Dr Says its Time for AVR

[escargome]

Heather Anne: My cardiologist said the same thing to me that yours did to you! One the other hand, Dr. Castro deos not consider it more risky because he does it this way for just about every surgery he does every day.

After a night of thinking (and luckily some sleep as well), I have narrowed it down to the following choices:

Option A: Tissue valve with Dr. Castro out of town. If I am likely to have another surgery, I would like the Dr. doing the first one to attempt to minimize the scaring. In addtion, Dr. Castro is very experienced with re-operations, so he could do my second one in 15 or so years.

Option B: Mechanical valve with Dr. Faber in town. With a mechanical and the ACT it requries, I am more interested in my cardiologist being part of the team through the surgery. My cardiologist already has had several conversations with Dr. Faber about my treatment and his office is physically connected to the local hospital. With ACT, I want the transistion from the hospital to the caridologist to be short pass not a "hail mary".

I plan to make a decision today and schedule surgery for early June. I agree with you that I feel much better having made the decision.

Thanks for all your thoughts and insight. -- Suzanne

Good to see you have an option A and option B. However, I am gonna play the devil's advocate.
Did Dr. Castro say 15 years or so with tissue valve? Cause that length of time has so far not been proven. And trans-catheter replacement is still only for high risk patients. So think about that option a bit before you jump on that ship. I have a tissue valve but know in my heart that I will likely need a replacement in maybe 5 more years (I of course am praying that the valve lasts longer). But anyway, good luck to you. I know that whatever decision you finally make will be in your best interest.

 

[SuzanneSLO]

Chris: Thanks for your reply. I have heard from numerous sources that the average life span of a current generation tissue valve is 17 years, but that this is based as much on projections as documented actual in-patient use.

I recognize that even if the projection is correct, I may not be "average" and may need replacement much sooner.

Even if I don't need to have it replaced for 15 years, I still may need yet another replacement 15 years after that. Thirty years from now I will be the same age as my father, who celebrated his birthday yesterday. And it is actually my mother's side of the family that live the longest; my maternal grandmother and all of her siblings lived into their 90's.

I won't say that I am mentally prepared for the worst case scenario but I do think I am prepared for a scenario that is less good than we had hoped.

I appreciate your input on these boards and will add my good thoughts to your prayers that you won't have a re-do in the next 5 years. -- Suzanne

 

[Duffey]

Good to see you have an option A and option B. However, I am gonna play the devil's advocate.
Did Dr. Castro say 15 years or so with tissue valve? Cause that length of time has so far not been proven. And trans-catheter replacement is still only for high risk patients. So think about that option a bit before you jump on that ship. I have a tissue valve but know in my heart that I will likely need a replacement in maybe 5 more years (I of course am praying that the valve lasts longer). But anyway, good luck to you. I know that whatever decision you finally make will be in your best interest.

Chris, I'm not sure why you think you'll possibly need a replacement in 5 years. I received the same valve as you, but mine was 3 years earlier in 2005, and I have had no problems whatsoever. I believe I will easily get 15 years out of my bovine valve.
Suzanne, if you suffer from anemia (I did too pre-surgery) due to bleeding, you might calculate that into your valve choice consideration. ACT might exacerbate it.

 

[SuzanneSLO]

Duffey: Did you find your pre-surgery anemia went away? That is what my hematologist is hoping. None of the doctors, however, expressed any concern that I should choose one valve over another due to the anemia.

In any event, I have decided to have Dr. Castro do the minimally invasive surgery with a tissue valve. I am scheduled for June 6.

Again, thanks to every one on these boards for sharing information and support. -- Suzanne

 

[Heather Anne]

Suzanne,

Congratulations on making your decision!! That is a big source of anxiety, and now it is gone. June 5 is a nice date; not too soon, so you'll have time to get a mani/pedi and maybe have your eyebrows done, but not so far away that you'll have too much time to get anxious about it.

I'll look forward to hearing more from you as the surgery gets closer, and I'll be curious how your recovery is with the minimally invasive procedure.

Take care!