TAVR

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Quarry1

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Jul 13, 2016
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Waiting for a TAVR this Thursday. 6 1/2 years on previous AVR which his deteriorating rapidly. Headaches and shortness of breath all starting now so I can't get this over quick enough .
since they don't remove the old valve, has anyone had any problems with a TVR being placed within the previous AVR? Thanks
 
Very sorry to hear that your valve failed so soon. Tissue valves usually do much better for patients over 70. Your valve was the Trifecta?

I expect that you probably were aware that the valve has been recalled due to early failure. See below.

https://www.fda.gov/medical-devices...ctural-valve-deterioration-letter-health-care
I hope that things go better with your TAVI procedure. At 80 years old, it would probably be the way to go if you are eligible in order to avoid another OHS at your age.

Please keep us posted on how things go. We have very few members with a TAVI valve placed inside of a prosthetic valve, sometimes called Valve in Valve, so your experience will be very valuable to others facing this in the coming years.
 
Good luck with your upcoming TAVI. That procedure, when possible, seems the better alternative for seniors needing replacement of failed valves rather than an open heart procedure.

Please come back post TAVI to share your experience. I am sure many readers of this forum would also be interested in this procedure (valve in valve).
 
Hi
since they don't remove the old valve, has anyone had any problems with a TVR being placed within the previous AVR? Thanks
they do (as far as I know) trim the cusps off and pull them back in along the catheter; then inserting the spring loaded valve into that ring as a bed.

Please keep us posted, because as far as I know the only other person here who's had a TAV didn't post for long after making his decision. This BTW is just indicative of the "normal poster" who's super interested in quizzing everyone, then never comes back to inform / report / help newbies.

If this forum was just filled with the waiting room pre-surgery and anxious people it would have almost zero value.

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Which just by the by is what burns me up about those who yell "don't listen to anyone on this forum"
 
Very sorry to hear that your valve failed so soon. Tissue valves usually do much better for patients over 70. Your valve was the Trifecta?

I expect that you probably were aware that the valve has been recalled due to early failure. See below.

https://www.fda.gov/medical-devices...ctural-valve-deterioration-letter-health-care
I hope that things go better with your TAVI procedure. At 80 years old, it would probably be the way to go if you are eligible in order to avoid another OHS at your age.

Please keep us posted on how things go. We have very few members with a TAVI valve placed inside of a prosthetic valve, sometimes called Valve in Valve, so your experience will be very valuable to others facing this in the coming years.
No, I did not know of the Trifecta recall. Thank you very much for that. Mild leakage stared about two years after the OHS and stayed fairly stable for another two years or so. Last May,6 yrs post op, fatigue started again and last month I had an echo which showed advanced deterioration hence the need for a new valve. Pre op is tomorrow and I will know a lot more about what is going to happen and the info on the new valve. My understanding now is that they do not remove the Trifecta but rather insert a new valve inside it. My worry is that as the Trifecta further deteriorates further will it impair the the TAVER. Sounds like there will be a lot more Trifecta replacements in the future.
 
Good luck with your upcoming TAVI. That procedure, when possible, seems the better alternative for seniors needing replacement of failed valves rather than an open heart procedure.

Please come back post TAVI to share your experience. I am sure many readers of this forum would also be interested in this procedure (valve in valve).
Will do
 
Last May,6 yrs post op, fatigue started again and last month I had an echo which showed advanced deterioration hence the need for a new valve.
So, did the deterioration happened in just the past 6 months? When the fatigue started in May, hopefully they gave you an echo at that time, especially as they knew that you have a Trifecta valve. The instruction from the FDA is for physicians to monitor patients with a Trifecta valve closely for signs of early failure. If they did not give you an echo in May, when was your last echo before the one that you just had recently?

My understanding now is that they do not remove the Trifecta but rather insert a new valve inside it.
That is correct. With a TAVR or TAVI procedure, the new valve is inserted inside the old valve and expanded. The old valve remains there, basically pushed to the sides by the new valve.

This video does a decent job of showing how it works. This graphic is demonstrating a TAVI on a native valve, but the concept is the same, with the old valve leaflets pushed to the side when the TAVI valve is expanded.

 
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My worry is that as the Trifecta further deteriorates further will it impair the the TAVER. Sounds like there will be a lot more Trifecta replacements in the future.
That's not how it works. It really doesn't matter what condition the Trifecta leaflets are (unless abnormally calcified), once a TAVI is deployed (properly) those leaflets are out of the way and should have no further ramifications.
 
The old valve remains there, basically pushed to the sides by the new valve.
I seem to recall videos where the leaflets are snipped off (where does the calcium deposit go? Into the capture net I suppose) before the TAVI valve is inserted.

anyone?
 
I seem to recall videos where the leaflets are snipped off (where does the calcium deposit go? Into the capture net I suppose) before the TAVI valve is inserted.

anyone?
I have never seen that but doctors have been known to do things "off label". Usually the restriction is the frame of the bio prothesis unless the leaflets are severely calcified. In such case a TAVI would be contra indicated (not recommended).
 
So, what company/valve will be used as a replacement?

Best wishes for a successful surgery and a complete recovery. Will be watching for your updates as the optimist in me thinks I might be a candidate in 15-20 years - maybe sooner.
 
Well, back home after the TAVR. Was in the hospital appx 48 hrs. The procedure went well and was actually a lot easier , at least on me, than I had anticipated. The whole thing took less than2 hrs. A Medtronic 26mm Evolt Pro was inserted. The least amount of contrast dye was used to do the job as I am also in Stage 4 CKD. Echo performed during the TAVR showed no regurgitation and secure fit was the result.Echo taken this morning confirmed yesterdays procedure. What I don't yet is what the ejection fraction is and also the pressure gradient of the valve. Cardio told me it will take some time for things to stabilize . New appointment in 2 weeks . Although it is early post op, I do feel a lot better. A lot more energy and no pain. Some discomfort in groin area but that is to be expected. Orders are to take it easy and not to overdue things even though I may feel like it. When you think about it, this is really an amazing procedure. Time will tell how this whole this plays out.
 
Hey
Well, back home after the TAVR. Was in the hospital appx 48 hrs. The procedure went well and was actually a lot easier , at least on me, than I had anticipated.

good to hear ... as I understood it, the procedure on you is about the same as having a stent placed.

Orders are to take it easy and not to overdue things even though I may feel like it.
sound advice. Follow it.

When you think about it, this is really an amazing procedure. Time will tell how this whole this plays out.
indeed and I'd say that for their design criteria they are an excellent solution.

Best Wishes
 

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