Did you do other exercise before that you have quit ? I myself have settled on a fairly low stress regime--about 8000 feet a day walk 25 mins cardio via the treadmill and 10 mins every other day of weight lifting
9 Questions for Those with BioProsthetic (Tissue) Valves
- Thread starter BionicBuddy
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Help Support Valve Replacement Forums:
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- Jan 3, 2022
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1. At what age did you get your bio-prosthetic valve? 58
2. How long have you had your bio-prosthetic valve for? 14 months
3. If your valve failed, what was the reason? No fail
4. Are there any medications you have had to take after surgery because of the bio-prosthetic valve replacement surgery? Metoprolol for a year and a baby aspirin
5. Did you have any complications after your surgery? No
6. What is your exercise tolerance like now after surgery? Same as before
7. On a scale of 1-10, with 1 being miserable and 10 being happy, how happy are you with your choice for bio-prosthetic valve? 10
8. Is there anything that you would do differently now, that you have had this experience, and from all the things you have learned thus far? No, this was my second OHS and I am accustomed to this. It feels normal to me and with medical advancements, and the possibility of TAVR, I have peace of mind with my choice.
9. Any further tips to share on how to experience success and a great quality of life having made this important valvular choice? Carpe diem! Do everything you can to enjoy your life on a daily basis and listen to your doctors, but maybe don't hesitate to get a second opinion on such a big issue.
2. How long have you had your bio-prosthetic valve for? 14 months
3. If your valve failed, what was the reason? No fail
4. Are there any medications you have had to take after surgery because of the bio-prosthetic valve replacement surgery? Metoprolol for a year and a baby aspirin
5. Did you have any complications after your surgery? No
6. What is your exercise tolerance like now after surgery? Same as before
7. On a scale of 1-10, with 1 being miserable and 10 being happy, how happy are you with your choice for bio-prosthetic valve? 10
8. Is there anything that you would do differently now, that you have had this experience, and from all the things you have learned thus far? No, this was my second OHS and I am accustomed to this. It feels normal to me and with medical advancements, and the possibility of TAVR, I have peace of mind with my choice.
9. Any further tips to share on how to experience success and a great quality of life having made this important valvular choice? Carpe diem! Do everything you can to enjoy your life on a daily basis and listen to your doctors, but maybe don't hesitate to get a second opinion on such a big issue.
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- Mar 26, 2023
- Messages
- 16
Ha! I was thinking about a survey like this and you beat me to it. According to my cardiac team, one factor was whether the patient has coronary disease that makes their veins harder and/ or narrower. I asked from a mitral valve perspective but assume aortic valve should apply too.
63 years
Since 6/6/2012. Almost 11 years. St. Judes Trifecta 25mm bovine aortic valve.
Eecho test every other year shows that it's working fine. I originally had a bicuspid aortic valve since birth.
No post meds if I recall. I don't take any meds due to my new valve.
No complications.
After the required physical therapy sessions, no restrictions on exercise. I'm a serious road cyclist and hiker.
10.
Nothing different. My wife insisted I avoid mechanical valves due to my somewhat risky activities.
Besides my bi-yearly echo tests my life goes on as if nothing happened.
Tom
1. 56 - 9/23/2009
2. ~14 years
3. no failure
4. Atenolol, lisinopril, aspirin, vitamin, Prilosec, Lipitor (all daily)
5. None
6. No restrictions
7. 10+
8. Nope
9. I was told to expect 10-15 years with this valve and then a re-do (hopefully TAVR) My last checkup last month, based on current conditions - can expect another 10-15 years (fingers crossed). But, if I did need to get another replacement, I have not maintained good eating and exercise habits as I have grown older. That is one big regret thus far…. Stay healthy.
Did your cardio or surgeon say it would be possible that in the very distant future, should you require another operation, that a TAVR could be done within your Magna Ease valve?
Did your cardio or surgeon say the re-do could be TAVR for you? What type of bioprosthetic/tissue valve do you have?
What type of bioprosthetic/tissue valve do you have, and did your cardio or surgeon say that you may be a candidate for future TAVR if necessary?
Did your cardio or surgeon say that a possible future intervention, (if you even needed one), could be TAVR with your Magna Ease?
What type of bioprosthetic/tissue valve do you have?
