Biological Or Mechanical

[redhawkjg]

Hi, folks. New member here.

Interesting thread, as are so many of the others I have bounced around. March 14th - had Aoritc Valve Replacement and two bypasses. Most of what was required was due to damage from radiation therapy for rare form of hodgkins that usually appeared in adults - in my case at thyroid and two other lymph nodes at age 13.

I went with a St Jude valve on recommendation of my cariologist and my surgeon, Dr. Mohammed Gharavi. The information I was given was that tissue valves do not last as long asn mechanical and so mech is the preferred option for younger patients who would porbably outlive a tissue valve. I am 51.

The reason I decided to join and post was one comment I keep seeing: that the mechanical valve will last "for life." Not what I was told, so either my surgeon is more honest or is mistaken. I opt for the former. He told me that tissue valves last 10-15 years, in line with other comments here, and that the St Jude is good for 20 - 25. I am sure there is the possibility of it lasting longer, but we have to consider what "for life" means. If we define that by expecting to live less than 20-25 years after replacement, then it may well be "for life". If the odds are that we will live beyond the estimated life of the valve, then it may not be "for life".

Either way, I chose warfarin/coumadin daily and the longer life valve rather than the probability of another repalcement in 10-15 years. Someone referred their friend to me who is 45 and facing aortic valve replacement as well, and SHE was told that the pig valve lasts for life! Go figure!

Anyway, I look forward to popping in here and learning more and helping others as I can.

 

[Ross]

Hi redhawkjg and welcome

Mechanical valves will last the lifetime of a patient mechanically. Now there has been problems such as infections, sewing cuffs leaking, clot formations and the like, but no mechanical failures. This is why we say life time. There are no guarantees, we understand that too. It's still the best option to hopefully avoid any future surgeries.

 

[twinmaker]

Hi Redhawkjg! Welcome to our site. Just wanted to let you know that this coming August, my St. Jude mechanical mitral valve will be 25 years old! I'll also be 54 in August. I'm hoping my mechanical valve lasts at least another 25 years! We're glad you found us and we look forward to getting to know you. LINDA

 

[Dustin]

Interesting summary: Searching for the Truth: A Mechanical or a Tissue Valve?

 

[Rush20]

I became so sick, so fast, that I never had a chance to discuss which type of valve I would receive. The doctor said that because of my age (41 in 1999) they always put a mechanical valve in. The doctor also told me that it had a "life-time warrantee? but never told me WHO?S "lifetime."

Good luck, Phil

Same with me (age 40 at the time). I was so shocked I had to have surgery, even the remote idea of having a second surgery in 10-15 years made my choice simple. I have the St. Jude and so far little issues with Coumadin. I'm still active, however my pre-surgery activities were baseball, softball, golf and running so it's not like I had to give up sky-diving or ultimate fighting.

 

[Mary]

It's interesting, but it neglects the population of women who need valve replacement, but have yet to start their families.
That's what I call a "cookie cutter approach" to the decision making process.

 

[Nancy]

Joe's mechanical aortic valve is 28 years old.

 

[PapaHappyStar]

Interesting summary: Searching for the Truth: A Mechanical or a Tissue Valve?

Hi Dustin,

This was a nice review -- but as these statistical comparisons between tissue and mechanical often do this one too seems to neglect ( for one ) age as a variable affecting the distribution of the data. I suspect if more variables affecting the lifetime of the tissue valve were included in the study some of the conclusions one draws from it might be different.

Thanks,
Burair

 

[tobagotwo]

The summary is interesting, but greatly flawed as a study of studies. It draws a great deal of its information about valves from other people's papers over a decade old, some 15 years or more.

That means it mixes in reporting on the results of tissue valves that were being manufactured or preserved 25-30 years ago as if they were similar to the tissue valves being used today. They're not. Neither are most of the carbon (mechanical) valves. The surgery itself isn't even the same.

Six to ten years is not an accurate gauge of tissue valve life by any current study that's not limited to teenagers.

There are plenty of reasons to go either cardon or tissue, but by blending so much defunct data into its conclusions, this paper fails to present a reasonable picture of reality or risk.

