discussing mechanical valve brands with your surgeon?

[pikacat]

i see a lot of posts in here about people discussing what their mechanical valve options are with their surgeons. my first surgery, i didn't have much of a choice. i was 19, and they told me if the repair was impossible, they'd do a replacement. i never discussed different brands or types with my surgeon. if it had turned out that i would have received mechanical valves, i never would have known what type they had put in my chest.

this time around, once again, the surgeon (different than my first surgeon) just asked if i wanted bio or mechanical and never did we discuss different brands or their pros or cons. is that normal? i've never had a cardio or surgeon discuss with me all the different brands or options.

is that a question i should be bringing up, or do the different brands even really matter? everyone seems a lot more in the loop than i am.

 

[mainframe]

I would discuss this with your surgeon especially if you have a perference. I ask my surgeon about the On-X which would have been my first choice with the St. Jude being my second choice.

My surgeon wasn't wasn't an On-X fan and didn't feel either the On-X or the St. Jude was the best choice for me because the size of my annulus was 23 mm and both the On-X and St. Jude valve have a sleeve the fits into the annulus (inter-annular) giving a reduction in flow. My surgeon felt that wouldn't be best for me being a bigger guy with a smaller annulus and felt the top hat by Carbomedics would be a better choice since it sits above the annulus.

Sounded like a pretty good reason to me to go with what the surgeon recommended but I felt good about asking and talking about the other valves.

 

[ALCapshaw2]

Many Surgeons and Hospitals only offer a limited selection of valve options which often means that when you pick a surgeon (or hospital), you are picking (or at least limiting) your valve options. IF you have a preference for valve choice, that should definitely be a part of your discussion with the sugeon(s) you interview.

dtread just posted a list of all of the Valve Manufacturers in the USA and their websites in another thread.
see http://www.valvereplacement.org/forums/showthread.php?35691-kinds-of-mechanical-valves

'AL Capshaw'

 

[Ross]

I discusssed my options with my surgeon. He wanted to put an On-X in, but needed a graft sleeve attached, so St. Jude it was. It's not that he couldn't have added a graft sleeve, he just didn't want any more sewing points then necessary.

 

[Luana]

Surgeon and I agreed on an On-X valve, but it didn't fit right so I got a St. Jude valve.

 

[Ross]

Surgeon and I agreed on an On-X valve, but it didn't fit right so I got a St. Jude valve.

I knew you were special.

 

[Bina]

I would discuss this with your surgeon especially if you have a perference. I ask my surgeon about the On-X which would have been my first choice with the St. Jude being my second choice.

My surgeon wasn't wasn't an On-X fan and didn't feel either the On-X or the St. Jude was the best choice for me because the size of my annulus was 23 mm and both the On-X and St. Jude valve have a sleeve the fits into the annulus (inter-annular) giving a reduction in flow. My surgeon felt that wouldn't be best for me being a bigger guy with a smaller annulus and felt the top hat by Carbomedics would be a better choice since it sits above the annulus.

Sounded like a pretty good reason to me to go with what the surgeon recommended but I felt good about asking and talking about the other valves.

My surgeon gave me the newer St. Jude Regent which is "supra-annular" fitting on top of the annulus. Lots of un-impeded blood flow !

 

[Bina]

Surgeon and I agreed on an On-X valve, but it didn't fit right so I got a St. Jude valve.

You have the Regent which is almost identical to the On-X......Yes, we ARE special. Hee hee.

 

[pikacat]

i like all these names. the supra & regent, eh? i want the emperor king valve.

but thanks! i'll bring all this up at my next appt.

 

[Luana]

You have the Regent which is almost identical to the On-X......Yes, we ARE special. Hee hee.

Oh, I have no complaints about my Regent, that's for sure! I wonder if one of the reasons I don't hear my valve is that I just assumed after surgery I had the On-X. It wasn't until about day 5 that one of the ICU nurses mentioned something about my St. Jude valve; that's how I found out. I'm thinking since I was thinking all that time I had an On-X and how quiet it was that maybe some of this noisy valve stuff is more grounded in what we hear from others?

 

[dick0236]

i like all these names. the supra & regent, eh? i want the emperor king valve.
.

That's neat that they give valve models names like they do for cars:biggrin2:. My valve, was like the Ford Model A, or was it the Model T,one model and any color so long as it was "black":tongue2:.

