Aortic Valve and Root replacement

[Lotti]

Hi, My name's Lotti and I'm due for aortic valve replacement in the new year.
I am also having my aortic root done as it is badly stetched.
Although I am a spring chicken (37) I am definately erring towards a tissue valve (porcine). The lifespan of these are now very good, being between 15 and 25 years if you're lucky.
Re-surgery does not carry a huge risk, compared to re surgery of a mechanical valve, and no anti-coagulants are required.
This to me seems a really good idea, rather than the oh so regular blood tests needed if on anti-coagulants (warfarin in this country) and the risk of not being able to control your clotting at all as some people find out.
My surgeon was very open with me as to the risks of all different valves and has enables me to make a very informed decision.
Hope this helps.

Lotti

 

[Emma]

Very pleased you are happy with your decision Lotti but you were lucky to have a choice. We had no choice with my daughter's valve, she had to have mechanical to keep her alive and those oh so regular bloods are nothing compared to what what would have happened had she not had the valve replaced. Warfarin is nowhere near as bad as its made out to be by a lot of cardiologists and surgeons over here at all.
Hope your replacement goes well

Emma

 

[Johnny Stephens]

Re-surgery does not carry a huge risk, compared to re surgery of a mechanical valve, and no anti-coagulants are required.
This to me seems a really good idea, rather than the oh so regular blood tests needed if on anti-coagulants (warfarin in this country) and the risk of not being able to control your clotting at all as some people find out.

I don't often chime in on these, as valve choice is a very personal decision. However, I don't believe it's valid to minimize the risks of multiple OHS while also inflating those of finger-sticks or at the worst veinous draw for blood tests. I'm not aware of a mechanical valve being any more difficult to re-operate than a tissue one. Additionally, even some people with tissue valves wind up on Coumadin for arrythmias induced by the surgery.

To echo Emma - there is a lot of fearmongering around the anticoagulation idea - but for me, my diuretics have been the thing that drives me nuts.

You have made a valve choice that you are comfortable with, which is great! I'd just encourage you to be careful about some of the assumptions.

All the best for your procedure

 

[Lotti]

Aortic Valve and Root replacement

Help! I need assistance from you all.
I am 37 and have had a bicuspid aortic valve since birth.
i am now very badly calcified, with a gradient of over 70 and an effective area of 6mm2. My aortic root is badly distended and have been told to stop all excercise. I am due to have surgery early in the new year.
I've met my surgeon, who is wonderful and has eased my worries a great deal, but am still left with the worry of valve type decision to be made, and walking around at risk of aortic dissection.
I am lucky enough to have a choice of numerous valves, both mechanical and tissue and a surgeon who was willing to discuss openly the pros and cons of each type, but I am still so confused.
Anyone out there got any good advice or words of wisdom.
I would really appreciate it.

Lotti

 

[Mary]

To echo Emma - there is a lot of fearmongering around the anticoagulation idea - but for me, my diuretics have been the thing that drives me nuts.

Johnny,
As a newcomer to the diuretic scene, I have to agree wholeheartedly with what you're saying.

 

[Dennis S]

Valve choice

Valve choice

On August 4th I had the same surgery you are anticipating. I did just fine, but would NEVER want to do it again. Remember if you go tissue you are likely to have 2 more surgeries after this one. Each time you and whoever is going to help you through are going to be 10 to 15 years older than the time before.

 

[neal1234]

I had a bicuspid aortic valve, having a replacement three years ago at the age of 33. Personally I do not like taking medication and was reluctant to go for the mechanical option, also even with taking Warfarin you are still at risk of a blood clot, my surgeon put this at 1% per year, I therefore made the decision to go for the Ross procedure, unfortunately my valves were not the same size to undertake the swap and therefore went for a homograft, operation was a success and I have definitely noticed the difference and hopefully according to the surgeon it could last 20 years.
I personally did not find the operation as bad as I thought it would be.
All the best whatever option you choose.
Neal

 

[Curtsmum]

Good luck with your choice, like Emma we havn't been given a choice and was told our son will be having a mechanical. The best thing you can do is as much research as possible, the only right choice is the one that you are happy with, all the best

 

[TomS]

I just turned 48 and opted for a mechanical AVR (with also an AAA repair) this past August. You'll find that surgeons will typically suggest tissue since they do the operation every day, while cardiologists will recommend mechanical knowing they can treat you medically. Members here will tell you that neither is a guarenteed future. You can end up with a second surgery with a mechanical, or go into afib post op and require Coumadin with a tissue valve. But the odds of this happening are comparatively low.
What swayed me was the variation in span between operations for a tissue valve, with some going as little as a few years. This seems to be particularly true of younger people who plan to give the new valve a "work out".
Having lived through the degradation process, the watching and waiting, and the pre-op routine, I had no interest in knowingly setting myself up for a do-over.

 

[djexec]

Valve choice

Valve choice

Lotti,
Im almost in your exact situation, Im 36 (will be 37 in January) and I also have an AAA with BAV. I feel incredibly blessed to have found this site and to have learned everything that I have these past several weeks. I strongly recommend that your read the posts of tobagotwo (Bob H) and others on this site and then make your decision based on what YOU feel comfortable with. Valve choice is a hotly debated topic on this site and it can become somewhat overwhelming to digest all the opinions, but ultimately its a decision that should be made between you and your doctors. As someone on this site told me "the only wrong choice is not making a choice". Be thankful that you have the time and option to research which valve is right for you, make a decision and then don't second guess it. You will find tremendous support here regardless of your valve choice. I have a call in to my surgeon to schedule my surgery and my first choice will be a valve sparing surgery (provided my BAV is not too heavily calcified) and second choice is CE Magna bovine valve. I wish you all the best in your final decision & your forthcoming surgery.

Deane