PFO Getting Fixed Next Week, Post OP Issues?

[Lopaka]

I posted months ago about losing hearing in my right ear along with having another vertigo episode after diving. No other symptoms of DCS, and DAN thought it unlikely after calling them. MRI showed evidence of a couple stroke areas, possibly the cause of the hearing loss. Further testing showed a "moderate" PFO. After the unending series of tests, scan, probes, and God knows how much blood for samples, I am scheduled for the Amplatzer PFO fix next Friday. Cardio and Neuro docs got things in order for insurance to cover it. A mainland cardiac surgeon that visits several times a year will do the fix.

I am curious what the SB docs think, and any SB members have had this done, about what to expect after the procedure. This will be an outpatient thing, in at 0700, out around 1200. I assume taking it easy for some time after, but how long? How long normally before diving?

I'm sure the surgeon will have his opinions and recommendations, but not sure if he is familiar with diving issues. No doubt all this will be covered, but I am a bit nervous about having the ol' ticker diddled with...............

 

[Saturation]

The occluder has to be followed to insure it doesn't dislodge. It has a chance of a small leak. No diving at least for 3 months, best after 6 months to allow the occluder to fully cover with tissue, to 'epithelialize' such that Plavix or ASA can be discontinued. Minimum is 1 month before initiating exercise.

Patient forum:
PFO closure and recovery information - HealingWell.com Forum

What to expect:
Learn More: Cardiac Implant Closure Devices

FYI:
http://www.theheart.org/article/773931.do

 

[Lopaka]

Thanks Doc. There are many levels of "exercise". Any opinion of what might be permissible? Certainly not heavy squats or sprinting up stairs, but maybe arm curls or brisk walking?

The occluder has to be followed to insure it doesn't dislodge. It has a chance of a small leak. No diving at least for 3 months, best after 6 months to allow the occluder to fully cover with tissue, to 'epithelialize' such that Plavix or ASA can be discontinued. Minimum is 1 month before initiating exercise.

Patient forum:
PFO closure and recovery information - HealingWell.com Forum

What to expect:
Learn More: Cardiac Implant Closure Devices

FYI:
http://www.theheart.org/article/773931.do

 

[Lopaka]

What to expect:
Learn More: Cardiac Implant Closure Devices

The post-op at this link sounds much more extensive than what the local Cardiologist described. He said procedure at 0830, take a couple hours, and leave around noon. The link says an overnight stay and quite a bit of testing, X ray and such.

The other forum describes some discomfort after, like a chicken bone stuck in your throat for several weeks, and other unpleasant effects. One guy started running after 10 days, lots of different reactions.

Oh well, got to get this thing fixed to dive again, not to mention reduce stroke risk. Had an uncle die from that, don't want any part of it.

 

[Saturation]

Thanks Doc. There are many levels of "exercise". Any opinion of what might be permissible? Certainly not heavy squats or sprinting up stairs, but maybe arm curls or brisk walking?

Hi Lopaka,

Yes, generally most will say nothing over 25# to lift and light aerobics is good; replace heavy weights with light weights at multiple reps, to maintain muscle tone and long duration walks.

 

[adurso]

Good luck and be well

 

[Saturation]

The post-op at this link sounds much more extensive than what the local Cardiologist described. He said procedure at 0830, take a couple hours, and leave around noon. The link says an overnight stay and quite a bit of testing, X ray and such.

The other forum describes some discomfort after, like a chicken bone stuck in your throat for several weeks, and other unpleasant effects. One guy started running after 10 days, lots of different reactions.

Oh well, got to get this thing fixed to dive again, not to mention reduce stroke risk. Had an uncle die from that, don't want any part of it.

Yes it is, but occluder placement is very personalized; its like getting a custom job, there are many similarities, and differences.

The forum I linked is unique as you can share experiences with other closure patients. As you note, their experiences vary and you can ask more questions there.

 

[Dr. Doug Ebersole]

As a cardiologist who performs these procedures, here is what you should expect:
1. You will have i.v. sedation and a local anesthetic for the procedure so you will not be uncomfortable. There is no pain or discomfort at all once the groin catheters are in place which should be no worse than having blood drawn.
2. There is usually both x-ray monitoring and some form of ultrasound used during the procedure -- either a TEE or intracardiac echo (I prefer the latter).
3. In general the procedure will take less than an hour and you will go to some form of step-down unit for the remainder of your hospital stay. The catheters will be removed and pressure held on your groin sites to achieve hemostasis (no further bleeding)
4. You will most likely stay in the hospital overnight and be discharged the following morning though some physicians discharge people who were done early in the morning by late afternoon. I usually keep people overnight and get a chest x-ray and a transthoracic (not TEE) the morning after the procedure as baseline studies.
5. I have never had anyone "notice" the device -- discomfort, chest pain, "chicken bone" example above, etc.
6. It is recommended that you not do any heavy lifting for several days (the recommendations for the amount of weight and duration is variable)
7. Regular aerobic exercise is fine and you can lift weights after several days
8. Most physicians will recommend you be on aspirin and Plavix for 3 months while the device is "healing over" with scar tissue.
9. I usually get a repeat echo at six months and then annually for several years to verify the position of the device and to make sure there is no shunting.

Hope this helps. Feel free to PM me with any specific questions.

Doug

 

[Lopaka]

There is no pain or discomfort at all once the groin catheters are in place

Oh great, so this could be read to say that I will have pain and discomfort until the tubes are shoved in! :shocked2:

Just kidding, after all the IV's, TEE, MRI's, and blood draws up to this point, what's a little more poking and prodding? They've had me on Plavix since July when the neuro first took a look at the MRI. Ultrasound of the legs showed no clotting issues, so I'd guess it is just a precaution while all the testing was done. Just keep taking it..............

Thanks for taking the time to describe it all Doc. Procedure is supposed to be at 0830, so maybe that is why I might be out later in the day.

 

[Dr. Doug Ebersole]

Best of luck with the procedure. If you haven't already, you can go to the Amplatzer website, AGA Medical Corporation > Welcome, and check out some videos of the procedure. I also wrote an article on PFOs in both Advanced Diver Magazine (November 2007 -- ADM Online) and Underwater Journal (Aqua Pages | Underwater Journal) around the same time. You can download back issues of Underwater Journal from the website. I'm not sure about Advanced Diver Magazine but it's worth a shot.

Keep us informed as to how it goes.

Doug