Choosing a valve

[kimfusca]

Hello All,
I was wondering how does someone go about deciding which valve is better for themself? I thought before my surgery was even remotely close that I would go tissue valve no matter what. But now that my date is coming closer, (I meet the surgeon July 18th) and I've read all the stories about life after coumidin (sp?) I am considering a mechanical valve.

Does/did you have a preconceived notion as to which you wanted? Did the surgeon's opinion sway you? How do you know what you think will be best?? I kind of confused and hoping things will get clearer after meeting the surgeon.

I am 37 and if I go tissue now I most likely will need to have my aortic valve replaced again. Take a chance that new technology will spare me open heart surgery or hope that a mechanical valve like On-X will be the way to go with less ACT...Decisions, decisions!

 

[Lynlw]

welcome, my first question would be if you planned on having any more kids, given your age an the age of your daughter, Lyn

 

[Georgia]

Here's one of the best discussions of mech v. tissue I've ever read:

http://www.valvereplacement.com/forums/showthread.php?t=14330

 

[kimfusca]

Kids

Kids

Hi Lyn, I would really like to have more kids. My daughter is only 2 1/2 and I always expected to have more kids. Given that, I know there is more than one way to skin a cat. We can have a surragote or perhaps have one on coumidin, although I've heard that's very difficult and not without serious complications and risks. There is always adoption too.

Part of the reason I am really questioning everything is that I spoke with a cardiologist (not mine, but the one who was to perform my angiogram), she was about my age and she said NO WAY would she go tissue even to have another baby. (Easy for her to say? She has 2 youngs kids already). I was surprized at her reaction and that it was so strong. My cardiologist said that he felt that the surgeon was best equiped to make that recommendation.

 

[Kate]

Hi Kim!
I had my aortic valve replaced with a tissue valve last year when I was 38 - and I'm not even planning to get pregnant. While I don't think this is the right choice for everyone, I'm very happy with it and certainly think it is a reasonable one for some people. I think Tobagotwo does a terrific job of laying out the specific pros and cons in the link posted above, so I won't go into all those details. However, as someone your age who has been through this, I just wanted to encourage you to learn all you can, think about what is important to you in life, make the choice that seems best and then advocate for yourself with your surgeon. My surgeon had every intention of giving me a mechanical valve, but once I argued for a tissue valve, admitted that he himself would choose tissue if sitting in my shoes. There are very good reasons for making either choice - the main thing is to be well-informed so you can make the best decision for yourself. If you do decide to go with a tissue valve, go to the best surgeon you can - there are some terrific ones in California and it really makes a difference when it comes to reoperations. Best of luck and keep asking questions! Kate

 

[Karlynn]

Kim, you are in a tough position. I would not recommend knowingly getting pregnant while on Coumadin. It is very tricky, not impossible, but not desirable in my opinion. If you want to have another bio child, tissue would be the way to go, understanding that at least one more valve replacement would be in your future.

I had my mitral valve replaced at 32. I had 2 children, 5 & 7 at the time. The 5 years leading up to the valve replacement took a toll on my family. I was glad to get a mechanical valve, not wanting to put my family through any more of my "heart stuff" than necessary. However, I will say that I went through a grief period because we had always planned on 3 children. My close friend was having her 3rd at about the same time we would have had ours, and it was tough. We brieflly considered adoption, and probably would have gone that route had we not had 2 children. By the time I was 2 years past my VR, I was very happy with my life the way it was and no longer had those pangs.

I will also say that I was grateful to not have to have another valve replacement at the time my life was the busiest it ever would be, with teenage children and all their activities. We traveled to Europe twice as a family right about the time I figured I'd be either approaching, having or recovering from another replacement. So my mechanical valve has made it through the times I needed it to make it through and I'm grateful. So while it's hard to project ahead, but try and figure out where you may be in your life when a tissue valve would need replacing again. (Mary has a crystal ball that may help you with this. )

If you highly desire another bio baby, it sounds like tissue would be your best bet. But I would question your surgeon and cardio about whether they felt that, with a tissue valve, your heart would be able to handle a pregnancy without issues. Looking at the way my heart was I doubt I would have been able to have a very easy pregnancy even with a tissue valve. But we have members here who have had babies with tissue valves without problem. So this is something that you would want to speak at length with your doctors about. I would also ask them to consider your age in the equation. I don't say this because 37 is old, but I just had a friend who had a baby at 41 (10 years after her last child) and she said that it was much harder on her body than the children she had at 27 and 31.

Best wishes as you make this decision.

 

[WesternNYer]

welcome...

welcome...

At 43...my surgeon was in agreement of my choice to go tissue....though his opinion would not have dissuaded me if he felt otherwise. Oddly enough...I find myself not reccommending one over the other...just that you overload yourself with enough info to make an informed decision based on how you want to thrive after this little bump in the road. And having said that....the fact that you do have a little one is something to consider( future resurgery whether for a replacement,of a time worn tissue...or to trim tissue intrusion into the mechanical.) as well...in addition to potential additions to your family. I felt I would have a better quality of life if it weren't complicated with a regimen I needed to monitor and sustain for the rest of my life( one day....or if graced....many) And the idea of potential or perceived valve related noise,,,from all that I've read....I just didn't want to go that route. But...having said that, I also think a mechanical is a great choice for others' with different needs...like concerns over vegetarian issues. But in the end...once informed...I feel we all can make the best decision for ourselves. So do your homework...read as much as you can here....and do what is right for you.

 

[brd]

post radiation

post radiation

Hi Kim, I am pre-op AVR too and my aortic stenosis is also a result of radiation many years ago. I have been told by two surgeons that there is no question but that I should have a mechanical valve. Due to the radiation effects they do not like to "plan" a second surgery. "Perkicar" was also told this at The Cleveland Clinic I believe. You might want to PM her. My opinions came from two Harvard Teaching Hospital surgeons (Ma Gen Hosp in Boston). It will be interesting to see what you are told. Keep us posted.

Barbara

 

[kimfusca]

Well, it's nice to meet a fellow radiation aortic valve person. I haven't been told anything re: vavles and radiation...yet. I meet with the surgeon on Tues. July 18th and I seem to expecting lots of clarity afterwards, which I'm not sure how realistic that it. Sometimes there seems like soo much to think about I turn tell myself I will think about that later, but I don't have too much later. Time to stop being overwhelmed and get back to research. thanks for the tip.