Surgery in March 2025. St.Jude???

kobaha21 · Dec 1, 2024

Hello.
Status: Aortic stenosis with biscupis aortic valves.

3 days ago done echo or ultrasound. AVA 0,7 cm and Ejection fraction LV 60%.

2 month ago my AVA was 0,5 cm and ejection fraction 54%....

How it is possible that after 2 month my AVA and EF is better???
I use every day Q10, K2D3 and Rizolit(for colosterol) 2xday.

BUT! Pressure Gradient go from 112 to 119.
I have agreement with my cardio surgeon that I must change aortic valve!
And I will. He will done mini thoracotomy 5,6 cm cut that I will pay(that do that in my clinic) (price is private). It's not OHS. Just little cut. He is one of the best mini thoracotomy surgeon. We have a deal and now question about valve.

Only valve is St.Jude they put. On-x not.

I read about On-x that is much better and new stuff but S.Jude is legend.

Any personal experiences about those the valves.

And I don't have any simptoms of aortic stenosis. I considering not to go to operation. What I made mistake and that put me mechanical valve with no reason because I don't have simptoms and feel good and healthy. Even my echo is better. Maybe for 4 months calcifications in valves disappear forever and AVA goes to 1 cm? Ejection fraction is higher than 2 months ago

Tnx .

pellicle · Dec 1, 2024

kobaha21 said:
How it is possible that after 2 month my AVA and EF is better???

Most common reason is that earlier measurements were incorrect.

It's hard to get exact measurements on something that's moving.

Best Wishes

3mm · Dec 1, 2024

kobaha21 said:
I read about On-x that is much better and new stuff but S.Jude is legend.

Any personal experiences about those the valves.

I am glad you are getting your surgery planned. Excellent!

I have an On-X aortic valve which is excellent. My surgeon decided which mechanical valve to use because he is the expert. My surgery was at Mayo Clinic in Rochester, Minnesota, USA. They use both the On-X and the St Jude valves. They told me that some surgeons (including my surgeon) prefer On-X valves, and other surgeons prefer St Jude valves.

nobog · Dec 1, 2024

kobaha21 said:
I read about On-x that is much better and new stuff but S.Jude is legend.

Better? How is that quantified? If one happened to have a OnX implanted then the OnX is "better".

Most of OnX's claim is that they are "newer" - doesn't make it "better".

I own a Chevrolet - it's much better than a Ford.

Your doctor may be an expert in the implantation of the valve but they know very little about the mechanics and flow thru any artificial heart valve.

kobaha21 · Dec 1, 2024

nobog said:
Better? How is that quantified? If one happened to have a OnX implanted then the OnX is "better".

Most of OnX's claim is that they are "newer" - doesn't make it "better".

I own a Chevrolet - it's much better than a Ford.

Your doctor may be an expert in the implantation of the valve but they know very little about the mechanics and flow thru any artificial heart valve.

Hehe.Yes. I have Chevi(Aveo)

.

I

Yankeeman2 · Dec 2, 2024

kobaha21 said:
Hello.
Status: Aortic stenosis with biscupis aortic valves.

3 days ago done echo or ultrasound. AVA 0,7 cm and Ejection fraction LV 60%.

2 month ago my AVA was 0,5 cm and ejection fraction 54%....

How it is possible that after 2 month my AVA and EF is better???
I use every day Q10, K2D3 and Rizolit(for colosterol) 2xday.

BUT! Pressure Gradient go from 112 to 119.
I have agreement with my cardio surgeon that I must change aortic valve!
And I will. He will done mini thoracotomy 5,6 cm cut that I will pay(that do that in my clinic) (price is private). It's not OHS. Just little cut. He is one of the best mini thoracotomy surgeon. We have a deal and now question about valve.

Only valve is St.Jude they put. On-x not.

I read about On-x that is much better and new stuff but S.Jude is legend.

Any personal experiences about those the valves.

And I don't have any simptoms of aortic stenosis. I considering not to go to operation. What I made mistake and that put me mechanical valve with no reason because I don't have simptoms and feel good and healthy. Even my echo is better. Maybe for 4 months calcifications in valves disappear forever and AVA goes to 1 cm? Ejection fraction is higher than 2 months ago

Tnx .

Yankeeman2 · Dec 2, 2024

I had aortic stenosis and had surgery many years ago to install a St. Jude valve in Boston. I do know that only 25% of people getting a mechanical valve live as long as I have. The need for daily blood thinners is not really a problem, and neither are regular INR tests.

3mm · Dec 2, 2024

Yankeeman2 said:
I do know that only 25% of people getting a mechanical valve live as long as I have.

When did you get your St Jude valve installed? What study supports your statement? Thank you!

Yankeeman2 · Dec 2, 2024

3mm said:
When did you get your St Jude valve installed? What study supports your statement? Thank you

Yankeeman2 · Dec 2, 2024

Valve installed July 3, 2007 at Beth Israel in Bodton. As for the 25%, I just got it off the Internet. Google " Percentage of people who have lived 17 years with mechanical aortic valve."

AZATADINE · Dec 2, 2024

Goodcreas

Yankeeman2 said:
Valve installed July 3, 2007 at Beth Israel in Bodton. As for the 25%, I just got it off the Internet. Google " Percentage of people who have lived 17 years with mechanical aortic valve."

Excellent example of not to believe everything you read on the internet

3mm · Dec 2, 2024

Yankeeman2 said:
Google " Percentage of people who have lived 17 years with mechanical aortic valve."

But ... Google doesn't do medical research. What is the source of the statistic you quote? I apologize if I am being obnoxious. However, I think it is important for all of us to list our sources when we state a fact so that others can do their own research. Think of a person who was just told they need surgery, and they come to this forum to start their search for answers.

