20 year life tissue valve?

[aaronep]

I will be having aorta heart valve replacement surgery. I am 76 years old and in fair to good health. No other major problems. I have read on internet sites and have been told by two cardiologists that the life span of a tissue valve is 8 to 12 years. However, the cardiac surgeon I visited says that 20 years is the current expectancy for a tissue valve. He said it would be a edwards valve.

I went to the Edwards Lifesciences web site and they list their Magna Perimount Aorta Valve and sure enough the description makes reference to 20 year durability. The web site link to this claim is:

http://www.edwards.com/products/heartvalves/lifelonganticoagulationbrochurepdf.htm

Does anyone have a comment on this claim? Is this simply marketing hype, or does the Edwards Company have some science break through that other valve makers do not have?

All replies, info, opinions, experiences, etc. welcomed!

Aaron In N. Hollywood

 

[Ross]

Hi Aaron and welcome to the forums.

Most of the new generation tissue valves are expected to last around 20 yrs. Key word "Expected", that doesn't mean that it will or won't. It's not marketing hype, it's been studied as far as it possibly can be and actually, they may last longer then that, but the jury is out until a longer date can be reached.

 

[tobagotwo]

Your surgeon is not misleading you.

The previous version of the Edwards pericardial valves (Carptentier-Edwards bovine models) have a track record of 80% still implanted after twenty years in patients over sixty.

In the last few years, they have added anticalcification treatments and a non-damaging fixation process to these valves. They are hoping for twenty-five years for the valves with these improvements, again in patients aged over sixty.

Your cardiologists weren't lying to you, either. They are just referencing old data, and they're not making any distinctions between different types of tissue valves or between different age groups of patients. Standard porcine (not bovine pericardial) valves made twenty-five years ago lasted an average of eight to ten years over a range of all patients, but that was more like ten to fifteen years for over-sixty patients, and four to seven years for much younger patients. They've been improved greatly as well, however.

As I understand it for your age group, statistically, the tissue valve carries a somewhat lower overall risk. This is due to an enhanced intracranial bleeding risk in older patients with the use of warfarin, required for mechanical valves. If you're already on warfarin (Coumadin) for some other reason, there would be no advantage gained by going with a tissue valve.

http://www.edwards.com/Products/HeartValves/PericardialCategory.htm

Best wishes,

 

[kodi]

Aaron,
Can't answer your question either, but I'm hoping they are right. As you can see by my signature I just had a Carpentier-Edwards valve. When I discussed this with my card & surgeon, they both estimated 18 plus. Like so many other things in life, it's just a maybe. We never know what someone else has planned.

 

[lynn]

Adam, isn't that the truth!

Two cardios basically said mechanical because of my age, not even mentioning tissue. Yet, when I met with my surgeon he gave me all options and I was to choose my path and he is 3 years older than me (he's 50 ) he said he would go tissue.

Please don't flame me, I'm just repeating what he said!

 

[BackDoc]

read this:

http://www.clevelandclinic.org/heartcenter/pub/guide/disease/valve/pericardialvalvestory.htm

at your age, a tissue valve is certainly worth considering.

I am 50 and in the waiting room. after discussing things with the surgeons and cardio's at Cleveland Clinic, I plan on a tissue valve.

 

[tobagotwo]

The bovine pericardial claim of 80% still implanted after 20 years is backed by over 20 years of actual data and patient use of the product. It's neither an advertising claim nor a guess. And that was before they added anticalcification treatments and a new fixation process that doesn't compress or damage the valve tissue. Their current hope is that these will now last 25 years or more.

In a 50-year-old, they're not likely to last 25 years, but they should give a long service. In a 76-year-old, they are highly likely to last longer than 20 years, and they don't enhance the risk of intracranial bleeding.

The 10-year estimate is from long-outdated studies, relating to old, untreated porcine valves from two decades ago, often repeated by competing salespeople. I'm always surprised when those cobwebbed numbers are still brought up by cardiologists.

