Gender and valve choice

[Duffey]

My view of the decision making process behind member's choice of valves might be skewered, so I thought I'd start a poll to see if I ccould find out.
It appears, on a superficial level, that female members are about evenly split on their decision to go with a mechanical valve or tissue. I think that younger women on the site might lean towards tissue if they are still considering having children.
However, when it comes to name brand and model, I think female members aren't as interested in making that decision. I know that I wasn't.
If you would mind marking your thoughts in regards to choice, I'd appreciate it.

 

[Bina]

I knew 2 people with St. Jude valves, so I was comfortable with that, and my chosen surgeon was using them. My trust in him was such that if he needed to do something different, I would be okay with it. My only surprise was that I got the newer Regent model. My husband was extremely pleased that I leaned towards a mech valve because it gave us a slightly better chance of not seeing me back on an operating table too soon again.
Otherwise, this OHS thing was very new to me and I hadn't found this VR group yet,
so I just did some very basic research, and every time I did that I felt nauseous afterwards.

 

[Mentu]

Valve Decision

I did a lot of reading and came to the conclusion that I was most comfortable with the CE Bioprosthetic but I wanted to hear what my surgeon had to say before I really committed myself to it. My Cardiologist suggested that I consider a mechanical because of my age but shared no other reason for his recommendation. The final decision was made a lot easier at the first meeting with my Surgeon when, before knowing my thoughts, he recommended the same valve I had developed a preference for. We then discussed why he thought it was a good match for me and what the best alternate would be if I changed my mind and wanted a mechanical instead of a tissue valve. His primary reason for recommending the CE concerned the likelyhood that I might share a family tendency for developing tissue growth at the site of the new valve which would be less of a problem with a tissue valve. This had already happened to my Uncle who had to trade out his mechanical valve for a tissue valve after only 7 years. It gave me a lot of reassurance that we had independently selected the same valve. My surgeon was true to his word and the day before surgery called to ask, if after a month to think about it, was I still comfortable with original choice? I appreciated the call but told him that I wanted to stay with our original choice so he used the CE the following day during my AVR. As others have observed, there just are no certainties when it comes to valve selection. We would all like to think that our valves will last through the end of our lives but reading the experiences of others here in VR has demonstrated that there is no single safe choice for everyone. All choices are compromises. We just have to make the compromise with which we are most comfortable and go on to live our lives.

 

[olefin]

My surgeon was 500 miles away, I met him the day before surgery. He had been recommended to me my local cardiologist. I had a lot of faith in my first cardiologist, went to him for about 15 years till, I moved out of state. He also did not recommend a pig valve. Of course I had final say but it didn't take a rocket scientist to know which valve to use in a healthy 56 year old.

 

[Duffey]

So far, so good, except I see Ross didn't post his sex. Anyone else want to answer that one for him?

 

[dick0236]

Duffey, when I had my surgery, I doubt there were many, if any, choices. Mine is an "old" Starr-Edwards mechanical that continued in production until a couple years ago. I never shopped for a surgeon, and I don't remember meeting him until after the surgery. As it has turned out, the guy who did mine did one helluva job. I had known for several years that I needed something done, but cardios kept telling me to wait a little longer for the technology to improve. In 1967 they punched my ticket and told me now was the time. The rest is history.

 

[Kathy McCain]

I chose the Medtronic Mosaic Procine Valve. I did research this valve myself, and also spoke with my surgeion Dr. David Ott. He felt very confident in my valve selection. It continues to be one of the best, current Porcine Valves on the market, despite reported early valve failures among a few of the elderly. My cardio also as of this date, feels it is a good selection.

At 56yrs my surgeon tells me I could have gone either way. He himself was 60 at the time and said he personally would choose a tissue valve. I have read that it's pretty much split down the middle with regards to valve choice, for people in their fifties and sixties.

Even though the medical community has come a very long way with regards to valve surgery, the reality of the situation is, THERE CURRENTLY IS NO PERFECT VALVE.

