Hard data on life expectancy after an Aortic Valve Replacement in 60 year old

[Guest]

Can anybody point me to some real, emotionless, factual data on how long someone my age (60 year old male) can expect to live after getting AVR?

The real reason I ask, is that if it shows that I only have a 20% chance of living past 75 (say), I'm going in tomorrow and telling my boss to go f%&$# himself. I am NOT wasting half of my remaining years in THAT job, I can tell you that.

Sorry... (speaking of emotionless!!!)

Thanks in advance...

 

[pellicle]

hard data is hard to find because data related to your situation (like are you morbidly obese and a heavy drinker and a smoker??) is important.

You need data which is ranked according to your variables

Some threads from here:

http://www.valvereplacement.org/for...387-what-is-the-life-expectancy-after-the-avr

http://www.valvereplacement.org/for...34697-life-expectancy-with-a-mechanical-valve

http://www.valvereplacement.org/forums/forum/heart-talk/37682-life-expectancy

http://www.valvereplacement.org/for...isorders/41457-bav-and-normal-life-expectancy

http://www.valvereplacement.org/forums/forum/heart-talk/41319-life-expectancy-of-valve-or-person

however if your feelings about the job are as you outlined why stay there at all even if you're heart situation is nothing more than a trigger.

The "sleep at the wheel of life" alarm seems to have gone off now ... roll over and go back or do something else?

Emotionlessly I'd say "play it by ear and don't burn your bridges" ... you can always quit 2 years from now after surgery.

 

[pellicle]

tobagotwo has a good point here:
http://www.valvereplacement.org/foru...345#post357345

 

[Agian]

Getting an AVR doesn't shorten your lifespan, it's the complications that might be associated with it and the comorbidities.

Take 100 asthmatics, if even one dies from an asthma attack it will reflect in the statistics related to expectancy. You could show that for any illness, even relatively benign ones.

Factor in surgical complications, poor management of inr, not addressing the risk factors that may have caused the problem in the first place (most people who need avr don't have bicuspid). A dirty tattoo is more likely to kill someone with an avr than a normie etc etc.

 

[dick0236]

Your life expectancy won't be shortened with valve surgery.....but probably will be if you don't have the surgery. So don't quit your day job until you have something better to go to.

 

[Nocturne]

Can anybody point me to some real, emotionless, factual data on how long someone my age (60 year old male) can expect to live after getting AVR?

The real reason I ask, is that if it shows that I only have a 20% chance of living past 75 (say), I'm going in tomorrow and telling my boss to go f%&$# himself. I am NOT wasting half of my remaining years in THAT job, I can tell you that.

Sorry... (speaking of emotionless!!!)

Thanks in advance...

This is a topic that is frowned on in this forum. I don’t agree with that, but there you are. I could say more but I probably should not.

I laughed when I read your post because I identify with it. In fact I have posted something similar here in the past. I work in what is basically an inner city public school and I wonder sometimes if I REALLY want to be working there until the day I die.

So - first, the good news. I’ve read a lot of what I feel to be clean, clinical data on this subject and one thing I have seen strong evidence for is that after age 65-67, AVR has NO impact on lifespan other than the obvious one mentioned by dick0236 above. The impact is less and less as one approaches closer and closer to that age. I can show you studies that show this if you like. So if you are 60, you are not doing too bad.

I can (and will, in a bit, but I am about to start a class and will be wrangling rowdy teens on the last school day before Christmas break in a moment) also show you the most positive data I have found to date on long term survival after AVR, that involves an actually study rather than feel-good platitudes (“Your valve will last a LIFETIME!”, etc.) Standby for that.

Best of luck. Only you can decide if your job is worth what it costs you, and in this case you have what my cousin’s wife (who was born with a heart defect) calls “the gift of time” - you are at least aware of the fact that your time is likely shorter than average, and might reconsider doing something like working those extra years until 70 in order to set yourself up into your 90s. Some people here hate this kind of discussion with something approaching rabid fervor (though they won’t reveal this at first), but the fact is, MOST people out there don’t have retirement plans that will carry them into their 110s, even though they MIGHT live that long - and there is a reason for that.

 

[Nocturne]

(Cont.)

If we don’t honestly assess our odds of surviving to reach a certain age, we risk wasting the time we DO have working for a retirement we will never live to enjoy. And of course if we DO work out that we have 20 years less than we thought, we run the risk of getting depressed about ethat and wasting the years we DO have on depression. So it’s a tricky thing.

 

[Nocturne]

OK here you go:

https://www.um.edu.mt/library/oar/b...78/OA138-1535-1-PB.pdf?sequence=1&isAllowed=y

You may have to download the pdf and look at it yourself.

LOTS of data on different subgroups. In the 60-67 year old group, average age 63.5, there was a 50% chance of surviving more than 16 years post AVR. The relative survival rate was about 90% compared to the general population at 10 years. I’d have to look at an actuarial table to see the average odds of a 63.5 year old living to be 79.5 — it’s probably more than 50%, though.

