Do you have a tissue valve?

[JeffM]

I had a stented 3rd gen porcine valve implanted in the aortic position at age 53 in Sep of 2008. Not having any issues so far. I just had my echo last week and will be going over the results with my cardio at the end of the month. I discussed pros and cons of tissue versus mechanical versus Ross with my surgeon before deciding on tissue. I'm hoping the promise of greater durability on this generation of valves is realized and also hoping advancements in the field will give me some additional options to OHS; however, I'm fully prepared mentally for another one. I don't know what shape I'll be in physically when the time comes, but I plan to maintain my athleticism and strong workout regimen as late in my life as possible to give my body the best chance at another quick (out in 3 days) recovery.

 

[jhc1]

I had a Medtronic Freestyle with root implanted on 6/10 at St Luke's in Houston. Had similar conversations with the cardiologist and surgeon. I'm 7 weeks post op, and recuperating just fine. I'm 55, and chose tissue for many of the same reasons that others have mentioned. I'm happy with my decision, and the valve will last as long as it lasts. I'll deal with that when I'm older, and less likely to be racing sailboats and traveling to remote places to scuba. Both the cardio and surgeon told me scuba would be right out if I chose mechanical/warfarin.

Joe

 

[Agian]

Joe, did they tell you why scuba would be out with a mechanical?

 

[start01]

Am in line for a valve replacement and tissue is the way to go for me. My question to you guys who have had the surgery - when it comes to exercise have you held back pushing yourself 110%?

 

[neo]

Do you have a tissue valve?

I had a tissue valve put in about 3 months ago. It's one of the newer 3rd generation ones, the St. Jude Trifecta. Just to let you all know, I am pleased beyond belief and God is good. I had severe aortic regurgitation going in, and my LV was pretty big. I thought it would take at least a year or more to remodel, but at the 3 month echo followup yesterday, it had already shrunk down to normal size.

I think if someone chooses a 3rd gen tissue valve, they have alot to look forward to. My hospital is already doing TAVR replacements, and quite a few of them, for people who dont qualify for open heart. It looks reasonable that this should be the gold standard of replacement in a few years, and they should be able to even fit a TAVR inside a stented tissue valve.

One of the main reasons I went with the Trifecta tissue valve was the durability it had proven. Every tissue valve has to prove that it can withstand 200 million cycles in a rapid accelerator. 200 million cycles represent approximately 5 years. Many of the other tissue valves start to fail at about 600 million cycles, which would equate to about 15 years. The Trifecta was still going at 1.2 BILLION cycles!

This is not to guarantee that the newer Trifecta valve will last 30 years. It does not figure in calcification and other factors, just the durability of the opening and closing of the valve in a lab. However, with the newer anti-calcification treatment it has, and durability up to 30 years, I think this is a great choice. By 20-30 years, replacing it will hopefully be something done in a day through the leg.

 

[knotguilty]

To start01, There is no limit and I can say I exercise at 100% of my heart rate. That is 160bpm, and it has come down from 165-166bpm as I get in better shape. I am around 182 lbs, and I am benching 190, running 7 miles a week and biking 15 miles a week, weather on a tread mill or on the road. I do not over exert myself lifting too much because I do not want to put too much pressure on my heart. But otherwise, no limits.

Thanks to everyone for all the responses. I do notice that there is no one I can find that has had a tissue valve longer than 8 years as compared to the mechanical side with unbelievable mile markers like 45 years. I am happy I selected a tissue valve. I think it is normal to question yourself at some point, but I would not have liked the blood monoitoring and worrying about bleeding issues with my life style.

 

[Duffey]

To start01, There is no limit and I can say I exercise at 100% of my heart rate. That is 160bpm, and it has come down from 165-166bpm as I get in better shape. I am around 182 lbs, and I am benching 190, running 7 miles a week and biking 15 miles a week, weather on a tread mill or on the road. I do not over exert myself lifting too much because I do not want to put too much pressure on my heart. But otherwise, no limits.

Thanks to everyone for all the responses. I do notice that there is no one I can find that has had a tissue valve longer than 8 years as compared to the mechanical side with unbelievable mile markers like 45 years. I am happy I selected a tissue valve. I think it is normal to question yourself at some point, but I would not have liked the blood monoitoring and worrying about bleeding issues with my life style.

We have forum members, with tissue valves that have lasted longer than 8 years and are problem free. They just haven't answered on this thread. In addition, tissue valves haven't been in use as long as mechanical so the longevity data will be different. Start a similar thread in two years time and see if you don't get more responses reporting longer years.:smile2:

 

[VegasBAV]

I'm 41 and received a St. Jude Trifecta tissue valve 9 months ago. As I am from Las Vegas, I asked my surgeon at the Cleveland Clinic what the over/under was on how long it would last in me. He guessed 15 years.

 

[Mike1952]

Hi,

I had a bovine tissue aortic valve installed on Aug 9, 2012. I was leaning towards the mechanical but my surgeon suggested going with tissue, partly because of the possible issues with coumadin, but also because I was not taking any medications at that time and I was very active (running). He said from a surgeon's perspective, a second OH surgery was very low risk, not much more than the first.
I am feeling great and my first surgery is hard to remember, actually. The worst part for me was the waiting for 2 months for the sternum to heal. I have no regrets!

 

[JeffM]

Am in line for a valve replacement and tissue is the way to go for me. My question to you guys who have had the surgery - when it comes to exercise have you held back pushing yourself 110%?

Not at all! Obviously, I had to take it easy for a few months, but I was able to push myself to the max with confidence once I got off all the meds. I did a little bit at a time of course so I didn't injure myself.

 

[Roberta]

I have a tissue valve that is 4 years old! I was in my mid 40's when it was done.

 

[FixedAgain]

I've only had my tissue valve for 2.5 years, and I was 63 years old at time of implant. I chose tissue for several reasons. The easy one was that Cleveland Clinic is now using (IIRC) about 85% tissue valves, regardless of patient age at implant time. They feel that confident that the newest tissue valves will last.

As for valve life span, the 15 year estimate is for the "second generation" valves, which are the oldest valves for which there exists long term statistical data regarding valve life. The manufacturers all have tests that project the lifespan of the current "third generation" valves to be substantially longer than the previous generation valves, thus their confidence in implanting so many of them in patients so young.

So, while we may not have concrete statistical history to substantiate the claim that these newer valves will last longer, we do have the manufacturers' projections and the agreement of the top-ranked heart surgery center in the country. There are no guarantees, but this seems like a decent bet at this time.

I had my MR repaired twice..Second time October 20111 but had made the decision to go with a Tissue valve in the (expected) event it could not be fixed. The chief of thoracic surgery at NYU (who performed the operation) said pretty much the same thing...There was no doubt as to what I wanted...I was 55 at the time of surgery..I think they last longer now and agree with the posts and thinking surgeries will become easier..

I'll add that my second surgery was a piece of cake compared to the first...not sure why but I was not at all prepared for the first one and had 2 years of procrastinating on the second...

 

[OldManEmu]

FixedAgain

I'll add that my second surgery was a piece of cake compared to the first...not sure why

My second surgery was also a piece of cake compared to the first because I was in good condition and ran a few kilometres the day before surgery, unlike the first surgery being in class IV heart failure an unable to walk 30 metres.

 

[Jkm7]

My second OHS was also much easier on me than my first.
My first was not valve.

 

[Superbob]

I have had my tissue value 8 1/2 years. Got it implanted at age 63. Doing fine at this point.

(Oops, I see I've posted this info already in this thread -- sorry for the repeat. )