recovery, even walking over to wish a neighbor well who was herself heading off to surgery.

Then on the 6th day it all began to fall apart. I went into atrial fib early that morning and soon my heart rate was up. By the time my wife – by this point heroic wife – got me to the emergency room, my heart rate was 150! Soon I was being fed IV bolus of Toprol and finally Cardizem. After some time my rhythm converted back to sinus rhythm but I was admitted overnight for observation. Late the next afternoon I was released having had no subsequent episodes. That is until the moment I got home when it all started again.

Two days later I had an echocardiogram. Awaiting my turn, I went into a fib again. Fortunately, it continued through both the EKG and the echo. The echo showed a build-up of fluid around the heart called pericardium effusion. Once again I was admitted and scheduled for surgery to drain the fluid the next morning.

To end this long story, I'll just say after that 4 day stay, I am home again and so far fib free. The cardiologist did say with the massive surgery I had, it would not be unusual to have a bit of it occur as far as 3 months out.

So, I seemed to have survived the ordeal and will soon lead a normal life (except for the Coumadin). This website helped me understand a little of what faced me so I felt compelled to share with subsequent patients. I think now is a good time to summarize and quit. If you would like to hear more, feel free to email me.

Just a few final comments:

Find a way to not go through this alone. There are just too many medical mistakes out there. A night nurse very nearly gave me a double dose of blood pressure medicine when my BP was already too low. Another one almost improperly gave me blood in a way that would have been considered contaminated. If you are not aware, somebody needs to be with you to serve as screener for what happens to you. And I was in a fine hospital.

Remember when you come home to monitor your fluid intake and output. Elevate your feet and weigh every day. A persistent cough should be brought to the doctor's attention since it could mean fluid buildup.

Take it easy during your recovery. Expect at least 4 or more weeks before you even go back to work. Be patient and good luck.

Discussion, comments, or questions: Ernie Seckinger

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