Age and valve selection

[lynn]

I'm going for a cath on Tuesday, I am really nervous about this...I'm not sure why, I've had one before but not with all the symptoms I've been having lately. Anyway, on to my question....

I just have it in my mind that once that cath is done and the report is sent to Dr. Martin at Shands that I will get an immediate call for surgery (my mind is going 100 mph). I know there are threads galore about valve selection and age but I'm worn out looking for them

Sooooo....I'll be 47 next month and my cardio just automatically said mechanical, as did my old cardio before him. But, if I go to Shands and ask Dr. Martin "what about a tissue valve" sure I'll be 57 or so when it gives out, what new things on the horizon is there at that time??

I have a-fib, mild I think....so am I on coumadin anyway for life???

 

[geebee]

First question - are you already on coumadin or do you just think you will be because of the a-fib you believe you have?

If you will be on coumadin anyway, it does not make sense to get a tissue valve.

If coumadin is not a given and you are really opposed to it, 57 is not old for a second surgery. Please just keep in mind that each time you have surgery, you are taking a risk and each recovery is harder.

I expect advancements in the future but, as I have said before, I am not a gambler. I look at what exists now and base my decisions on those facts. Others feel much differently and I hope they find things are the way they want 10 years from now.

Best of luck whatever you decide. Maybe your cath will show you don't need to decide yet.

 

[lynn]

Hi Gina,

I was on coumadin for about a week when hubby and I decided to have the cardio get with the surgeon, I felt waiting 3 months to have another echo was kooky!! The pulsating in my neck is driving me nuts, and my numbers just don't look all that great...why wait? I did the holter and he said I had "an episode" of a-fib, I could take my chances and go on aspirin or do the coumadin, I did and then stopped to have the cath. Heck, I didn't even get over an INR of 1.1

Thanx for listening

 

[Ross]

An INR of 1.1 is unanticoagulated. A normal person can test at 1.1.

 

[KAJ]

Lynn,

I will go ahead and put in my two cents worth. I had my AVR at age 47. I also wanted to go with a tissue valve but the surgeon recommended against it. It was my decision but since he is the expert, I went with his recommendation. Now I am very glad I did. Lord willing, I hope I never, never, have to have another surgery. Coumadin has not been a big deal for me as I initially feared. Until now, I never, had to be on a long term medication. However, I think that is very minor compared to various medical treatments others have contend with such as chemo and so forth.

Karl

 

[DeWayne]

just had surgery 10 weeks ago, I am just a bit older than ou at age 52, it was my second surgery. I had an aortic aneuyrism in addition to the valve replacement so most of my ascending aorta was replaced as well.
If I had just needed the valve I would have opted for a mechanical valve, but with the aorta as well I went tissue valve. All I have read about 3rd generation tissue valves I am really expecting 20 years or more from it. The idea of 10 years and need a new one are for much older valves. The main problem with tissue valves is calcification, todays technology has lead to major improvements in that area and means tissue valves should last much longer than you might be reading from old articles. But at age 47 and just a valve I would probably go mechanical just knowing chances are I would never have to return for more surgery. I would also listen to the recommendations your surgeon has, after all he is the one that has the experience with this stuff.

 

[StretchL]

Hi, Lynn...

Hi, Lynn...

Sorry you're feeling anxious about your cath. I hope it goes smoothly for you and that you're comfortable throughout the procedure.

Just MHO RE: Valve Choice- Pray, trust your gut, and go with the one that feels like the best choice for you. Consult a couple/three very reputable surgeons if possible. I've found many very open to answering my questions via e-mail.

 

[temp69]

On-x a good choice. I got one three months ago. the coumadin is a pain in the ass -- but so was taking cholesterol lowering drugs a few years ago. get used to it.

there is some thoughts that if you do an on-x you might not need coumadin in a few years -- it's going through trials.

you want to live well into your 90's, so mechanical valve is the way to go.

 

[lynn]

Thank you all for your comments, every little bit helps!

As far as taking meds, it's not a problem for me, being a BC survivor, meds are just another part of my everyday stuff!

 

[Ross]

I'm for anything that is going to hopefully keep you from having another heart surgery, so that would be mechanical at your age. I don't care how many times they tell you that this can be done again. After 2 OHS's, I can say with certainty that you don't want to go there.

 

[Mary]

I know there are threads galore about valve selection and age but I'm worn out looking for them

You're right; there are threads galore. Have you looked in the valve selection forum? Oh, that's right, you've posted in the valve selection forum, so you know where it is!
Tobagotwo's threads concerning selection are at the top of the valve selection forum; have you read those?
VR is a wonderful site for valve replacement for members, but it's impossible to recap all the threads for every new member. Take a deep breath, grab a cup of coffee, and feel free to start reading!