 

[Ross]

So far, so good, except I see Ross didn't post his sex. Anyone else want to answer that one for him?

I most certainly did, but you left the alien catagory out, so it's not accurate.

 

[Duffey]

I most certainly did, but you left the alien catagory out, so it's not accurate.

This is worthless without pictures!

 

[twinmaker]

Since my valve replacement was done back in 1981, there weren't a lot of choices. Since we already had three children and this was my second OHS, there was never any discussion about a tissue valve. The only discussion was about which mechanical valve to use. My surgeon highly recommended the new St. Jude mechanical. He said it might NEVER have to be replaced and it was a real possibility that the older mechanical ones might have to be replaced. I was only 29 at the time. So I signed the papers (since the valve had not been approved by the FDA yet) and the rest is history. If I ever have to have another replacement, I will probably do a lot more research on my own and with my surgeon, but believe me...I'm not complaining about the valve I have. It's lasted 28 years so far. Good call by the surgeon! LINDA

 

[Ross]

This is worthless without pictures!

Well if you insist, but it's kind of x rated.

 

[Ross]

When I first came to this planet, I had to go buy one of these. Do you know how hard it is to become employed looking like a walking stick?

 

[sue943]

I live on a small island that has a cardiologist but no 'proper' cardiac surgery, only pacemakers and defibulators and similar devices, for anything else we are flown to the UK. Whilst being treated for endocarditis my heart murmurs became worse so I was flown to England and taken to St George's Hospital. As is the practice in the UK, I was allocated a consultant (senior doctor) who came to see me late on the Saturday evening. He spoke about perhaps operating in days but it was later decided to try to clear the infections.

A few months later I had my angiogram and an echo then it was said I needed surgery within a few weeks. It was just accepted that the surgeon allocated to me would perform the surgery, I had been referred to a surgeon who was capable of dealing with complex cases. The surgery could have been done on the NHS, I was being treated within that system but I opted to go to a private hospital but still had the same surgeon.

The evening before the surgery he asked me whether I wanted mechanical or tissue, it was a sort of toss up really, I was 57 so didn't really want a re-operation when I was in my early 70s so went for mechanical.

I didn't know there were types of tissue, or different brands, I gave it no thought. I just let the surgeon do what he wanted - I am here and as I hadn't really been expected to survive I have no complaints and should I require further surgery I would like the same surgeon to do the operation, if he is still around. If he isn't then I will still trust the hospital to give me the correct person to do the job. All a matter of trust I guess.

 

[Superman]

I answered based on my first replacement when I was seventeen. Pretty much left it up to my surgeon and cardiologist. 19 years later, I'm glad they chose what they did and stuck with the same equipment the second time around (they were only digging around because of my aorta, the valve was still going strong).

Of course I was male at that time and still am. That hasn't changed. I did do a lot more homework for the second operation than the first.

 

[Marguerite53]

Hm, well, I was 52 and had immediate instincts toward the CE bovine valve. When I met with the surgeon my cardio recommended, he too favored this valve (said he would choose it for his wife, himself, etc.. -- we are the same age). If he had insisted on mechanical I would have certainly looked elsewhere for a surgeon (we have a large handful of excellent ones here). So I checked that I sought him out -- even though I actually just got lucky with the first surgeon I consulted.

I really like Mentu's comments on this thread.

Marguerite

 

[ajay_22_86]

This poll doesn't make sense because gender isn't linked to choices, so all we're seeing is how many males and females took part? But anyway, I'm from the UK and had a long time to make my choice (I didn't need my surgery straight away). I even switched hospitals because I wasn't happy with one. I made the choice to go mechanical. I did want the ON-X but it's not so common here in the UK, and to be honest, I'm perfectly happy with the St. Jude. So that's another thing - people from UK don't usually make the choice of brand etc. Just type of valve

 

[TXWildflower]

My surgeon was 500 miles away, I met him the day before surgery. He had been recommended to me my local cardiologist. I had a lot of faith in my first cardiologist, went to him for about 15 years till, I moved out of state. He also did not recommend a pig valve. Of course I had final say but it didn't take a rocket scientist to know which valve to use in a healthy 56 year old.

