54M, reasonably active. Mechanical bentall procedure (49% EF, 5cm aortic root, etc).
Talked to numerous cardiologists and cardiac surgeons. Some had opinions - go with a mechanical valve given my age and activity level. Others just listed the pros and cons of tissue vs mechanical valves and said it was up to me. They effectively said if I was responsible and could handle managing a daily drug regimen, then mechanical would work. If not, tissue was best.
When I met with the surgeon who will be doing the surgery, he said that if I chose tissue, he would attempt a repair if he thought it was possible. He also said that the best repair duration for a BAV he was involved with was 10 years. If I were to go tissue, he said the tissue valve would last 10 to 20 years. To determine, the number of future surgeries, he used 10 years, saying that assume I would get 10 years from the tissue valve and assume I was eligible for a TAVR giving me an additional 5 years. That would give me a total of 15 years. So, an operation now at 54 and then again at 69 and then potentially again at 84 assuming I lived that long.
My preference was for one and done. There are no easy choices. Trading off multiple surgeries (tissue) for lifetime ACT and noise (mechanical). I heard a lot of interesting stories. Some who had tissue valves went over 20 years, but some were far less. Large range of outcomes. An acquaintance's relative had OHS at 82 with a tissue valve. She is now 90 and her valve is failing and they are looking at whether she is eligible for TAVR. On the other hand, I spoke with a doctor who was initially upset when his father was given a mechanical valve at 73. However, the father lived until 94 and passed away from other causes.
I thought about doing a tissue valve first and then doing mechanical after the tissue valve failed assuming that technology would come to the rescue in time. However, I wasn't keen on multiple OHS's as I read more and more, especially if the valve failed in the early years.
Weighing the pros and cons, it seemed that mechanical would work best for someone in my situation.
Surgery coming on July 23.
This site is fantastic. Thanks to all the members for their contributions. It has been really helpful in my research and decision making process.
Talked to numerous cardiologists and cardiac surgeons. Some had opinions - go with a mechanical valve given my age and activity level. Others just listed the pros and cons of tissue vs mechanical valves and said it was up to me. They effectively said if I was responsible and could handle managing a daily drug regimen, then mechanical would work. If not, tissue was best.
When I met with the surgeon who will be doing the surgery, he said that if I chose tissue, he would attempt a repair if he thought it was possible. He also said that the best repair duration for a BAV he was involved with was 10 years. If I were to go tissue, he said the tissue valve would last 10 to 20 years. To determine, the number of future surgeries, he used 10 years, saying that assume I would get 10 years from the tissue valve and assume I was eligible for a TAVR giving me an additional 5 years. That would give me a total of 15 years. So, an operation now at 54 and then again at 69 and then potentially again at 84 assuming I lived that long.
My preference was for one and done. There are no easy choices. Trading off multiple surgeries (tissue) for lifetime ACT and noise (mechanical). I heard a lot of interesting stories. Some who had tissue valves went over 20 years, but some were far less. Large range of outcomes. An acquaintance's relative had OHS at 82 with a tissue valve. She is now 90 and her valve is failing and they are looking at whether she is eligible for TAVR. On the other hand, I spoke with a doctor who was initially upset when his father was given a mechanical valve at 73. However, the father lived until 94 and passed away from other causes.
I thought about doing a tissue valve first and then doing mechanical after the tissue valve failed assuming that technology would come to the rescue in time. However, I wasn't keen on multiple OHS's as I read more and more, especially if the valve failed in the early years.
Weighing the pros and cons, it seemed that mechanical would work best for someone in my situation.
Surgery coming on July 23.
This site is fantastic. Thanks to all the members for their contributions. It has been really helpful in my research and decision making process.
