Decision time...

[cgv]

Hello. I?ve been following the posts here for a couple of weeks and have found this forum to be enlightening and helpful. I am scheduled for AV replacement on May 27 at Porter Hospital in Denver.

I am a 58 year old male, 6-6, 204 lb with no other health issues other than controllable asthma. I work out daily; on the ski patrol at Winter Park (have skied for 53 years); hike; bike; ride motorcycles; enjoy fine food and wine. I am a consultant for electric power generation and work out of my home with some travel to Asia as well as domestic.

The leaky valve was caught in a physical; I had no symptoms. I was told it had been leaking for a while and after an echo and TEE I was told it had to be replaced. An angiogram showed my heart including coronary arteries was in good shape. Since the diagnosis and complete shock, I have been totally consumed trying to decide which valve to go with. I have researched the valve options pretty thoroughly and have made a tentative (still have a few days to change) decision on the valve although I can make a case for either mechanical or tissue.

I am interested to hear from anyone with a similar lifestyle and age, and what and what and why they made the decision they did.

 

[ALCapshaw2]

My Aortic Stenosis was diagnosed at about your same age. When I spoke with the surgeon who performed my Bypass surgery, he said I was in a "Gray Area" where a good case could be made for either a mechanical valve or tissue valve.

My First Choice was for a Bovine Pericardial Valve but due to heavy scar tissue resulting from Radiation Treatment for Hodgkin's Disease, the surgeon felt I needed to have a mechanical valve instead. There are times (mostly when contemplating other invasive procedures) that I wish he had given me the tissue valve in spite of the consequences.

'AL Capshaw'

 

[Bill Hall]

Cgv - Welcome to our group. I had some similarity with your case, but had my surgery about 10 years younger and 60 lbs and 10 inches less. I played softball among other physical sports, but not really to your degree. I chose a homograft (human valve) for my aortic valve and mitral valve repair. I am happy not to worry about the coumadin, but that will last for ten more years when I face resurgery. Hopefully, something will change and I won't have to do it or my valve lasts linger than expected. Anyway, I finally did give up softball and took up chess. I miss the softball, but I am almost as happy without it. Good luck, I suspect you already decided to go tissue.
Bill

 

[Superbob]

Tough decision

Tough decision

It's a tough decision, isn't it? -- one of the hardest I've ever made. I am 63, and also a pretty big and active guy. I chose the tissue understanding that some of them are lasting 15, maybe even 20 years in us older codgers. Of course, there's the possibility of a re-operation, but also the possibility of advances making the surgery less invasive. I didn't want to deal with the fine-tuning of the blood thinners -- I didn't think I personally would be very adept at that. Many on here have done just fine with it, on the other hand.

Still, if I were 58, I might well have chosen the mechanical. It's a close call. Make the best decision for you, then don't look back. You'll do fine.

Bob

 

[tobagotwo]

I'm 52, and went tissue. There is another valve waiting for me when I'm about 70, and that one should see me through.

I live a "normal" life, except for antibiotics before dental work, and once-a-year echoes. I didn't have a bad time with the surgery (something you don't get to find out until afterwards, unfortunately), so I am content with knowing it is in my future.

At 58, a tissue valve should last longer than the average male lifespan. Of course, none of us believes we will only last the average lifespan.

They are already putting in percutaneous aortic valves (done with stents, through a catheter). Those valves will have improved greatly in 20 years, so I may well not even have OHS next time.

Best wishes,

 

[wpribyl]

I also love to snow and water ski. I am very active and had the bomb dropped on me 4 yrs. ago. It seemed like I read everything , but it all came back to do I want to stay this active and not worry about falling etc. At 56, last Nov. I got a Edwards Magna tissue valve. The one thing I didn't know was that they made the Magna without therma fix to begin with and I got one of those. Thought they were all the same, but there is a 3000 and a 3000fx. I have to take an aspirin a day and my same blood pressure med. I am doing everything now I did before. I realize I might have to do it again, but am hoping by then they have another fix. I got a 27mm so hopefully it will last. I think that if I am having any sumptoms and am still healthy at 70 or so I probably wont push it.?????

Good luck.

One thing I have found is that almost everyone is happy with their decision, no matter whick they choose.