Understand that this isn't intending to persuade you to go tissue: it's just to set the record straight regarding the accuracy of the bovine pericardial valve life estimations. I had my own surgery at 53, and had a Mosaic porcine tissue valve implanted, which I believe should last about 18 years for my age group.

Best wishes,

 

[RCB]

Adding to Tobagotwo's sage advice

Adding to Tobagotwo's sage advice

It is almost stupid to make blanket statements regarding life estimates of tissue valves with out specifying which valve position and the age of the recipient. Even then, the point of SVD varies greatly for those under 60 and even greater for those under 40. I have never seen a study that had age groups by a single year. Of course the data exists, but biostatisticians simply don? think it is relevant to group data by year. Group data by valve position (aorta or mitral) is very significant, with the mitral valve achieving SVD much faster in recipient under 50.

In people over 65, there is very little chance of ever needing to replace a tissue valve of any type or position. I have read some anecdotal reports of tissue valves lasting as long as???Well, I?ll just say it would bring a big smile to Tobagotwo?s face, because I know he has been looking for this affirmation.

If I make it to that age and it is safe to replace my mechs.- it is all new tissue valves for me.

As for cards vs. surgeons on valve decision, ultimately it is always a surgeon decision.
If your think your card. knows more about valves than your surgeon, that is a pretty big clue you need to get another surgeon!

 

[aaronep]

thanks to all for your input!

thanks to all for your input!

Dear Friends: 100,000 THANK YOUS for the quick & informative responses to yesterday's post. It has made my acceptance of the surgeon's choice easier.

Please come back to this site 20 years from Nov. 21, 2006 & I'll post results of the tissue valve insertion!

Best to all! Aaron

 

[Superbob]

2026 -- got it! It's on my calendar. Will be just past my 85th birthday, so it will be easy for me to remember.

I know, I know -- but I'm banking on the power of positive thinking....

Thanks for an informative thread and the good comments it generated.

 

[Granbonny]

Hi Aaron

Hi Aaron

I normally don't post to choice of valves. But, my hubby will be age 76 Thanksgiving Day. No way, I would let him choose anything but a tissue valve..God willing, he never has to have one. ..for he just finished replacing our den..from carpet to hardwood..using a nailgun Cleans the pine straw off our steep roof, and won't even take a Tylenol, must less, thinking he would have to take a tiny pill a day (coumadin). ...However, with me taking coumadin..no problems. I have sense enough not to do those crazy projects.. At age 66 with a mech. valve. only have to make sure the Grandkids don't hit me in the head.. jumping on top of me in the pool, ect. Bonnie

 

[JohnnyV_46]

I'll settle for 20 years. I have the TFX3000 pericardial Bovine. I hear at the time it was "The" valve for tissue. I'm around 15 months with it. With my history of Coronary artery disease, I'm more worried about more blockage than the valve.

 

[marshameesha]

Age related to valve longevity

Age related to valve longevity

I am not sure I understand why the dramatic change in longevity of valves with younger ages? It seems I should know this since I have researched this some but don"t. Can anyone enlighten me?

 

[Bina]

Marsha,
I believe the tissue valves become calcified much quicker in younger patients than in older patients.

 

[marshameesha]

Age related to valve longevity

Age related to valve longevity

Could it have anything to do with activity level.

 

[Debster]

Hey Marshameesha-I have wondered the same thing-as my mom got an Oinker at age 64...and BTW_where do you live in Kansas? I live in Louisburg-about 25 miles south of KC..... Deb

 

[Phyllis]

Marsha, It took me a while to find this, but I hope it helps- a discussion we had back in 2005: http://valvereplacement.com/forums/showthread.php?t=10219

 

[tobagotwo]

The age relationship has a lot to do with chemical reactivity, and very little to do with physical activity. The demise of a tissue valve is usually based on calcification. Younger people can generate mineral growth more rapidly than older folks. For once, age is plus factor.

In a very similar way, many drugs are far less effective on older people than younger ones. An example is Lyme disease, which often requires much more aggressive antibiotics and has a much lower cure rate in post-menopausal women than in younger ones.

Best wishes,