Aortic Valve Choices

[newarrior]

same here. if i wear a hat with a brim it's exaggerated at the brim.

Post opp it was very visible, now its very subtle

That's great that the scar faded away I'm pretty neurotic I think I would probably want to get a plastic surgeon and try to erase any sign of it I live in the tropics and I like running around on beaches without my shirt on having a scar would sort of screw the whole thing up..

 

[newarrior]

My experience is exactly the same. As we have discussed, to me it sounds like a thud- like a normal heart beat just louder. Interesting that when others listen to my chest they hear it as a click. But, they have to put their ear right on my chest to hear it. No one has been able to hear mine just sitting next to me.
I was kind of bummed about that, because I love those stories about how people wonder where the ticking is coming from, especially the bomb scare story.
And, I am starting to not hear mine any more. It is quiet right now and I was completely unaware of any beating. But, I stopped and listened for it- yup, it is there, especially on deep breaths, but I am just tuning it out automatically now.

I suspect a lot of people in this group are extremely busy people with families and jobs and responsibilities so they may not have time to notice some of these effects from their new valve such as noise. But since you're early in recovery and probably chilling out at home a lot it's good to hear that you're already not noticing the sound. I have hearing loss and bad ringing of the ears and my doctor always advised me to never be in silence he said it's not normal so I'm always keeping pink noise and white noise in the background. Or keeping windows open

 

[tezza]

same here. if i wear a hat with a brim it's exaggerated at the brim.

Post opp it was very visible, now its very subtle

Yes, it is something I have always been aware of, even with my first surgery, but I think it is definitely exaggerated post surgery from 5 weeks ago. I expect it will settle again and it won't be so noticeable as time goes by.

 

[tezza]

Interesting you said the inner ear I've had ringing of the ears or tinnitus for 24 years too many clubs concerts playing guitar too loud headphones The Usual Suspects I'm not sure if that's going to make me more or or less adoptable to noises from a new heart valve. It doesn't sound good I don't see anything good about it I am used to keeping white and pink noise in the background all the time when I'm at home my hearing doctor always told me to avoid silence

I'm not sure. I have tinnitus as well but I don't know whether that makes me more or less aware of the heart sounds.

 

[newarrior]

Yes, it is something I have always been aware of, even with my first surgery, but I think it is definitely exaggerated post surgery from 5 weeks ago. I expect it will settle again and it won't be so noticeable as time goes by.

thanks and understood

 

[newarrior]

I'm not sure. I have tinnitus as well but I don't know whether that makes me more or less aware of the heart sounds.

Sorry to hear--I may be over thinking it)

 

[user 16827]

That's great that the scar faded away I'm pretty neurotic I think I would probably want to get a plastic surgeon and try to erase any sign of it I live in the tropics and I like running around on beaches without my shirt on having a scar would sort of screw the whole thing up..

Hi Dave I wasn't referring to my scar but as you mention it I always take my shirt off at the beach I also like the sun.
It doesn't bother me one bit I'm just not that vain

 

[elMIguel]

Hi Dave I wasn't referring to my scar but as you mention it I always take my shirt off at the beach I also like the sun.
It doesn't bother me one bit I'm just not that vain

Although I didn't get the full zipper (minimally invasive) I'm actually proud of my scar. To me it represents something that I've overcome.

 

[Superman]

That's great that the scar faded away I'm pretty neurotic I think I would probably want to get a plastic surgeon and try to erase any sign of it I live in the tropics and I like running around on beaches without my shirt on having a scar would sort of screw the whole thing up..

That’s not neurotic. That’s narcissistic.

Don’t get me wrong. You’re definitely neurotic too!

* All in good fun. I hope.

 

[tom in MO]

Scars are cool. A friend was shot in the shoulder, his scar is a badge of toughness One person with multiple surgeries who passed young said she said each scar was a sign of success.

 

[d333gs]

Hi
Curious
When is minimally invasive AVR not an option? When is the Full Zipper necessary? I would not think twice about minimally invasive AVR .....Its being split open I don't like
TIA
John

 

[Superman]

Hi
Curious
When is minimally invasive AVR not an option? When is the Full Zipper necessary? I would not think twice about minimally invasive AVR .....Its being split open I don't like
TIA
John

Well, I like it. I liked it so much I did it twice!

As for your question. That’s really up to the surgeon and their team. You would have to shop around to find someone willing and confident to do minimally invasive.

I’ve read enough stories on this site to believe it can be done in just about any circumstance if you find the right surgeon and trust them to do it.

 

[nobog]

Hi
Curious
When is minimally invasive AVR not an option? When is the Full Zipper necessary? I would not think twice about minimally invasive AVR .....Its being split open I don't like
TIA
John

You're weighing not the best access to about as good as it can be access. The Dr. is doing everything through a tube vs wide open. If it were my turn, and I was in reasonable shape, I would go the full zipper. Its hard enough with the tiny cuffs they are using to get a good seal and even a 1mm paravalvular leak is a big deal. Nothing worse than a "re-do" when it comes to heart valves.