 

[Mary]

My brother-in-law's brother, age 51, had his aortic valve replaced with a porcine valve in late January. I called him last night to specifically ask how he felt about undergoing resurgery at a later date, since he has a fresh memory of it.

He has been in the Army Reserve Medical Corps for 30 years and had done two med rotations in Iraq. His valve allowed him to get out in December so he could have the surgery in January (that's cutting it close!) The desert heat was hard to take with the stenotic valve, but he says it wouldn't be a problem now.

He said he would do the surgery again without a second thought. His recovery has gone without a hitch, and I found that reassuring. I don't know if this helps you, but maybe it will. As everyone says, it's your decision and you will be fine with whatever you chose.

 

[cgv]

cgv

cgv

Decision was made and surgery is complete! I chose a Medtronics Freestyle Stentless Porcine Valve. Had the surgery at 8:00 am on Friday, May 27th and came home yesterday (May 30th). I'm feeling a little tired and sore, but better than I expected at this point. I had my last pain pill at 3 am Sunday morning. I think the worst part was the breathing tube making me gag. Fortunately they took it out shortly after I regained consciousness in the ICU.

I'd like to thank my surgeon (Dr. Myles Guber) and the staff at Porter Hospital in Denver for a great job. Also, thanks to those who replied to my posting on this website.

As one who has a fair amount of anxiety by nature, the decision on valve type and then the impending surgery was quite taxing, but now I am looking forward to a quick recovery. My goal is to be back close to normal by the beginning of ski season in November.

My best to all who are still choosing valves and surgeons and thanks again for a great website.

Oink Oink!

 

[Phyllis]

That's great news - best wishes for a continued and uneventful recovery.

 

[coryp]

I also love to snow and water ski. I am very active and had the bomb dropped on me 4 yrs. ago. It seemed like I read everything , but it all came back to do I want to stay this active and not worry about falling etc. At 56, last Nov. I got a Edwards Magna tissue valve. The one thing I didn't know was that they made the Magna without therma fix to begin with and I got one of those. Thought they were all the same, but there is a 3000 and a 3000fx. I have to take an aspirin a day and my same blood pressure med. I am doing everything now I did before. I realize I might have to do it again, but am hoping by then they have another fix. I got a 27mm so hopefully it will last. I think that if I am having any sumptoms and am still healthy at 70 or so I probably wont push it.?????

Good luck.

One thing I have found is that almost everyone is happy with their decision, no matter whick they choose.

What are the exact differences on the 3000 and the 3000fx? Why wouldn't the surgeon give you the best one off the bat? Have you heard of any newer technology advances from edwards in this series? I am getting a magna in 1 week (just want to be sure it is the best one) I am only 34

 

[Mary]

Decision was made and surgery is complete! I chose a Medtronics Freestyle Stentless Porcine Valve. Had the surgery at 8:00 am on Friday, May 27th and came home yesterday (May 30th). I'm feeling a little tired and sore, but better than I expected at this point. I had my last pain pill at 3 am Sunday morning. I think the worst part was the breathing tube making me gag. Fortunately they took it out shortly after I regained consciousness in the ICU.

I'd like to thank my surgeon (Dr. Myles Guber) and the staff at Porter Hospital in Denver for a great job. Also, thanks to those who replied to my posting on this website.

As one who has a fair amount of anxiety by nature, the decision on valve type and then the impending surgery was quite taxing, but now I am looking forward to a quick recovery. My goal is to be back close to normal by the beginning of ski season in November.

My best to all who are still choosing valves and surgeons and thanks again for a great website.

Oink Oink!

It's great to hear that you came through with flying colors! Good luck on making your November goal.

 

[cgv]

cgv

cgv

What are the exact differences on the 3000 and the 3000fx? Why wouldn't the surgeon give you the best one off the bat? Have you heard of any newer technology advances from edwards in this series? I am getting a magna in 1 week (just want to be sure it is the best one) I am only 34

You are referring to the Carpentier-Edwards Perimount Magna valves. These valves are stented and I think the only difference between them is that the 3000fx incorporates the latest anti-calcification treatment. The data on their website shows very promising results and performance. My Dr. said he would put in any valve I wanted, but for tissue valves, he has been mainly using the Toronto and Medtronics valves. Based on my research, I decided I wanted a stentless valve, due to its closer simulation of the natural aortic valve. Both the Toronto and Medtronics have good track records, but the Medtronics incorporates the latest anti-calcification treatment. The Toronto valve has not yet received approval for their new anti-calcification process.