No...because at that time it wasn't thought that TAVR could be inserted within a previous aortic valve replacement.
As it is, even if that had been a possibility, my valve, at 19mm, is too small to take a TAVR.
- Joined
- Jan 3, 2022
- Messages
- 68
I have the Inspiris Resilia valve and I was told I could be a TAVR candidate in the future.
I do have Patient Prosthesis Mismatch (the valve is too small for my body size) !!! How did that happen?
1. At what age did you get your bio-prosthetic valve?
67
2. How long have you had your bio-prosthetic valve for?
1.5 years
3. If your valve failed, what was the reason?
4. Are there any medications you have had to take after surgery because of the bio-prosthetic valve replacement surgery?
No
5. Did you have any complications after your surgery?
No
6. What is your exercise tolerance like now after surgery?
High
7. On a scale of 1-10, with 1 being miserable and 10 being happy, how happy are you with your choice for bio-prosthetic valve?
10
8. Is there anything that you would do differently now, that you have had this experience, and from all the things you have learned thus far?
No
9. Any further tips to share on how to experience success and a great quality of life having made this important valvular choice?
Hard to say , I really did not make many decisions , I went with the doctors suggestions
67
2. How long have you had your bio-prosthetic valve for?
1.5 years
3. If your valve failed, what was the reason?
4. Are there any medications you have had to take after surgery because of the bio-prosthetic valve replacement surgery?
No
5. Did you have any complications after your surgery?
No
6. What is your exercise tolerance like now after surgery?
High
7. On a scale of 1-10, with 1 being miserable and 10 being happy, how happy are you with your choice for bio-prosthetic valve?
10
8. Is there anything that you would do differently now, that you have had this experience, and from all the things you have learned thus far?
No
9. Any further tips to share on how to experience success and a great quality of life having made this important valvular choice?
Hard to say , I really did not make many decisions , I went with the doctors suggestions
I've had very high pressure gradients ever since my AVR, around 56 peak, 35 mean. Three years after surgery I was referred to a cardiac surgeon for review about this (I didn't see the surgeon who did my AVR because I wasn't too happy with her). I liked the new cardiac surgeon very much. This is when he confirmed that I had moderate patient prosthesis mismatch which can be worked out from the size of the replacement valve, the patient's weight and height and calculations in echocardiogram. The surgeon explained that when the bicuspid aortic valve is removed the 'annulus' is measured and that tells the surgeon what size valve to put in - he explained that the annulus is made of very fibrous material and it doesn't stretch to put in a bigger valve than it's size.
A surgeon should be able to calculate at that point in surgery if the replacement valve will be appropriate - if there is some patient prosthesis mismatch I suspect they have to decide if that will be acceptable or if they have to do something else like putting a bigger valve in supra-annular position. I've no idea what my surgeon thought because in the Operation Note she simply wrote she measured the annulus and put in the 19mm valve.
Nine years later the valve is still okay despite the high pressure gradients.
What type of tissue valve was it, and is it TAVR ready, or did your surgeon say a valve-in-valve was an option for you in the future if necessary? Thanks!
Pellicle, not to sidetrack this thread, but do you or others here think that lot's of activity wears a bio valve out early? I realize the medical establishment leans to a no answer.
Sim
Member
I have a mechanical valve and I believe I also have a mismatch. I received a St. Jude 21mm and I am a 5 10 male. My pressure gradients are a little more than normal. I have cold extremities all the time but I am able to exercise with no problems. I was 34 at the time of surgery, 2nd OHS to replace the aorta and a new valve. My old valve was placed when I was 10 and had it for 24 years. My left ventricle is mildly hypertrofied but it was like that before surgery but I had nonsymptoms. It's been 8 years since my surgery. Hope to have this valve for many decades.
pellicle
Professional Dingbat, Guru and Merkintologist
Good morning
Sun just coming up here in (my part of) Australia, and I like going for an early morning walk in the wintertime to escape the cold of the house; so I'll try to be brief.
So, my short answer is yes; but its probably not what you think.
I don't think its just related to the pressures the valve experiences and increase in frequency of actuation (mechanical wear) that does it. Instead I believe its related to the associated biochemistry of the cocktail of things circulating around in your blood.
First lets say there are correlations and causations. Sometimes correlations are indicators that causality is there and we should look for it, other times its just only that - correlation.