 

[Nocturne]

First actuarial table I found indicates that a 63.5 year old man can expect to live about 18 more years. So that seems two years off? Of course the Malta study lumped men and women together, which would make it a greater difference on average, but still, you’re talking about 5 years or less. Enough that you could very likely live old enough that no one would grieve that you died young.

 

[DJM 18]

There are two medical pieces with good data implying that with good care and no other significant health issues you should expect a normal life expectancy...

http://circ.ahajournals.org/content/123/1/31


http://www.annalsthoracicsurgery.org/article/S0003-4975(07)00667-4/fulltext



In both the survival observed was comparable to the age matched general population.

There are other studies you can look at, less specific, that show similar data on what they call relative survival after avr. The data is quite encouraging so just make sure you look both ways before crossing the street.

hope this is of help.

 

[pellicle]

This is a topic that is frowned on in this forum

Only in your mind. The response here makes it hard to sell that line too. Perhaps tou need you look at your self for whynsome of those other discussions have left only you with that impression

 

[mikeccolella]

Getting an AVR doesn't shorten your lifespan, it's the complications that might be associated with it and the comorbidities.

Take 100 asthmatics, if even one dies from an asthma attack it will reflect in the statistics related to expectancy. You could show that for any illness, even relatively benign ones.

Factor in surgical complications, poor management of inr, not addressing the risk factors that may have caused the problem in the first place (most people who need avr don't have bicuspid). A dirty tattoo is more likely to kill someone with an avr than a normie etc etc.

Perfect Agian,
Lies, damn lies and statistics!
MARK Twain

importantly many people with valve disease have poor
ifestyle-not all people but enough to skew results towards the negative. Also poor outcomes at some hospitals. So pick the right hospitals where they are top notch.

 

[pellicle]

https://www.um.edu.mt/library/oar/b...78/OA138-1535-1-PB.pdf?sequence=1&isAllowed=y

You may have to download the pdf and look at it yourself.

that's a good study, thanks I'll keep that one in my evernote

I found the summary position interesting:

Conclusions
Patients over 68 years discharged from hospital after aortic valve replacement had a similar 10-year survival as an age- and gender matched population. In this age cohort surgery restored the patient’s normal life expectancy

 

[Superman]

importantly many people with valve disease have poor
ifestyle-not all people but enough to skew results towards the negative.

Disagree here. Valve disease isn’t a “lifestyle” situation. It’s not a result of smoking, lack of exercise, poor diet, or any of the other lifestyle issues that lead to cardiovascular trouble.

BAV is a congenital heart defect. There are other congenital defects that affect the development of other valves as well. Other people have valve issues due to rheumatic fever. But these aren’t a matter of, if I’d only pushed the plate away and went for a jog, I never would have needed surgery or had that aneurysm.

Many people, with and without valve disease have poor lifestyles. Do you have any data to support the assertion that valve patients have, on average, worse lifestyle choices than the general population?

 

[Agian]

Agreed Superman, but most people that need AVR don't have bicuspid. Poor lifestyle does indeed complicate things.
Most CAD risk factors are 'modifiable'. He did say "... not all people but enough to skew the results towards the negative." That's actually true.

 

[Agian]

Some people here hate this kind of discussion with something approaching rabid fervor (though they won’t reveal this at first)...

 

[cldlhd]

At the age of 48 I realize that time is moving faster than I'd like but I would think 75 is about a normal life expectancy for a normal western male.

 

[dick0236]

For a loooooong time I used to dwell on life expectancy. Now that I have blown away the accepted statistical tables regarding "how long will I live with an artificial valve" I see how foolish that game was.........but we all go thru the game. One stat is for sure, "the older you get, the older you're gonna get"......and that is the only guarantee that matters. Bear in mind that I am speaking with the benefit of hindsight and hopefully someday you will also have that hindsight. Merry Christmas!!

 

[Nocturne]

For a loooooong time I used to dwell on life expectancy. Now that I have blown away the accepted statistical tables regarding "how long will I live with an artificial valve" I see how foolish that game was.........but we all go thru the game. One stat is for sure, "the older you get, the older you're gonna get"......and that is the only guarantee that matters. Bear in mind that I am speaking with the benefit of hindsight and hopefully someday you will also have that hindsight. Merry Christmas!!

Dick, I have been meaning to ask — when DID you stop dwelling on life expectancy?

After a certain age, I’d imagine it’s no great trick to stop worrying that you’ll die young. No offense.

 

[Nocturne]

Only in your mind. The response here makes it hard to sell that line too. Perhaps tou need you look at your self for whynsome of those other discussions have left only you with that impression

Your response here is a wonderful, crystal clear example of how this topic of discussion sets off some of the regulars in this forum. There’s typically a “first wave” of positive responses, but woe betide the person who scratches the surface and comes back with skepticism.

But credit where it is due - you DID give him a few real studies with positive findings.

As for the the study I posted that you liked, I have posted it here several times in the past. You may not have noticed the first time because you were in a snarl about the topic of discussion.