 

[d333gs]

Nobog , are you in the waiting room or on the other side? If so what did you get done?
Thanks

 

[pellicle]

Nothing worse than a "re-do" when it comes to heart valves.

yet people here regularly do plan for exactly that:

I'm going to have a tissue prosthetic, which will get me 20 years (and then get 15 or less) and a TAVR (oh, sorry you're not a candidate) after that and I'll skip on in without ever a care in the warfarin world...​

just to avoid a little pill.

In the past when I said things like that I'd get called a tissue valve hater.

 

[Chuck C]

yet people here regularly do plan for exactly that:

I'm going to have a tissue prosthetic, which will get me 20 years (and then get 15 or less) and a TAVR (oh, sorry you're not a candidate) after that and I'll skip on in without ever a care in the warfarin world...​

just to avoid a little pill.

In the past when I said things like that I'd get called a tissue valve hater.

Hmmmm..... you sound kind of like a tissue valve hater

 

[pellicle]

Hmmmm..... you sound kind of like a tissue valve hater

I hate it when I wear the wrong shirt to a party

 

[d333gs]

yet people here regularly do plan for exactly that:

I'm going to have a tissue prosthetic, which will get me 20 years (and then get 15 or less) and a TAVR (oh, sorry you're not a candidate) after that and I'll skip on in without ever a care in the warfarin world...​

just to avoid a little pill.

In the past when I said things like that I'd get called a tissue valve hater.

Shoot, you are getting no 2? When I asked about a TVAR they said "that will be your second one", I guess thats not always true............

 

[pellicle]

Shoot, you are getting no 2?

Are you asking if I'm looking down the tube at a No2?

No, I've already had 3. First as a child in the 70's as a repair, which got me through to #2 in early 90's which was a homograft, #3 last week's of 2011 which was a bental with a mechanical.

My observations above are based on observations and statistics. Someone wins on the roulette table, might be you. Might be better to go with more certain odds.

Not my call. I exist here to offer thoughts and help people with the pragmatic issue of INR management.

... they said "that will be your second one", I guess thats not always true............

It's a question you yourself need to answer. There is already a lot of good posts here on that topic. I'd also do some hard statistical examination on what doesn't make you a candidate.

Also sit and read nobogs words slowly and think about things. Have you had much experience in repairing things?

Best Wishes

PS: I just consulted your Bio ... you are 67 right? In such a situation you would stand a higher chance of getting 17 (maybe more) years out of a tissue prosthetic. If you make it to 84 would you be wanting another procedure? You may well be frail enough that TAVR is your only remaining choice if the progression of SVD leaves you in a difficult position.

https://www.ahajournals.org/doi/full/10.1161/circulationaha.117.030729

SVD Definition​

SVD is an acquired intrinsic bioprosthetic valve abnormality defined as deterioration of the leaflets or supporting structures resulting in thickening, calcification, tearing, or disruption of the prosthetic valve materials with eventual associated valve hemodynamic dysfunction, manifested as stenosis or regurgitation. The precise mechanisms of SVD are not known but likely include tissue disruption or thickening over time because of mechanical stress in conjunction with abnormal flow shear stresses at the surface of valve leaflets, collagen fiber disruption, and tissue calcification.​

 

[cldlhd]

I'll try to keep this brief. I was diagnosed with BAV & ascending aorta aneurism at age 50. Monitored the aorta for 2 years and had replaced by dacron graft at 52 at the Cleveland Clinic. Surgeon inspected the aortic valve and confirmed it to be a unicuspid that was healthy and functioning so he left it alone. Here I am 7.5 years later with severe stenosis and need replacement soon. I'm very healthy, active and asymptomatic. Heck, I walked over 12.5k steps at the Cleveland Clinic the other day walking between the many testing area's. I've pretty much decided that I only want to do this one more time. This second time is difficult enough. I can't see installing a tissue valve with an expiration date of anywhere between 1 and 20 years. Yes, the thought of Coumadin sucks, but I feel it safer than more invasive surgeries down the road. Yes, there is TAVR but that has many potential risks as well.
So, for me it appears to boil down to either the St. Jude Regent or On-X valves. Has anyone directly compared these two valves? They are both made from the same pyrolitic carbon and are very similar in design. But, my surgeon appeared to favor the SJ as it appears a larger SJ can be installed in the same area as a On-X, and he mentioned the On-X is "Bulky" and I guess requires a larger annulus for proper installation. Which valve has better hemodynamics? They both appear to be robust enough and tested to last a "lifetime". Any thoughts/comments/experiences appreciated. I apologize if I am re-visiting an old topic. Thanks everyone! By the way, this is a great site.

I can understand you looking for more information about differences with the specific valves because in my humble opinion surgeons are like other humans who have a particular specialty and like to go with what they know. Also for what it's worth I agree with your choice to only have one more surgery and I'm sorry to hear you need another surgery in the first place. I worry a bit about a potential future surgery but there's no point thinking about it too much. I had my BAV repaired 6 years ago while they were replacing my aneurysm with the dacron graft. It sounds like you're in good shape and also in good hands so I'm sure you will come out of this well.