44 years old athletic need AVR within month

[torreypines]

Christine,
I am in the same position as your husband. I just turned 40 on 11/14 and have been tracking an aortic anuerism and bav for the last 5 years. My anuerism is now 5.0 and I have an appointement Dec 8th to discuss planning surgery. I am very active, I played colligiate and club lacrosse, have studied karate for 30 years and run 5 miles 4-5 times a week. I have gone back and forth on which valve I want but as of now it is mech. My thought is that the bio valves although lasting longer in general, wear out faster in younger active patients. I dont know if I want to depend on new technology being around by the time I need another operation so I will do what it takes to avoid another open heart. As routine as it has become it is still a major surguery with possible complications and recovery times that effect work,and demands on family. I have two young girls and I dont want to have to explain twice in their life that I cannot pick them up or do things with them.
I am not thrilled with meds but it seems that people get used to it and live very active lives.
Hope this helps
Nick

Hi Nick,
Thanks for your note. It looks like you and I are about the same age. And if all goes as planned Kurt will have his OHS on my 40th! While I hate the thought of him having to go through the surgery, having him for the next 50 years is the best present I could ever ask for. After discussing this extensively for the past 5 days, we've decided to go with the On-X valve that the surgeon recommended. Our reasons are the same as yours. The prospect of having 2 or more surgeries for this is something we decided was too much. And not just the surgeries but the preceding deterioration. Best of luck to you when it's your time for OHS.
~Christine

 

[torreypines]

Hi Christine,

I am 46 years old and had two mechanical valves put in about 3.5 months ago. While I don't think anybody calls me athletic, I do like to keep active and hope to return to running soon.

I also chose mechanical because I did not want another operation (and recovery) looming in my future.

So far, the mechanical valves have been just fine. I can hear them (this is common, as you probably already know) but it's not too distracting.

Coumadin has been fine. I don't have a machine yet but my anticoagulation clinic is nearby and the apppointments are quick.

I had no qualms about being on a daily medication "for life" as I am already on synthroid every day forever anyways.

I suspect that many people who avoid mechanical because of the need for medication for life are shortchanging themselves, because once they are in the care of a cardiologist they often find themselves on a daily statin or beta blocker or baby aspirin, so end up having to think about medication every day anyways.

Hi LuckyGuy,
Thanks so much for sharing your personal story. I'm glad to hear you're doing well...that's encouraging to hear. Your kids are adorable!
~Christine

 

[Barry P.]

I never thought taking Coumadin was a tether. After a couple of months you get regulated and it is like taking any medicine once a day. I self test, and I do it about every three to four weeks. Taking Coumadin isn't as scary as most people make it out to be, and it isn't as sensitive as you might think.
I didn't want to opt for surgery every 10 to 15 years, even though the art gets better and better.
The mechanical valves for the most part are like Timex watches, the take a licking and keep on ticking.

 

[vprnet]

Welcome and all the best for your surgery.

Also a BAVer I went with the ON-X and conduit. I bike, use power tools, and have had my share of cuts and wounds since being on warfarin. The worst was when I bit my toung while recovering. I think it was the percaset effect.In all cases the bleeding stopped within reasonable time.

I chose the ON-X for many reasons but ultimatly becasue there seems to be good reason to believe it's more forgiving at the low end of the INR range, which may be born out when the PROCAT study is completed.Taking warfarin is easily managed with the home testing unit. It's going on a year now and the ease of managing the drug is just as advertised.

I don't think I would be as care free about the future if I had to live with the odds of a reop and the thought of when I would have to plan to dedicate another six months of my life for it.

Best of luck with your decision.

 

[JohnCalderwood]

Ross,
Please be careful when you are biting your tongue. It could lead to internal bleeding. LOL. You should give your opinion Ross. It is a good one. Even if you cut and paste it again. It may have swayed me. So please respond away.Then again if the ticking keeps me awake you could be the first I call late at night.LOL. If that is my only concern I will gladly take it.

 

[Mileena46]

Ticking is also not an issue. In my case I have a muscular torso which I'm told helps to muffle any valve noise. I was aware of it at first, but don't even notice it now unless I focus on trying to hear it.


Yea yea yea...I am listening to mine through a pair of Double Ds and it is still LOUD!

Mileena

 

[river-wear]

hmm, Mileena, there's another thing for the "pre-surgery" to do list: implants!

 

[Mileena46]

Well, I asked my surgeon if he couldn't just give me a little lift...after all he would already be in the area. Since he is a professional and I don't know how to act around them, he just left the room! It was good for a laugh!

 

[jimbo]

Hello. I was in a situation very simular to your husbands. (Age and BAV) I skiied, weight lifted, backpacked, played golf, sailed, etc... I had my valve replaced 2 years ago with a mechanical. Today...., I ski, weight lift, backpack, golf, sail, etc... I live the same way as I did before. The only difference is I take my cumadin every night and I don't do back flips on skiis anymore! Life does go on. I've hit some small speed bumps along the way (a-fib a couple times) but I live everyday like it's my last.

