What is the effect of a pacemaker after aortic valve replacement surgery?!
Question: My father, aged 46, had open heart surgery on Wednesday and had his aortic valve replaced with a mechanical valve.
His heart has not yet started up again on it's own (although he is awake) and they are now going to put in a pacemaker on Monday.
I don't really know what all this means. Is it common? What risks are involved? The doctors seem fairly relaxed about the procedure and have ensured us there is nothing to worry about.
Any information would be greatly appreciated.
Answers: My father, aged 46, had open heart surgery on Wednesday and had his aortic valve replaced with a mechanical valve.
His heart has not yet started up again on it's own (although he is awake) and they are now going to put in a pacemaker on Monday.
I don't really know what all this means. Is it common? What risks are involved? The doctors seem fairly relaxed about the procedure and have ensured us there is nothing to worry about.
Any information would be greatly appreciated.
"His heart has not yet started up again on it's own (although he is awake) and they are now going to put in a pacemaker on Monday."
Your Dad's heart is a muscular organ with four chambers designed specifically to work efficiently , reliably, and continuously over his lifetime. the muscular wall thereof contract on a regulated sequence, which then pumps blood as required by the body while expending as little energy as possible during each heartbeat.
The contractions of the muscle fibers in the heart itself is controlled by electricity that flows through the heart in a precise manner along distinct pathwaysand at a controlled speed.
The electrical current that begins each and every heartbeat originates in your Dad's natural pacemaker, that is the sinus or sinoatrial node, which is located directly at he top of the upper right heart chamber or right atrium. The rate at which your Dad's natural pacemaker discharges its electrical current determines his heart rate. This rate is influenced by nerve impulses and by levels of certain hormones in his bloodstream.
In adults at rest, the normal heart rate is usually between 60 and 100 beats per minute. However, lower rates are possible in young adults, especially if physically fit. Yet, the heart rate is considered by doctors to be normal ONLY when the heart rate is inappropriately fast or is irregular, but also when the electrical impulses travel along abnormal pathways.
Age-related changes in the heart's electrical system make make some arrythmias more likely, possibly as in your Dad's case. An overactive thyroid gland, sometimes...no cause can be found to identify one.
Most arrythmias neither cause symptoms nor interfere with the hearts ability to pump blood, and pose little or no risk, although they can cause considerable anxiety if someone becomes aware of them. However, some , harmless in in themselves, can lead to more serious arrhythmias. Thus, any arrhythmia that IMPAIRS THE HEART'S ABILITY to pump blood adequately is serious stuff. How serious depends on whether the arrhythmia originate in the natural pacemaker of the heart, in the atria, or in the ventricles. Those that originate in the ventricles are more serious than those that originate in the pacemaker. However there are exceptions....
Your Dad's aortic valve replacement may possibly have been due to abnormal rhythms (arrhythmias) that are also known as sequential heartbeats that are irregular, too fast, too slow, or conducted via an abnormal electrical pathway through the heart. For with harmless arrhymthmias, reassurance is treatment enough. In your Dad's case, which I deduce is serious, an artificial pacemaker has been decided to help him regulate his heartbeat.
Please note that sometimes the area of the natural pacemaker were your Dad's surgeon intenionally felt safe to cut into sometimes gets damaged in heart surgeries. ...as all heart surgery are purported to be the taking of risk ...and in a risky situation, some things just happen ...unknowingly and without malice.
The natural pacemaker of your Dad's heart, the sinoatrial node, has two places involved, where when one portion of this natural pacemaker is damaged, the other takes up the slack. Sometime this 'slack' isn't strong enough or does not occur. Thus a pacemaker implant is the decision of the Doctors that will act in place of your Dad's own pacemaker to his benefit. They implant it surgically under the skin, usu. below the left or right collarbone,...then connect it to the heart by running wires inside of the brachiocephalic vein. It's low-energy circuitry and battery designs now last a patient about 10-15 years undesturbed.
When you Dad's heartbeat, after placement, slows below a certain threashhold set by the doctors on the pacemaker, the electronic pacemaker will begin immediately by firing the necessary electrical impulses to assist your Dad in increaseing his heart rate accordingly.
I hope this helps...
Much Love and Respect
N.B.:
I agree with POPO: Your best answers are going to come from the cardiologist who is caring for your father, don't be afraid to ask.
Since his heart is not beating properly, the pacemaker will will help establish a regular heart beat for him. This is somewhat common with people with heart problems and sugeries. Just know it will keep his heart beat going regularly.
I don't know if your father's aortic valve was replaced due to a bacterial infection or a defect. If it was a bacterial infection then perhaps the electrical part of the heart was damaged as well and the natural pacemaker needs a little help. A good rule of thumb, if the doctor does not appear to be distressed, then relax and research just as you are. Having your valve replaced is a big surgery, and the pacemaker may be temporary just to ease the burden of the hearts function. Your best answers are going to come from the cardiologist who is caring for your father, don't be afraid to ask. Write your questions down at home so your are not tongue tied when the doctor arrives. They are usually very good about answering questions from family.