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dwfreck
Everyone,
Thank you very much for sharing your experiences, your opinions, your biases and your thoughts related to valve selection. They have been invaluable to me during my own decision process.
I have made the decision. I have selected the Ross procedure as "plan A" and a Carpentier-Edwards bovine pericardial valve as "plan B" if the surgeon determines during the operation that the Ross procedure won't work for me. If the surgeon feels we need a "plan C" then I'll have some quick thinking to do, but I've got a few ideas in mind.
So you don't have to go hunting for it, here is my medical history: congenital bicuspid aortic valve, currently both stenotic and regurgitating, received recommendation for surgery in Sep, 2003. No other heart problems, but personal and/or family history of colon polyps, prostate cancer, and anemia.
For the benefit of anyone facing this decision, here are the reasons for my choice:
1) I prefer NOT to be on lifetime anti-coagulation therapy at the present time. The folks here have convinced me that Coumadin IS manageable, and that there is significant hope for a more manageable alternative. However, I want desperately to return to downhill skiing, among other "contact" sports, and my doctors and I feel that there is too great a risk of brain hemorrage if I ski while on anti-coagulation therapy of any kind.
2) I believe I can handle a second surgery some time down the road. I know it will be more risky and more difficult. I know that I can't predict my future health or how it will affect my chances in a second surgery. However, I believe the risks are still relatively small and are therefore worth taking to reach the goals I have for my life and lifestyle.
3) Since reasons #1 and #2 lead to the choice of a tissue valve, I wanted to pick the tissue option with the greatest longevity. Neither the Ross procedure nor the CE valve have track records longer than about twenty years, but the track records they do have look very promising and seem to be extending into the seventeen to twenty year longevity range. I picked the Ross over the CE valve because it has, at least intellectually, the possibility of being a "permanent" solution. (NOTE: the word permanent is in quotes because I know that every valve choice has the possibility of developing problems).
If or, more likely, when I need a second replacement valve, I'll be at a different point in my life, my goals will have changed, and I'll more than likely make a different choice.
I'll post the details of the who, where and when of the surgery in the "Pre-surgery" forum as soon as I know them all (I'm still waiting on the "when").
Thank you very much for sharing your experiences, your opinions, your biases and your thoughts related to valve selection. They have been invaluable to me during my own decision process.
I have made the decision. I have selected the Ross procedure as "plan A" and a Carpentier-Edwards bovine pericardial valve as "plan B" if the surgeon determines during the operation that the Ross procedure won't work for me. If the surgeon feels we need a "plan C" then I'll have some quick thinking to do, but I've got a few ideas in mind.
So you don't have to go hunting for it, here is my medical history: congenital bicuspid aortic valve, currently both stenotic and regurgitating, received recommendation for surgery in Sep, 2003. No other heart problems, but personal and/or family history of colon polyps, prostate cancer, and anemia.
For the benefit of anyone facing this decision, here are the reasons for my choice:
1) I prefer NOT to be on lifetime anti-coagulation therapy at the present time. The folks here have convinced me that Coumadin IS manageable, and that there is significant hope for a more manageable alternative. However, I want desperately to return to downhill skiing, among other "contact" sports, and my doctors and I feel that there is too great a risk of brain hemorrage if I ski while on anti-coagulation therapy of any kind.
2) I believe I can handle a second surgery some time down the road. I know it will be more risky and more difficult. I know that I can't predict my future health or how it will affect my chances in a second surgery. However, I believe the risks are still relatively small and are therefore worth taking to reach the goals I have for my life and lifestyle.
3) Since reasons #1 and #2 lead to the choice of a tissue valve, I wanted to pick the tissue option with the greatest longevity. Neither the Ross procedure nor the CE valve have track records longer than about twenty years, but the track records they do have look very promising and seem to be extending into the seventeen to twenty year longevity range. I picked the Ross over the CE valve because it has, at least intellectually, the possibility of being a "permanent" solution. (NOTE: the word permanent is in quotes because I know that every valve choice has the possibility of developing problems).
If or, more likely, when I need a second replacement valve, I'll be at a different point in my life, my goals will have changed, and I'll more than likely make a different choice.
I'll post the details of the who, where and when of the surgery in the "Pre-surgery" forum as soon as I know them all (I'm still waiting on the "when").
) carte blanc, but in this case I have to put my complete faith in his hands because I won't be awake to discuss it with him.