 

[soccerdad]

Hi Kurt,

I'm 46 and will be having a St. Jude mechanical "installed" on Dec 29th. I researched a Ross, tissue and mechanical and feel like I've done my homework along with a great surgeon (McGiffin / UAB-Kirklin Clinic), I feel like I've done all I can do. I weighed the coumadin and re-op's, etc. and for me the St. Jude's the way to go. I'm looking forward to getting back to my "wide-open" self again.
Full Steam Ahead.

Kurt

 

[RunMartin]

Hi Kurt

I am 47 years old and have been watching this forum for 6 years. I was very active until two weeks ago when I was admitted to hospital and told it was time to have my valve replaced. I made my decision a few years ago to go mechanical after listening to people like Ross and others. Whilst in hospital I asked a cardiologist what valve he would choose if he were in my position. He immediately answered with mechanical (I did not tell him what my choice was before hand). It was good to get someone elses independent view. This has made me feel better about my choice.

Martin

 

[SignlRun]

Hey Kurt,

I am 44 year old that is just over 17 months post op from AVR and repair of ascending aorta. I went with On-X valve for very similar reasons as other folks.. once at this dance is plenty. I was very active before surgery; Ironman triathlon in 2006, couple of marathons, a few century rides on the bike. The surgery does take the wind out of your sails for a few months but you will recover just fine; patience is key. I am back running and have my first half-marathon scheduled for February. I absolutely will do more marathons, triathlons and at least one Ironman. Nothing to keep me from it. Coumadin is no big deal for me and the ticking sound is good conversation at parties.. my kids love to gather their friends around to listen to it (the younger you are the better you can hear it.. kids have really good hearing no matter how much they ignore their parents).

If you have any questions at all feel free to ask.. I know I was very apprehensive about the whole deal. My heart surgery was the first time I had ever been in the hospital.

Best of luck to you!

Blake

 

[torreypines]

Hi Kurt thanks for your post, it is good to see the thought process behind each individuals decision. Thanks much Kurt.

 

[torreypines]

Thanks Martin, I am glad to hear a solid reply to your question from a Cardiologist. The choice between Biomechanical or Mechanical obviously is a personal one, but an answer none the less is good to hear.

 

[ALCapshaw2]

Hi Kurt,

I'm 46 and will be having a St. Jude mechanical "installed" on Dec 29th. I researched a Ross, tissue and mechanical and feel like I've done my homework along with a great surgeon (McGiffin / UAB-Kirklin Clinic), I feel like I've done all I can do. I weighed the coumadin and re-op's, etc. and for me the St. Jude's the way to go. I'm looking forward to getting back to my "wide-open" self again.
Full Steam Ahead.

Kurt

Which St. Jude Valve did you choose?
(Master's series with 30 year track record or the newer Regent which is their answer to the On-X Valve).

Did you evaluate ALL of the Mechanical Valve options (ATS, CarboMedics, On-X, St. Jude Master's, St. Jude Regent, and the older Medtronics)?

 

[soccerdad]

I did not research specific models of the St. Jude. I will ask Dr. McGiffin which we'll go with. My assumption is that it would be the newer (Regent) version of the St. Jude. I'll post when I find out. McGiffin left it up to me to decide. He outwardly didn't have a favorite but said that they use St. Jude unless otherwise decided. Only On-X and St. Jude were ever discussed. I've had other discussions with other heart surgeons (friends of friends) and their choice would be St. Jude. Even when I was thinking Ross.

 

[ALCapshaw2]

I did not research specific models of the St. Jude. I will ask Dr. McGiffin which we'll go with. My assumption is that it would be the newer (Regent) version of the St. Jude. I'll post when I find out. McGiffin left it up to me to decide. He outwardly didn't have a favorite but said that they use St. Jude unless otherwise decided. Only On-X and St. Jude were ever discussed. I've had other discussions with other heart surgeons (friends of friends) and their choice would be St. Jude. Even when I was thinking Ross.

MY choices would be On-X first, then St. Jude Master's Series second.
I have some personal reservations about the Regent.

 

[Luana]

Hi Christine and Kurt,
I just had AVR surgery on Nov 20, two weeks ago tomorrow. When I initially met with the surgeon, he suggested a mechanical valve over tissue, as a tissue valve would mean an additional two, or possibly three surgeries for me because of my age. This seemed like the right decision for me at the time and I had no reason not to agree with him. His choice was an On-X valve and I was pleased with that, too. I must admit, as the surgery date grew closer, I did wonder if this was the right choice and had doubts that maybe a tissue valve would be better.

In the first few hours of regaining consciousness after the surgery, I found myself repeatedly thanking God that I would most likely never need another AVR and blessing the surgeon for the wisdom of his choice. For me this is as much of a relief as it will be to get my life back.

Turned out he needed to use a St. Jude valve instead, and there's no disappointment on my part with it. I am mostly unaware of it. My damaged aortic valve was much more audible! I sleep on my left side and don't hear it when I get in bed and lie down. I can sometimes hear it when I'm sitting or standing and it's very quiet and my heart rate increases, but it's not unpleasant or annoying in any way.

It hasn't been long for me, but so far I'm very pleased with the way it's turned out. I wish you all the best for your surgery and recovery.
Luana