Aortic valve replacement in the near future

[gotogal44]

I am reposting this as a new thread. I had posted this as a reply to Marie (Earline) but it occured to me that I might get more replies if posted as new.

So here it is again

Before I tell you about me, and ask my questions I do want to Thank Marie (Earline) for giving me this site. I belonged to a valve replacement site over 5 years ago when I thought the aortic valve was going to be replaced. I had gastric by-pass surgery almost 4 years ago and seemed the weight loss helped me keep the hard working but sad valve longer. Now it looks like the valve has gotten worse.

I had rheumatic fever when I was a kid, and that left me with an enlarged heart, and of course a valve that has issues.

I actually typed all this before, and then went to spell check and everything disappeared, so here I am typing it again hoping the same thing doesn't happen. Back to my story, the murmur didn't show up until my first pregnancy at about the age of 21, it was very quite, now it is so loud it blocks out the sound from the carotid which has created yet another problem.

We have found that the left side (carotid is totally blocked) Luckily I have collateral veins that have taken over, the right side is blocked but still OK, but seems it is building up more quickly then the vascular surgeon likes, for that matter I am not so thrilled. - but hey at least this is not caused from the rheumatic, this is apparently hereditary from my mom. She had to have her carotid roto rootered at the age of 80, I on the other hand am 63, DARN, couldn't inherit that longer time.

I will be seeing my Cardiologist on Monday, trying to make sure I have all my questions in a row, help is needed here. I know that Earline was able to have the valve changed without the cracking of the chest, because her arteries (not the carotid) were clean, she had an angiogram. My last angiogram was over 5 years ago. So I think I should request that be done.

I wanted a tissue valve replacement, but my cardiologist wants to do a mechanical valve, for those of you that have one tell me about it. Are there different types and are some better then others. I think his reasoning is because they last for ever, or until the body just is done, where the tissue valves are only good for about 10 years.

Please give me some advice on other questions I should be asking. My vascular surgeon has met with the cardiologist, and I will be seeing him again in three weeks. I think he wants to get the carotid cleaned out, seems it is blocking faster then we realized and he doesn't want to take any chances, but often they (the surgeons) want to do both surgeries within days of each other.

So please tell me about what valve was used if you have had a valve replacement (Aortic) - and any other info that can help me make a good and educated decision. I also deal with anemia, so I am concerned about taking blood thinners which it is my understanding you must take when the valve has been replaced with an artificial valve.

I am sure that I have more things I want to ask but I will stop here and look forward to hearing from any and all of you.

Rosie

 

[Ross]

Rosie at your age, I'd go tissue. The new tissue valves are lasting up to 20+ years. Don't have solid evidence as of yet, but they are much more promising then the earlier valves.

I have Mechanical and it should last my life time, but there are no guarantees. Things like infection, blood clot forming on the valve, sewing cuff diishencing etc, would call for another replacement.

Blood thinner is a bad word around here. Coumadin is an anticoagulant. You blood doesn't get thinner, it simply inhibits clotting. If you decide to go mechanical, please read all you can at www.warfarinfo.com and include Coumadin as part of your learning process. Also check the anticoag forum stickies and forum in general. My thinking is, tissue might well last you the rest of your natural life and you wouldn't have to deal with the Coumadin issues. They aren't that bad, but they do create inconveniences.

 

[gotogal44]

coumadin- Darn that was the word I wanted

coumadin- Darn that was the word I wanted

Thanks Ross for the quick response- I should have said coumadin, my dad use to call it his blood thinner, but the word escaped me. So I will use the word coumadin for sure. LOL

The surgeon I am going to wants to use the artificial, I have been going to him for over 7 years, but at this point I want a say in this. I would prefer tissue, but will go to the sites you have suggested and read away.

I think this is going to happen more quickly then I had thought.

Again thanks for the quick response and advise.

Oaktree thanks for the info as well, my caridologist is the surgeon, and he is the one that wants to do the machanical. He and I will be talking a lot more starting Monday.

Rosie

 

[Ross]

Give it some time for the tissue folks to come aroiund. They know more about them then I do. I'm pretty concentrated on Mechanicals. It's slow on the weekends here also, so you may not get many responses until Monday.

Oh and yeah, it's Anticoagulant not blood thinner.

You do have a right to choose, so you came to the right place. I think we have at least one of every kind of valve made in the membership.

 

[Bina]

Hi Rosie and welcome.
I have a mechanical valve and take warfarin (Coumadin-brand)....I don't have any problem so far with the drug and I test my blood at home.
If a tissue valve lasts you for 15 yrs, you will be 78 and needing OHS. Of course the valve could still be perfect and something else comes up. We just never know for sure, so we go with our gut feeling.
It's a decision that you need to make with your doctors, we can only share our experiences and opinions.

 

[ALCapshaw2]

Welcome Rosie,

The Tissue Valve with the Longest Proven Longevity is the Bovine Pericardial made by Carpentier-Edwards. In patients over age 65 at implant, it is approaching 20 years durability about 90% of the time. Their newer products have an anti-calcification coating that is *hoped* to increase that by another 5 years or so.