Also, keep in mind that most of the studies on valve life are done by the manufacturers and they are obviously going to slant performance in their favor as best they can. In addition, the new anti-calcification treatments and stentless valves don't have much long-term data yet as they are relatively new.

I suggest that people do as much research as possible and ask questions. If you don't get answers you are happy with then talk to someone else. I did a lot of research and had total confidence in my surgeon which is very important.

 

[Phyllis]

Dick received the Edwards, Magna 3000 as the newest calcification treatment came out a month or so after his surgery. I would suspect that all Magna valves shipped now are with the new calcification treatment, but it wouldn't hurt to ask and make sure that you are getting that one and not an old one in stock. The Magna valve was brand new when Dick got it and he bugged the surgeon's office right up to the day of surgery to make sure he was going to get it. I thought he would refuse surgery if they said. "no"!

 

[brd]

Congrations!

Congrations!

Decision was made and surgery is complete! I chose a Medtronics Freestyle Stentless Porcine Valve. Had the surgery at 8:00 am on Friday, May 27th and came home yesterday (May 30th). I'm feeling a little tired and sore, but better than I expected at this point. I had my last pain pill at 3 am Sunday morning. I think the worst part was the breathing tube making me gag. Fortunately they took it out shortly after I regained consciousness in the ICU.

I'd like to thank my surgeon (Dr. Myles Guber) and the staff at Porter Hospital in Denver for a great job. Also, thanks to those who replied to my posting on this website.

As one who has a fair amount of anxiety by nature, the decision on valve type and then the impending surgery was quite taxing, but now I am looking forward to a quick recovery. My goal is to be back close to normal by the beginning of ski season in November.

My best to all who are still choosing valves and surgeons and thanks again for a great website.

Oink Oink!

WOW! Three days in the hospital and you're feeling good. You give me hope! I'm having mine done sometime in the next few months. Have not decided on where to have it or what kind of valve yet. I am the same age as you and also very active - former marathoner and triathaloner, although I am too tired to run right now. Well, congratulations!!!!! brd

 

[cgv]

cgv

cgv

WOW! Three days in the hospital and you're feeling good. You give me hope! I'm having mine done sometime in the next few months. Have not decided on where to have it or what kind of valve yet. I am the same age as you and also very active - former marathoner and triathaloner, although I am too tired to run right now. Well, congratulations!!!!! brd

BRD,
The valve choice and fear over the surgery was difficult, but you have to realize that you really only have a choice about the type of valve, not whether it needs to be replaced. I felt that the next 15-20 years of my life are likely to be more active than after that. I wanted to be able to do the things I wanted without having to be concerned about coumadin and its side effects. I was afraid I would be afraid to ski remote areas or worry when I was in an area far away from medical attention. I know people on coumadin do these things, but I have high anxiety and tend to worry unnecessarily. I am planning to be in good shape if and when I need another valve replacement. My mother had a quintuple bypass when she was 80 followed by a knee replacement the following year and she came through both operations fine. (She did say the knee replacement was worse.) I also feel the surgical techniques and valve choices will continue to improve. I would guess that there will also be a replacement for coumadin at some point that will not have the negative effects as well.

If you are unable to run now, I would suspect that your valve must be leaking pretty badly (or is quite stenotic). Mine apparently had been leaking for a while, but I was able to continue my workouts up until the day before surgery. I did back off a little on the weights and running speed after I was diagnosed. I would make a decision on valve type and get it done sooner rather than wait a few months. If you do it now, you should be getting back to your workout program in a few months.

Good luck with your choices.

 

[Superbob]

Two Little Piggies

Two Little Piggies

To CGV:

Oink, oink back at you, kinfolk Hawg! Looks like you wound up with a valve replacement much like mine (though mine was for the root as well as valve).

Congrats on your successful surgery and best wishes for a strong recovery. Hope you'll keep posting so we can compare notes as to how it's going. For many years, I hope.

I don't know about you, but I can't look at a plate of pork BBQ quite the same anymore.

Cheers,

Bob