I did Google "Percentage of people who have lived 17 years with mechanical aortic valve." I didn't find a clear answer to this question.

dick0236 · Dec 2, 2024

Who really knows how long a valve will last? When I got mine the docs told me it had a 50 year life in testing outside the body. Mine has already lasted over 57 years with no failure in site. So much for life span testing.......even tho its durability is well documented my valve was taken out of production, after 800,000 inplants, in 2007 for other reasons......part of the reason was with the "ball-in-cage" design, but also I suspect, was the manufacturer became very involved in the "tissue valve" market.

St. Jude has a long and well-documented history. Onyx has a good history although their low INR target is still suspect.

Valve life is somewhat of a crapshoot for each of us, but normally, the life of a mechanical valve is much longer than 17 years. It is extremely difficult to wear out a mechanical valve, and failures are usually due to other conditions.

carolinemc · Dec 3, 2024

You will have the issues, but the health issue can improve greatly. Feel great that you feel a lot better. Just enjoy the life you have.

carolinemc · Dec 3, 2024

AZATADINE said:
Goodcreas

Excellent example of not to believe everything you read on the internet

I have had mine, St. Jude's Aortic leaflet valve, 23 years and counting, since 2001.

Chuck C · Dec 3, 2024

Yankeeman2 said:
As for the 25%, I just got it off the Internet. Google " Percentage of people who have lived 17 years with mechanical aortic valve."

Hi Yankeeman2. This figure is not supported by several studies which I have read. Also, such a figure, without taking into account the age of the patient or comorbidities, is meaningless. A lot of patients who received mechanical valves in the 1970s, 1980s and 1990s were over 70. For such patients the number living more than 17 years after their procedure will be low and skew the statistics, giving the appearance that there is a low life-expectancy after SAVR.

Yankeeman2 · Dec 4, 2024

3mm said:
But ... Google doesn't do medical research. What is the source of the statistic you quote? I apologize if I am being obnoxious. However, I think it is important for all of us to list our sources when we state a fact so that others can do their own research. Think of a person who was just told they need surgery, and they come to this forum to start their search for answers.

I did Google "Percentage of people who have lived 17 years with mechanical aortic valve." I didn't find a clear answer to this question.

OK. Try to Google "Average life span following implantation of mechanical aortic heart valve" and see what you get. Key word if course is "average" meaning some live a long time and some don't, of course depending on whatever unrelated health problems they have. I didn't just make up the information...

3mm · Dec 4, 2024

Yankeeman2 said:
Google "Average life span following implantation of mechanical aortic heart valve" and see what you get. Key word if course is "average" meaning some live a long time and some don't, of course depending on whatever unrelated health problems they have.

That Google query worked better for me. It gave the answer:
"According to research, the average life expectancy following implantation of a mechanical aortic heart valve is around 16 years for patients aged 65 or younger, with survival rates significantly impacted by factors like patient age, overall health, and post-operative care; younger patients generally having longer life expectancies after the procedure compared to older patients."
So this Google answer does acknowledge some of its limitations. It also lists 2 other links which are both about bioprosthetic valves; I wonder how these impacted the AI generated answer?

I agree with your "average" and "unrelated health problems" comment. It is critical for all of us to remember how much impact our lifestyle choices will have on our own lives. Thank you for this conversation!

dick0236 · Dec 4, 2024

3mm said:
That Google query worked better for me. It gave the answer:
"According to research, the average life expectancy following implantation of a mechanical aortic heart valve is around 16 years for patients aged 65 or younger, with survival rates significantly impacted by factors like patient age, overall health, and post-operative care; younger patients generally having longer life expectancies after the procedure compared to older patients."

I think this type of info gives the new person to OHS a bleak feeling about their lives after such surgeries. Most younger mechanical valvers have lived many years past 16 with no issues from the valve. Some, like me, may be outliers but on average the mechanical valvers can realistically expect a near-normal life expectancy.

When I had the surgery in 1967, at age 31, I thought I would live for about 20 years, to age 50. I am now almost 89 with that original valve. My life and lifestyle has always been normal......and a little on the wild side when l was young. For those of you who are young, you should believe that you will have a normal life for several decades.....not 16 years.

pellicle · Dec 4, 2024

Hi Dick

dick0236 said:
I think this type of info gives the new person to OHS a bleak feeling about their lives after such surgeries. Most mechanical valvers have lived many years past 16 with no issues from the valve. Some, like me, may be outliers but on average the mechanical valvers can realistically expect a near-normal life expectancy.

I think that the problem is that other things interrupt the valve remaining in situ such as:

aneurysm
endo
miserable failure at ACT (causing obstructive thrombosis combined with poor appreciation of the option of tPA)

Often this is mentioned in the depths of the journal article (which to be honest are aimed at professionals who should understand that).

I would suggest that this study is pretty interesting and positive for many reasons

https://www.ahajournals.org/doi/10.1161/JAHA.123.030629

However people think "me" when reading about "everyone" and see a graph like this:

and think "oh my god I'll only live 15 years" when the truth of the matter is that when members of the study are 68yo there'll be a reduction in those numbers when they become 82yo's for other reasons. For instance:

In 2022, the average life expectancy for men in the United States was 74.8 years

So its pretty hard to present substantiation to a person who's

in a panic
never had a science education
isn't good at statistics and population studies
isn't familiar with stuff like "all cause mortality"

In that above graph at first glance a person could be forgiven for thinking that bio performed better than mech, but greater than 75% survival is better than around half.

I guess that's why discussions are important.

Best Wishes

Surgery in March 2025. St.Jude???

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