To MY mind, the Best Mechanical Valves are the relatively new On-X Valves which were introduced in 1996. They have several promising technological improvements over their predecessors. Over 60,000 On-X Valves have been sold to date.

See www.onxvalves.com and www.heartvalvechoice.com for more info. You can contact the company to find out the names and phone numbers of surgeons in your area who have used the On-X valve. (contact Catheran Burnett at 888-339-8000 ext. 265)

Other (older) designs are made by ATS, Carbomedics, and St. Jude. The St. Jude valves hold the award for longevity, having been around for 30 years now.

'AL Capshaw'

 

[Superbob]

Hi Rosie, and welcome.

I, too, was 63 when the time finally rolled around for my valve replacement. A lot of considerations go into valve choice, so do your research, then decide what's best for you and go with it.

One thing I'd recommend, if you haven't done it already, is go to Valve Selection and read the sticky, "Famous tobagotwo writings on valve selection." You will get a remarkably balanced and well written rundown there.

I agonized quite a bit over my selection. In my case, my cardiologist and my surgeon were (and are) both top-rate but they left the choice of valve type entirely up to me after the surgeon had presented the various options. (Of course if I had picked one that was not a reasonable or doable choice, I am sure he would have told me that.) It was a hard choice but I am glad that I got to make it.

I made a list of the advantages and disadvantages of tissue and mechanical. One consideration is that tissues tend to last longer in we "senior" folks -- our bodies tend to wear them out more gradually. So with the advances in tissue valve technology, I figured that there is a chance this is the only one I will ever need and there will be no re-op. Of course, with a mechanical the chances of never having a re-op would be even greater, on average.

The problem is that we lack a crystal ball. As Bina indicated, suppose a person getting a tissue at 63 has a really good run with it of 20 years, and is around at 83 and needs a replacement. That's one of the considerations. My resolution is to try to make myself as fit an old geezer as possible so that if I am around at 78 or 83 or whatever age and wind up needing a re-op, I will have a good shot at handling it. I certainly don't minimize what that would entail, and those who say a mechanical would be the surest way to avoid being in that situation have a point.

One consideration with me that may not apply to you: I also had a severely enlarged aortic root that needed replacing, and in my research I found that Medtronics had developed a combined aortic root and valve replacement -- it is porcine and seemed to be a seamless deal. It hasn't been around a real long time, but early results with it seem promising. When I presented my choice to my surgeon, he was enthusiastic about it.

Anyway, because we are close in age, I wanted to present my experience. I also want to reassure you that you can only make a good choice here. The only bad choice would be to forgo this life-extending surgery. Lots of good folks will be here to support you all the way. Welcome to our world!

 

[WayneGM]

Welcome, Rosie. Glad you joined us. I can't help you with the valve choice as I had a repair. Best wishes and good luck with your valve choice and ultimately yoiur surgery.

 

[Freddie]

Welcome Rosie

I can't help a hole lot neither, but just wanted to welcome you to the this forum family.

 

[gotogal44]

Thanks all of your for your reply's

Thanks all of your for your reply's

Thanks all of you for your replies and advise as well as sites to check. I will be reading a lot. The best part of this site (VR) are the folks on it. I knew there were lots out there, but not sure where the out there was.

Nice to see folks my age and younger, survivors of surgery and excited about their lives after surgery.

I wanted t share with all of you how important this is to me, and why, I have these wonderful 6 grandkids, I have had 4 wonderful years with them since my Gastric by-pass now I am greedy and want more, these next surgeries will give me that. I have an 11 year old granddaughter with a band, she and the other two girls are amazing, two 12 year olds and Liz the 11 year old doing so great 80's songs as well as newer stuff. I am the videographer, and groupie, so I have to stay strong.

Of course the other 5 grandkids are very special as well. I want to be around to see each one of them graduate, one already has and has almost completed 2 years of collage, now the youngest is 7 so I need to be around for a min. of 20 years.

Thanks again to all of you.

Rosie

 

[Phyllis]

Can't add to all the good advice you have already gotten, Rosie, but just want to say welcome and read, read, read. There is a lot to absorb here and knowledge is empowerment. Dick was 70 when he got his Edwards Magna valve and we are hoping for at least 20 years out of it. I know what you mean when you talk about wanting to be around for your grandchildren. We have three , 9 years to 18 months and Dick loves playing tennis, bike riding and boating with them. Hopefully, he will be doing it for many more years to come and I know that with your attitude, you will be enjoying your grandchildren too.

 

[gotogal44]

Thanks Phyllis

Thanks Phyllis

Thanks for writing and the encouraging words. YES he did rob the craddle
My hubby is 68 and he to robbed the craddle.

I have many sites to go to and much reading to do.

Thanks again for the welcome.

Rosie

 

[marie]

Rosie
I want to welcome you to the forum. It's good to have you on board.
Earline

 

[Leah]

Ditto on the support!

Ditto on the support!

Hello Rosie. I'm also very new to the site (joined last week) and am still "exploring my options" and being tested up the wazoo.

I can't offer expertise or experience - am really just starting my research in earnest - but wanted to support your instinct to ask as many questions as you feel are needed and allow yourself to talk to more than one expert if that's what you're moved to do.

Good luck!

Leah