How do they keep tissue valves from decaying?

[mrichardson]

I've been doing more research on my upcoming pulmonic valve replacement surgery. I've been told (not by the surgeon herself, though) that I will be getting a valve made from bovine tissue.

So, how do they keep the valve from decaying? And how do they get it to "meld" (for lack of a better word) with your existing tissue? And how "sturdy" is the patch? Because based on what I've read, when they install the valve, they put a "patch" over the incision site on the valve/heart. So I'm just wondering how all that works.

 

[Paleowoman]

Before I had surgery I wondered how, when they sew the valve in place, that the small spaces between the stiches don't 'leak' for want of a better word. I watched some videos of surgery on YouTube, and either there or on a website, I heard or read that, just like when you cut yourself on your skin the skin heals itself 'together', so when the valve is sewn, the place it's sewn to heals over, and very, very quickly. There is probably more to it than that, but that's the principle behind it - the body heals any cuts, stitches etc very quickly.

PS - I just remembered, it was a cardiologist told me ! When the valve is sewn into place there is a very rapid immune response by the body to the 'injury' and so the area heals or melds quickly.

I've not heard of a patch. I had a bovine valve too, CE Magna Ease - I thought there was some kind of ring which is sewn in place, the leaflets of the valve being made of pericardial bovine tissue but the ring of some other material - plastic ? Here's some info about the valve I have, scroll down and on the picture you'll see there are "suture markers" on a "stent base": http://www.edwards.com/devices/heart-valves/aortic

Maybe you can find out more from your surgeon ? I'll be interested !

 

[skeptic49]

Tissue valves are treated to insure durability. For example, I have a St. Jude "Trifecta" bovine valve. St. Jude states: "The Trifecta valve is treated with the patented Linx™ AC anticalcification treatment during the sterilization process."

Jim

 

[pellicle]

Hi

So, how do they keep the valve from decaying? And how do they get it to "meld" (for lack of a better word) with your existing tissue? And how "sturdy" is the patch? Because based on what I've read, when they install the valve, they put a "patch" over the incision site on the valve/heart. So I'm just wondering how all that works.

as others have said its treated (as leather is actually treated tissue too) to reduce that. But indeed like leather it does break down over time. So depending on your age and activity (and other factors) it may last up to 15 or so years.

They don't get it to "meld" the body does that. Cells of the vascular system grow over the stitching areas and like ivy covering a wall grip on and make it solid. The surgeon's job is to stitch it in neat and oriented accurately. After that, your body fixes everything.

Kinda "creative destruction" ... the surgeon destroys (removes) your old valve and your body creates joins with the new one. Because it is not living tissue there is no anti-rejection drugs required.

So, pulmonary valve hey .. you're one of the rare ones. Without having done a survey I'd say its Aortic / Mitral / Pulmonary in about that order of occurence.

Best Wishes

 

[JulienDu]

Hi

So, pulmonary valve hey .. you're one of the rare ones. Without having done a survey I'd say its Aortic / Mitral / Pulmonary in about that order of occurence.

Best Wishes

Do they do mechanic for pulmonary valves ?

 

[mrichardson]

Do they do mechanic for pulmonary valves ?

I think they do. However, I've been told I will have a bovine tissue valve.

 

[mrichardson]

as others have said its treated (as leather is actually treated tissue too) to reduce that. But indeed like leather it does break down over time. So depending on your age and activity (and other factors) it may last up to 15 or so years.


Best Wishes

I'm almost 40, and I have started doing exercising, and afterward I do want to continue that exercise, and incorporate some bike riding. I'm going to ask the doctor all these things in my consultation, and see what she tells me. Although I have been told that in 15-20 years (because it's a bovine tissue valve) that they might need to do a replacement, but that is less invasive than what they're doing now.

 

[pellicle]

Hi

I'm almost 40, and I have started doing exercising, and afterward I do want to continue that exercise, and incorporate some bike riding. I'm going to ask the doctor all these things in my consultation

that's one of the real benefits of this place ... more think about and go to ask questions of the one you should trust ... the surgeon

Although I have been told that in 15-20 years (because it's a bovine tissue valve) that they might need to do a replacement, but that is less invasive than what they're doing now.

they keep saying that, and in the future it may be true ... just don't put your bet on the table based on that.

Best Wishes

 

[pellicle]

Do they do mechanic for pulmonary valves ?

seems there are...


http://www.ncbi.nlm.nih.gov/pubmed/21095354

[h=4]CONCLUSIONS:[/h] Thromboembolic complications are rare with therapeutic international normalized ratios and mechanical PVR provides excellent durability and freedom from reoperation. Tissue PVR does not eliminate bleeding complications. Mechanical PVR should be considered in select patients with multiple prior operations, or when there is another need for warfarin anticoagulation.

