French valve job

[dlangton]

I have a friend in France who was diagnosed with a serious mitral problem about which I do not have details except that there is a lot of regurgitation and I think the valve was damaged by extensive bacterial infection -- endocarditis. They stuck him in the hospital immediately and he is right now on the launching pad for mitral valve repair-or-replacement, depending on what they find in there. The surgeon, a big prestigious character apparently and a tv personality, has told him that he MUST get a mechanical valve and that bio-valves only last five years. Personally, I would not work with a surgeon -- no matter how big and important -- who told me that, but maybe the French are more conservative in their OHS methods and don't adopt the new technology right away? It's hard to believe since their medical system is supposed to be so wonderful, but then it is still not unusual even here in the US to find surgeons and cardiologists who haven't updated their knowledge and recommendations to current standards.

My friend is 67 years old, so a biological valve (or On-X) seems like a good choice for him to me, since he is not likely to require a second surgery, and considering his other health problems and the risk of clotting, thrombosis, etc. (I'm not entirely clear on what his other health problems are, though he had a brain tumor removed 30 years ago and now has occasional seizures, and there are other complexities in his health picture.)

My friend is incommunicado in the hospital, so I gently offered my $.02 to his wife, and I guess that's all I can do. I feel I should do more but am not sure what to do. Anybody have any ideas? He is in good hands in every other respect, I think, but ... I don't know.

 

[Bonzo Dog]

Based on UK experiences, to fit a mechanical into a patient susceptible to endocarditis is verymuch not the thing to do The artificial nature of the valve makes it a collection point for bacteria and puts the patient at severe risk.

An arrogant Frenchman, never.

 

[Ross]

Based on UK experiences, to fit a mechanical into a patient susceptible to endocarditis is verymuch not the thing to do The artificial nature of the valve makes it a collection point for bacteria and puts the patient at severe risk.

An arrogant Frenchman, never.

Yeah but Bonzo, anyone is susceptible to endocarditis, anyone.

 

[sue943]

My mechanical valves were fitted in the UK and my surgery was required because I had had endocarditis so I am afraid I have to disagree with you Bonzo Dog - my surgery was carried out by a surgeon from St George's and that is a centre of excellence for cardiac surgery. The surgeon asked me if I wanted tissue or mechanical, he gave no preferences for himself, it was my choice and I went mechanical due to being 57 and not particularly wishing to have repeat surgery at 70 ish.

 

[Bonzo Dog]

My mechanical valves were fitted in the UK and my surgery was required because I had had endocarditis so I am afraid I have to disagree with you Bonzo Dog - my surgery was carried out by a surgeon from St George's and that is a centre of excellence for cardiac surgery. The surgeon asked me if I wanted tissue or mechanical, he gave no preferences for himself, it was my choice and I went mechanical due to being 57 and not particularly wishing to have repeat surgery at 70 ish.

Interesting Sue.

Not wanting to start bragging rights about UK Hospitals, but the Leeds General is also as specialist unit, having in it the Yorkshire Heart Centre, taking all the tricky stuff from the region that district heart surgeons either can't or won't touch. In my case the pacemaker wires within my heart and the previously fitted mechanical valve were the conduit for and the seat of severe endocarditis. Pacing wires were stitched onto the outside of my heart and a homograft root and valve fitted as anything artificial within had a great risk of attracting a stray bacteria and endocarditis errupting again.

Well that's what I was told and have always believed. Was that thinking wrong?

Yeah but Bonzo, anyone is susceptible to endocarditis, anyone.

Quite right Ross. I didn't mean to alarm mech valve users in general. By 'susceptible' I was drawing on my own experience as someone who was smitten with severe endocarditis and presumed pretty open to it again.

Again I don't want to be alarmist, but 'tis a fair point in these days of prevalent hospital aquired MRSA, should a mech valve user contract MRSA their outcome is possibly graver than Joe Public without a mech valve. Throughout my numerous pacemaker replacements the medical mutterings were about infection and the vulnerability of the valve. Unfortunately the soothsayers got it right.

 

[Susan BAV]

I have a friend...

...The surgeon, a big prestigious character apparently and a tv personality, has told him that he MUST get a mechanical valve and that bio-valves only last five years. Personally, I would not work with a surgeon -- no matter how big and important -- who told me that...

...My friend is incommunicado in the hospital, so I gently offered my $.02 to his wife, and I guess that's all I can do. I feel I should do more but am not sure what to do. Anybody have any ideas? He is in good hands in every other respect, I think, but ... I don't know.

A few times friends/acquaintances have been facing similar issues and I felt like all I could do was try to gently/respectfully offer my experience; and for several people, I've also recommended this site. Some people, perhaps not your friend though, seem to rather just let the medical professionals make their decisions for them without understanding their options.

I'll be looking forward to responses to your question.

Also, one [doctor] we spoke to pre-op also told us something similar and we were surprised to see his measure so clearly displayed.

 

[dlangton]

the followup..

the followup..

Just to complete this story, my friend got a biological valve sewn into the mitral position yesterday and is doing well post surgery.

 

[EireCara]

Great news about your friend. Best wishes for a smooth and complete recovery.

 

[ALCapshaw2]

Just to complete this story, my friend got a biological valve sewn into the mitral position yesterday and is doing well post surgery.

Do you know what Type of Biological Valve?
Procine or Bovine?
Modern "improved" Tissue Valve with anti-calcification treatments or Old Style without anticalcification treatments?

Just Curious.

 

[dlangton]

which bio-valve

which bio-valve

I called him in his icu room yesterday but it was difficult getting information since he seemed agitated and was complaining about hallucinations, and there were others in the room with whom he was also speaking. I asked him about the type of bio-valve they put in but he didn't know, so I just tried to reassure him that post operative hallucinations are common though it did not happen to me.
I'll know more later and will post info about the particular valve to this thread since ALCapshaw2 has expressed interest. He did speak to the (celebrity) surgeon just before I called and what he told me about the actual procedure sounded complex -- they replaced the mitral valve but also removed some obstructive material (a fold of tissue?) from the ventricular wall, and in order to do that they had to sever the aorta and go through the aortic valve opening. I have not heard of that sort of thing but the surgeon had his training with Charpentier, the inventor of one of the principal methods for mitral valve repair, so it seems he was in pretty good hands.