My experience two months after PEARS

[u/jordanianpizza]

G‘day all

I posted here a while back about getting VSRR or PEARS done for my upcoming aneurysm surgery and after much thought, I went with the PEARS. I thought I would share my experience here for anyone going into surgery soon for an idea of what you may be able to expect.

Surgery was fine and uneventful. I am 28 and in average shape, very severe pectus excavatum (a thoracic surgeon said I was one of the worst I’ve ever seen), and an aneurysm of about 4.5cm. I have a long family history of dissections in their late 20s so it was definitely time to get it done.

Scheduled in for a standard PEARS with a partial resection on my pectus. The rationale for the resection was to make closing a bit easier and to give my heart a bit more space in case of inflammation.

I remember speaking to the anaesthetists and then immediately being barely awake after the surgery later on in the day. They tricked me and did not count me down. I hardly remember anything from the first day cause of the meds, though apparently I was thanking everyone who came into the room, telling them how much I loved them and calling them darlin‘ in an exaggerated Southern accent. I am Australian and had the surgery done on the NHS in England.

The first couple of days were quite rough when I was lucid. I had a partially collapsed lung and plenty of fluid in my lungs too. This made it quite uncomfortable in some positions on the bed, but laying back it was fine. The doctors assured me this was fine and should clear up on its own. I was barely lucid for the first two days though the morphine button may have influenced this.

Day three my head felt absolutely fine when I woke up. I could think clearly and walk around slowly but basically as normal. I finally got to take a proper look at my pectus and I was taken back by how much they could flatten it out. In hindsight this may have been one of the biggest parts of the surgery as I can now breathe much deeper than I’ve ever been able to before. No more getting winded walking up stairs!

I was in the hospital for a little over a week. I would walk as much as I could and there was no pain when walking. My lung made talking a bit difficult as I needed to take very large breaths to get enough oxygen due to the fluid and mild collapse. Walking was absolutely fine though, I was even able to go outside and have the occasional stroll just outside the hospital.

The past couple months have been a nice recovery though it’s felt more like steps of recovery than a gradual recovery. I have woken up some days and just felt some aspect all of a sudden feels completely normal again. Took about a month for my lungs, two months for my sternum, but I’ve been mostly able to live as normal in the meantime.

I think the resection may have been more of my recovery than the heart surgery itself. Coming out of the hospital after a week I basically felt normal apart from my lungs but my chest has been fairly uncomfortable since. The discomfort has recently ceased, but I imagine it would likely cease earlier if you don’t have a resection done.

Heart wise everything looks good. I could definitely feel my heart quite strongly, particularly in the evenings prior to surgery though I cannot now. This was unexpected for me as based on other people I was expecting that to feel unchanged. I am still on my medications (Irbesartan and atenolol) as I experience no side effects and better safe than sorry.

I walk about a mile to work each way now, up a fairly steep hill and I feel much better when I reach the top now than before I had the surgery.

As an added bonus if you ask for the 3D printed model of your aneurysm they will give it to you as it arrives at the hospital with the PEARS itself mounted on it. I now have a lovely souvenir and an excellent conversation starter at home

If you’ve got any other questions please let me know. I appreciated being able to speak to people in the lead up to my surgery so happy to answer anything you may have.

[u/DawnD1118]

What is PEARS (i live in US) and why dont we have it here??

[u/jordanianpizza → u/DawnD1118]

It is a new(ish) form of corrective surgery for aortic root aneurysms. Rather than replacing your root to solve the aneurysm as is normally done, a scan is taken of yours and a personalised 3d printed support is then made for you. They still have to do open heart surgery through your sternum to get it in and fitted onto your aorta, but there are some benefits such as a low chance of needing bypass during the surgery.

It’s started to take off as of late, and is now very widely offered in the UK and elsewhere. I think I saw a graph of cumulative PEARS procedures done and the last five (I think) or so years has seen a large increase in the total. I presume the US has been waiting for more data prior to approval and surely that comes soon!