 

[Jay F]

Just got a tissue valve

Just got a tissue valve

Hi there, I know how you feel. Seems that between the ages 40-55 is a tough valve desicion. I am 11 days post op with an aortic tissue valve. I am 44 years old from the NY area. I went to what would be considered the finest cardios / surgeon / hospitals. They all said tissue was the way to go. They all seem to have alot of confidence in current valve technology and much confidence in the future of surgical technology. I had spent countless hours here trying to make a decision along with email to doctors and consulting with friends of friends in the medical fields. This is how I made my decision: I researched to find who would be considered the best doctors for me / who I would feel most confident taking care of me and just asked them. There does not seem to be any perfect answer. 50% of people on Coumadin will tell you there is no problem whatsoever and the other 50 will tell you horror stories. If you have been on coumadin before and it never was a problem for you then maybe that should help you make your decision. I know that would have helped me. Nevertheless, if you have time, do your research and tap every resource you can imagine but remember one thing: You have to rest in between. Your body and mind need a break, dont make yourself sick. Before I made my choice I was getting 2-4 hours sleep every night and my surgeon new it the minute he met me... God Bless, you are on your way.........J

 

[Karlynn]

I've had my St. Jude mechanical for almost 15 years. I'm very pleased that it's given me 15 surgery free years. I had mine done when I was 32, so I'd most likely be well into my 2nd valve replacement by now. My recovery was long after my VR and I'm glad I haven't had to take time out of my busy life for that. The choice was good for me and my life style. I was already taking drugs for arrhythmia, so one more drug didn't matter to me. I home test and do my own dosing and life rolls along.

I would disagree with Jay that 50% have horror stories. But I get his point. There will be some people who hate taking Coumadin. I think most of us are fine with it. The statistics are good, but as in any statistical equation, whether it be warfarin, reoperations or auto accidents, there are people on the wrong end of the stats. If you want to get a thumbnail view, read this thread http://valvereplacement.com/forums/showthread.php?t=17116 .

One thought I had was that some people have post-operative issues with a-fib. The unknown for you is "Will the VR decrease your risk of A-fib, or will it cause you to have more." I'd hate to see you go with a tissue valve and end up on Coumadin anyway, since you've already had a brief history with a-fib.

But as Stretch said, go with your gut, the Holy Spirit, intuition, or whatever it is you call that "thing" that lets you know you are feeling better about one option as opposed to another.

The only wrong choice is not getting the surgery done at all.

Best wishes.

 

[catwoman]

I would disagree with Jay that 50% have horror stories. But I get his point. There will be some people who hate taking Coumadin. I think most of us are fine with it. The statistics are good, but as in any statistical equation, whether it be warfarin, reoperations or auto accidents, there are people on the wrong end of the stats.

I'm inclined to agree with Karlynn.

Compliance (taking Rx daily, getting INR tests, etc.) and having a competent anticoagulation manager -- and they ARE out there! -- separates the successful patients from the disgruntled ones.
It's a no-brainer, as far as I'm concerned.

 

[Jay F]

Correction

Correction

I stand corrected by Karlynn. My statement of 50% horror stories may have been an exaggeration and thank you Karlynn for understanding my point. There just seems to be an equal balance of positives and negatives. Her post was excellent! especially the end which I will quote again as I say goodbye and God Bless

Said by Karlynn:

" One thought I had was that some people have post-operative issues with a-fib. The unknown for you is "Will the VR decrease your risk of A-fib, or will it cause you to have more." I'd hate to see you go with a tissue valve and end up on Coumadin anyway, since you've already had a brief history with a-fib.

But as Stretch said, go with your gut, the Holy Spirit, intuition, or whatever it is you call that "thing" that lets you know you are feeling better about one option as opposed to another.

The only wrong choice is not getting the surgery done at all."

 

[Matt]

Turned 47 last month, the same month as my surgery. My two cents...
I went mechanical for all the reasons already mentioned. I wanted the best of what was avaiable today as timing has never been a strong suit for me. So guessing about the future and what it would hold in terms of advances was hard for me to grasp.
Also, now post op for 4 weeks, I am in complete agreement with Ross: I do not want to go through OHS again if I can help it.

 

[lynn]

Again, thank you everyone for your insight! This is why I posted this to get personal stories

Cath went good yesterday, arteries look clear!! My back was killing my from laying flat on that hard rock hospital gurney...ugh! I'm chillin' at home today, maybe watch a movie or two!

I have an appointment with Dr. Martin at Shands next Monday for consult, I'll have to start my list of questions!

 

[belajob]

One item I have not seen discussed with valve replacement has to do with using a surgeon who does the minimal invasive surgery (such as done at the Mayo clinic) vs the standard 8-10 incesion (sp) I think the recuperation period may be much shorter. Has anyone gone to the Mayo clinic for the minimal invasive surgery?

 

[DM2059]

Tomorrow Oct. 14 will be my five month anniversary for aortic valve replacement. I am now 46 and chose a tissue over the mechanical that the doctors were recommending. It was not a simple solution. After much research I based my decision on lifestyle. I own a landscaping company in south Fla. and drag race for a hobby. Work would be a real hassle if I was on Coumadin. Coumadin is not allowed in any form of motorsports. I was not willing to change my lifestyle for the doctors. Besides common sense told me that in 10 to 15 years there will be advancements no matter what valve you choose. Good luck with your decision.

 

[StretchL]

One item I have not seen discussed with valve replacement has to do with using a surgeon who does the minimal invasive surgery (such as done at the Mayo clinic) vs the standard 8-10 incesion (sp) I think the recuperation period may be much shorter. Has anyone gone to the Mayo clinic for the minimal invasive surgery?

Jay F. had a minimally invasive procedure by Dr. Colvin at NYU (I think) a couple of weeks ago, and, based on speaking with him the other day, he seems to be doing remarkably well.