 

[Lee]

I've been doing more research on my upcoming pulmonic valve replacement surgery. I've been told (not by the surgeon herself, though) that I will be getting a valve made from bovine tissue.

So, how do they keep the valve from decaying? And how do they get it to "meld" (for lack of a better word) with your existing tissue? And how "sturdy" is the patch? Because based on what I've read, when they install the valve, they put a "patch" over the incision site on the valve/heart. So I'm just wondering how all that works.

Hi have had the pulmonary valve replaced about 1 year ago with a bioprosthesis valve, unfortunately mine is showing early signs of deterioration due to calcification of the valve. I have no idea how this happens so quickly as I was told when i went in that it would last around 10-15year if not more due to the lower pressure in the pulmonary valve. But it had notably started calcifying only 5 months after the surgery, now a year on it is noted as being "fairly calcified" whatever that means.

 

[pellicle]

Hi

Hi have had the pulmonary valve replaced about 1 year ago with a bioprosthesis valve, unfortunately mine is showing early signs of deterioration due to calcification of the valve. I have no idea how this happens so quickly as I was told when i went in that it would last around 10-15year if not more due to the lower pressure in the pulmonary valve. But it had notably started calcifying only 5 months after the surgery, now a year on it is noted as being "fairly calcified" whatever that means.

every time I read this sort of thing I just feel sad ... I've just heard this story too many times to be comfortable ... especially among the young.

 

[Lee]

Just trying to find my way around the website. Just a test

 

[Lee]

Pellicle, have you heard this story before. My Cardio has told me it is very unusual to happen and I just dont know what they are going to do or what causes it. I feel so up in the air and out of sorts. Do you know anyone this has happened to and what the outcome was, I am 49 (well 50 soon). I dont have an appointment until 10th March with a new Cardiologist who specialises in Congenital Heart Disease. My original general cardiologist has told me I have Pulmonary Hypotension and that he does not know why the valve has started to deteriorate so quickly. Hence I sort a second opinion. when I sent the new Cardiologist my latest assessment with PH written on it, he told me that it is all to common that Cardiologists who do not specialise in Congenital make the error of a PH diagnosis. So i am feeling pretty tense until I get in and see the new Specialist for an assessment. I am praying that the original Cardiologist has got it wrong, which is a pretty bad thing to get wrong. And he told me to come back in one year at that?? I dont get it !!!

 

[pellicle]

Hi

Pellicle, have you heard this story before. My Cardio has told me it is very unusual to happen and I just dont know what they are going to do or what causes it.

I've never spoken with or heard anything about anyone who has had a pulmonary valve replaced, my experience and reading is primarially about Aortic and I know a little about Mitral.

I do realise its uncommon to have a valve calcify fast, but you know, its not so uncommon that is would not bear discussion. What I find a failure of duty of care is to omit to discuss it as a possibility. Let say its 1% of cases, how many valve replacements does the under 50 age group represent? More so the under 40 (where calcification seems to my reading more common).

Causes are as yet a matter of conjecture as (to my knowledge) noone has the pathway clearly defined. Some suggest its the immune system. I had thought it was tightly correlated to activity, but it seems that is more tightly correlated to age (which usually implies activity if you ask me).

BTW If you click on my name, and read "about" you'll find out that I'm Australian too.

Also, I don't know if you read either of my PM's to you, as your PM's to me appeared to imply you had not read either of my replies to you.

 

[Lee]

Hi Pellicle, I have only just read your reply, I am only new to this forum and still finding my way around and getting around to reading whats going on. I do appreciate your responses and any information that you have. I seen a new cardio yesterday as I was not happy with the information from m original. My original told me some information that I have now discovered is incorrect, and I have an inkling its to protect his mate, my surgeon. I have found out that the valve operation I had Dec14 was not a success and at this point I have a severely leaking valve. I am at the point of going for MRI ect. But my valve will need to be re-done When that is, I dont know at this point, but my new cardio at RPA is amazing and he tells me I should be able to get a transcatheter valve replacement and not go through the open heart yet a 3rd time.

 

[Lee]

Hi Pellicle, I have only just read your reply, I am only new to this forum and still finding my way around and getting around to reading whats going on. I do appreciate your responses and any information that you have. I seen a new cardio yesterday as I was not happy with the information from m original. My original told me some information that I have now discovered is incorrect, and I have an inkling its to protect his mate, my surgeon. I have found out that the valve operation I had Dec14 was not a success and at this point I have a severely leaking valve. I am at the point of going for MRI ect. But my valve will need to be re-done When that is, I dont know at this point, but my new cardio at RPA is amazing and he tells me I should be able to get a transcatheter valve replacement and not go through the open heart yet a 3rd time.

 

[zee112]

I had a donor pulmonary valve at the age of 8. I am now 23, and it is only mildly leaking, and may not progress for a while now, and when it finally does, they have some new technology which will clip my pulmonary valve to fix the leaking. Is leaking the sign of calcification?