Best wishes,

 

[Andyrdj]

Avoiding further surgery

Avoiding further surgery

One thing I think people should be aware of is the health of the rest of their body, aside from their valve. This might even involve the heart - a valve replacement patient might conceivably require a bypass operation later in life.

The issue that would concern me is the need for bridging therapy - as I understand it, this is moving from a high anticoagulation regime into a lower one prior to an operation.

I seem to recall that even with this, there is an increased risk of bleeding during the operation. (correct me if I'm wrong).

So while it is farily likely that a mechanical valve patient will not require another valve operation, this should surely be balanced with their knowledge of how creaky the rest of their body is!

 

[Nancy]

Joe has been on bridging therapy many, many times. The only one that even remotely caused problems was Lovenox. And that was because Joe has kidney issues, and Lovenox can build up in people with kidney issues, either prior to surgery or due to surgery. In this case it did contribute to a total bleedout. There were other problems with the surgery too, but it is reasonable to assume that Lovenox made its own contribution. Fragmin would cause a similar problem.

Bridging with Heparin IV has not been a problem at all, and Joe is closely montored throughout.

Those without kidney problems on this site have not had problems with Lovenox.

 

[geebee]

I have had 4 major operations after going on coumadin and have never had an issue with bridging therapy.

 

[Gerry]

Coming out of hibernation

Coming out of hibernation

Hello redwakjg and from an "old" valvie from downunder and an early member of this website, let me say "welcome to the club".

Statistics are wonderful things and very few people really understand how they work. They should be used like a drunk uses a lamp post - more for support than for illumination!

In my case, I had an allograft 5 years ago after having undertaken extensive research into the various alternatives. My choice was "the best for me" decision, but not necessarily the best for anyone else. My surgeon told me something like there would be a 75% chance that I would get 20 years out of my valve. What does that rally mean? It means that if I lived my life 100 times, then 75 of those times I would get 20 years out of the valve and 25 times I would get less. So which category is my one and only life in? Who knows, except I can hope that I've get a better than even chance of getting 20 years. Then Ill be up for a new one again and by then there may be different alternatives and I may make a different choice, depending on all the pluses and minuses at the time.

To answer your original questions : mechanical valves are so good these days that they are virtually indestructible, so that's why they say they will "last for life", even for a young person. The famous "pig" valve is more favoured for elderly people because it is reputedly only good for about 10 to 15 years, so if you are 85, then a pig's valve would be a strong contender.

Once again, welcome and feel free to ask any further questions.

Gerry

 

[Rush20]

Hi Redhawkjg! Welcome to our site. Just wanted to let you know that this coming August, my St. Jude mechanical mitral valve will be 25 years old! I'll also be 54 in August. I'm hoping my mechanical valve lasts at least another 25 years! We're glad you found us and we look forward to getting to know you. LINDA

Wow! I love hearing these type of success stories. Congratulations! This is indeed an inspirations to us clickers.

Also, I tend not to even use the term mechanical anymore. When I did, people mistakenly thought that batteries were powering my valve to open/close. When describing my condition, I now inform people that I have an artificial valve.

 

[Sir Reel]

The famous "pig" valve is more favoured for elderly people because it is reputedly only good for about 10 to 15 years, so if you are 85, then a pig's valve would be a strong contender.
Gerry

Careful with this kind of generalization, it doesn't help people making choices. My surgeon told me 1.5 years ago that the pig valve I have is still functioning in 98% of the patients at 12 years.

I think you will find that a lot of highly regarded surgeons use pig valves in other than elderly patients. My guess is that they evaluate their choices and use the best tissue valve that is available at the time of the surgery.

A concern about generalizations is the extent to which they are based on older technologies and/or levels of care. Tissue valves are being improved continuously, so the current crop likely has a longer potential life span than any average based on the last 20 or 25 years. In addition, cardiologists know more about care (e.g., blood pressure management and lifestyle) and thus today's patients are likely to get more mileage out of the same valve as someone starting 25 years ago.

 

[Andyrdj]

further questions regarding bridging therapy

further questions regarding bridging therapy

Would be interested in knowing what's involved in bridging therapy, in detail, if someone would care to describe it?

Also, what tactic do they use for emergency operations - e.g. car crash, burst appendix or whatever?