 

[pikacat]

Many Surgeons and Hospitals only offer a limited selection of valve options which often means that when you pick a surgeon (or hospital), you are picking (or at least limiting) your valve options. IF you have a preference for valve choice, that should definitely be a part of your discussion with the sugeon(s) you interview.

dtread just posted a list of all of the Valve Manufacturers in the USA and their websites in another thread.
see http://www.valvereplacement.org/forums/showthread.php?35691-kinds-of-mechanical-valves

'AL Capshaw'

as for this, i don't know. i never interviewed surgeons. i had some congenital defect and i always got sent to very specific congenital heart defect specialists. my first surgeon was dr. laks at the ucla medical center who's all cutting edge.

http://spotlight.ucla.edu/faculty/hillel-laks_cardio/

my cardiologist told me it was either go to him or someone in chicago. since my dad lived in l.a., i went there. this time around, i'm seeing the head of cardio surgery at the teaching hospital here who specializes in complex congenital heart defects in adults. my surgeons have never been much of a choice. it's funny, my surgeon said oh, this must have been explained to you a thousand times so he didn't really get into what was wrong with me. but it never really has. i just know i have a bunch of holes in my heart and 2 leaking valves. lots of people seem to know their heart measurements or specific names of their problems, but i've only ever been told in very gross generalizations what i have wrong with me. i always assumed it's because they didn't want me to worry and to focus on school.

 

[Bina]

Oh, I have no complaints about my Regent, that's for sure! I wonder if one of the reasons I don't hear my valve is that I just assumed after surgery I had the On-X. It wasn't until about day 5 that one of the ICU nurses mentioned something about my St. Jude valve; that's how I found out. I'm thinking since I was thinking all that time I had an On-X and how quiet it was that maybe some of this noisy valve stuff is more grounded in what we hear from others?

Luana, the Regent doesn't seem to have the more "metallic" click of the St. Jude Master. I've heard those babies before.

 

[Bina]

Pikacat, many of us learned all this "stuff" after surgery. It really becomes a learning experience, and the internet is our library.

 

[pikacat]

That's neat that they give valve models names like they do for cars:biggrin2:. My valve, was like the Ford Model A, or was it the Model T,one model and any color so long as it was "black":tongue2:.

a true classic!

 

[pikacat]

i'm not sure why i assumed everyone's doctors were a lot more informative than mine. well, i guess then everyone just has a brighter burning natural curiosity than i do. i tried looking it up my congenital defects once, but the words that i recalled my surgeon as saying didn't turn up any hits, so i figured i misheard him and i just wasn't all that interested weirdly, i'm interested in a lot of things about surgery and how people identify with disability. but as far as how they fix me up and all -- i just want to get back to my life again ASAP.

 

[Lynlw]

i'm not sure why i assumed everyone's doctors were a lot more informative than mine. well, i guess then everyone just has a brighter burning natural curiosity than i do. i tried looking it up my congenital defects once, but the words that i recalled my surgeon as saying didn't turn up any hits, so i figured i misheard him and i just wasn't all that interested weirdly, i'm interested in a lot of things about surgery and how people identify with disability. but as far as how they fix me up and all -- i just want to get back to my life again ASAP.

If you know what your different congenital heart defects were called, we could probbaly help you if you are interested.

 

[pikacat]

my understanding is that i was born with a cleft mitral valve, and that much i understood. then i understand that i had a few vsds (i have at least 2). that was understandable, too. what i don't understand is my aortic valve. i thought my surgeon told me that i had a "floating canal type" and he figured someone had explained this to me all before so didn't get into it. i may have misheard him, too, because when i tried looking that up, i couldn't find that at all. but actually, no one had ever explained to me what was wrong with my aortic valve before. they had just told me it was leaking. but maybe someone knows something or has heard something similar. i should have asked but i was really overwhelmed.

then on top of all that, i had bacterial endocarditis which had left a lot of scarring on both the aortic and mitral valves so they don't close completely (previous surgeon attempted to shape the leaflets so they would).

that's the extent of my knowledge. thanks if anyone knows anything more!

 

[dick0236]

......that's the extent of my knowledge. !

I'm like you. I never really cared about all the "whys"..... just fix it. I remember them telling me I had aortic stenosis. They thought it was probably due to rheumatic fever in childhood although my mother maintained I never had rheumatic fever. I did have scarlet fever. The docs today tell me "it was more likely a bicuspid valve". Over the years, virtually all of my early records have disappeared, but a few years ago I was a able to get a hospital record to prove to Edwars Lifesciences that I had one of their early valves. The following quote is from the hospital "operative record" and is ALL I know of the situation that forced my surgery.
"Mr. F is a 31-year-old gentleman who has aortic stenosis with mild calcification. He has been nearly asymptomatic. Cardiac catheterization was performed and showed that he had a gradient of 117 mm. over the aortic valve".

I pretty much took the cardiologists' and surgeons' word on "faith".....but I had known for several years, from other docs, that I did have a problem. Since I'm still around, I think they did the right thing at the right time.

Pikacat, I apologize. I did not mean to sidetrack your original question.

 

[pikacat]

Since I'm still around, I think they did the right thing at the right time.

exactly! it would be nice if someone here happened to know what my surgeon was talking about -- but when i googled "floating canal" and just found stuff on venice, italy, i was like. oh well. it wasn't that important anyway. in fact, italy is more pertinent to my life. i can visit italy. i can't do anything about the inner workings of my heart. when it's all good, i'm good!