I didn't vote in the poll as I am still waiting and have not had to make my choice, but I think your statement implies if you are healthy 56 year old - as I am - that you'd be stupid not to get a mechanical valve. I am not a rocket scientist, but my no means am I stupid either. I have been doing my research and I am leaning towards tissue when the time comes. Perhaps even a new ATS 3f equine valve that is purportedly as close to a naitve valve as you can get (contraindicated for those with BVD). I just don't think it as cut and dried as you make it out to be at least not anymore. There are no guarntees in life either way. You could get a bum mechannical valve or a not so perfect replacement job and still have to have OHS again. The 2 surgeons I consulted and my cardio all 3 recommended tissue and they concurred that it is a very real possibility- almost a certainty to their thinking, that by the time I would need a reop, they would be doing these replacements percutaneously. So to me, going tissue make more sense and I can avoid coumadin - hopefully. I know those of you on ACT don't find it to be that much of an inconvenience, but I think with my passion for travel and eating different cuisines and local foods everywhere I go that doesn't fit well with my lifestyle. But there are no guarantees that if even on tissue that I wouldn't have to go on coumadin for Afib or something like that.

Rhena

 

[olefin]

I think your statement implies if you are healthy 56 year old - as I am - that you'd be stupid not to get a mechanical valve. I am not a rocket scientist, but my no means am I stupid either.
So to me, going tissue make more sense and I can avoid coumadin - hopefully.

Sorry, I did sound a little blunt. But I did have a bad experience from AVR.

Warfarin was no big deal to me. My wife had been on warfarin for a year due to blood clots in her pelvic area. So I had no fear of warfarin.

The doctors were concerned about me going on warfarin due to having a severe bleeding duodenal ulcer the year before. But even with a history of a bleeding ulcer, they didn't want to use a pig valve. I hadn't gave it much thought as far as what kind of valve. Or much though about having to repeat surgery. (I wasn't on the internet back then)

At that time I didn't think valve surgery was too big a deal. From what I'd heard, most folks went home within 5 days. Heck, I felt could take anything for 5 days. Had I known then, how my surgery would go I would have demanded a mechanical valve! Yes, I saw men 20 years older than me going home 5 days after AVR. Complications from valve surgery was rare, even 18 years ago. I spent a total of 7 days in ICU and 20 days in the hospital. It took a full year to get back where I was before surgery. But I feel very lucky to have been in a hospital that could deal with complications. I owe the doctors and hospital my life.
I also think anyone that has had complications during valve surgery will feel similar when it comes to type of valve.

I know those of you on ACT don't find it to be that much of an inconvenience, but I think with my passion for travel and eating different cuisines and local foods everywhere I go that doesn't fit well with my lifestyle.

As far as food, I eat the same food I did before warfarin. My INR swings, probably due to my eating but that's no big deal... the dosage can be adjusted. As far as travel... we were on the road in a motorhome before and after surgery for several years. Now days it's several cruises a year and road trips. We have 2 cruises booked in the next 4 months.

I can't think of taking more risk of another surgery due to food? But that's your choice and I wish you the very best and hope your valve last your lifetime.

 

[Bina]

This poll doesn't make sense because gender isn't linked to choices, so all we're seeing is how many males and females took part? ............

ON second thought.....I agree. The poll is showing the decision making process for male/female, but not the actual valve choice.

 

[njean]

Back in the year (1975) that I had my AVR & MVR, like dick0236, I was not given a choice of tissue or mechanical valve. The surgeon (Dr. Cooley) made that decision for me & I was happy & content with what he had decided.

In fact, one of the old valves (mitral) still resides in my heart today after 34-years! The other valve, aortic, had to be swapped out in 2006 for wear & tear with a new St. Jude.