Hi. I understand that your third surgery was to fix the aneurysm. But why did your mechanical valve that you had inserted 22 years prior, also need to be replaced? Thanks in advance.
34 Year old man awaiting Aortic valve replacement / repair
- Thread starter jeffreycaulfield
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Hi. I understand that your third surgery was to fix the aneurysm. But why did your mechanical valve that you had inserted 22 years prior, also need to be replaced? Thanks in advance.
pellicle
Professional Dingbat, Guru and Merkintologist
Because a single preattached unit of valve and tube is faster to fit and more reliable. In redo surgery there is enough complexity (meaning time) due to scar tissue that anything to reduce the time is chosen.
Duration of surgery is a direct predictor of undesirable outcomes (infection for instance).
It's sort of like asking why did they change the $30 part in the middle of the engine when it's a full $12,000 rebuild anyway.
Yes, surgery easier with valve conduit combined than suturing conduit to old valve.
Only decision was mechanical vs tissue. At age 57 with three open hearts the decision to go mechanical was easy. Also no TAVR at that time to complicate the decision process.
17 years later still doing OK.
Only decision was mechanical vs tissue. At age 57 with three open hearts the decision to go mechanical was easy. Also no TAVR at that time to complicate the decision process.
17 years later still doing OK.
I understand that everyone is individual, with different desires in life, different advice given by different surgeons, etc., etc.
However, I'm curious, since you are old enough to look back, you have lots of experience, and you appear to be very athletic. With what you know now, and all of the studies to date regarding efficacy/longevity, if you were 65, needed SAVR (or TAVR), and were going to go with SAVR, would you choose mechanical or tissue? (I realize there is no wrong decision here, I was just curious, because you have lots of experience, are very athletic, and can see things in retrospect because you are 74).
Thanks again!
If I was facing my first aortic surgery at 65 I would probably go with a tissue valve with the idea that TAVR was also an option later. Maybe even if this was a redo I might also consider tissue. But in my case due to AFIB I need anticoagulants anyway. So a mechanical might make more sense for someone with AFIB. Potentially one and done.
Thank you for your response. I respect your input, as I do so many others on this site. Very helpful.