That its only correlation is usually cleared up with more data. There is clearly a causal link between Structural Valve Degradation (SVD) and youth. This is well known and not subject to any leaning in the scientific community (I say scientific because surgeons are not the ones who research, design and make valves; they just stitch them in).
If you read up on SVD (I recommend this link as an excellent roundup from 2020) you can see that a lot of what causes SVD is directly related to exersize generated biochemistry. In short the mineralisation of the "piece of leather flap" that is essentially what a bioprosthesis is gets attacked by the biochemistry of the living body.
Much of this slows down with age of course, but it is my view that it slows down less in people who are active.
Next you should look at the physiology of the native valve, and observe key points like "cellular regeneration". This article is a deep dive but depending on your patience in reading such things is very informative. I'll snapshot a good point
Basically the structure of the native valve is such that the tissue is not only regenerative but very flexible, its not "vascularised" (like skin is) because its permanently immersed in a bath of the freshest blood. If its not then you have broader systemic problems ;-)
Anyway I recommend you read that pointer to SVD in the first link and then get further down to Strategies for SVD Prevention. Note these are at the manufacturing stage and note also the words: "Its exact mechanism is unknown".
This leaves us with "more research is needed" as well as the basic observable facts (called statistics), such as the onset of SVD based on age and the interesting observation that all bio-prosthesis manufactures seem to like terminating their research into longevity of valves at 10 years. Perhaps that's because they think that the median age is in the mid 70's for valve replacement. I googled that exact question and got this:
So since that's their market that's what they make. Questions of "will it last longer in young active, sporting and fit 60yo" are not of interest to them.
Thus we are left to conjecture. So, look around this forum and see how many of the fit active sporting weight lifting types have mechanical, and which have tissue.
HTH
Best Wishes
Sun just coming up here in (my part of) Australia, and I like going for an early morning walk in the wintertime to escape the cold of the house; so I'll try to be brief.
nicely phrased question.
So, my short answer is yes; but its probably not what you think.
I don't think its just related to the pressures the valve experiences and increase in frequency of actuation (mechanical wear) that does it. Instead I believe its related to the associated biochemistry of the cocktail of things circulating around in your blood.
First lets say there are correlations and causations. Sometimes correlations are indicators that causality is there and we should look for it, other times its just only that - correlation.
That its only correlation is usually cleared up with more data. There is clearly a causal link between Structural Valve Degradation (SVD) and youth. This is well known and not subject to any leaning in the scientific community (I say scientific because surgeons are not the ones who research, design and make valves; they just stitch them in).
If you read up on SVD (I recommend this link as an excellent roundup from 2020) you can see that a lot of what causes SVD is directly related to exersize generated biochemistry. In short the mineralisation of the "piece of leather flap" that is essentially what a bioprosthesis is gets attacked by the biochemistry of the living body.
Much of this slows down with age of course, but it is my view that it slows down less in people who are active.
Next you should look at the physiology of the native valve, and observe key points like "cellular regeneration". This article is a deep dive but depending on your patience in reading such things is very informative. I'll snapshot a good point
Basically the structure of the native valve is such that the tissue is not only regenerative but very flexible, its not "vascularised" (like skin is) because its permanently immersed in a bath of the freshest blood. If its not then you have broader systemic problems ;-)
Anyway I recommend you read that pointer to SVD in the first link and then get further down to Strategies for SVD Prevention. Note these are at the manufacturing stage and note also the words: "Its exact mechanism is unknown".
This leaves us with "more research is needed" as well as the basic observable facts (called statistics), such as the onset of SVD based on age and the interesting observation that all bio-prosthesis manufactures seem to like terminating their research into longevity of valves at 10 years. Perhaps that's because they think that the median age is in the mid 70's for valve replacement. I googled that exact question and got this:
What is the average age for aortic valve replacement?
The mean age in the study population was 75.1 ± 6.6 years
So since that's their market that's what they make. Questions of "will it last longer in young active, sporting and fit 60yo" are not of interest to them.
Thus we are left to conjecture. So, look around this forum and see how many of the fit active sporting weight lifting types have mechanical, and which have tissue.
HTH
Best Wishes
Last edited:
However, google likely lumped BAVs in with normal tricuspids. I think this important variable could factor into conjecturing about this topic. What do you think?
