I have made my decision w/ 1 remaining Q.

[Farid]

I have decided to go with Dr. Michael Argenziano at Columbia Presbyterian Hospital, NYC. The operation is scheduled for 21 November 2006. He will use the On-X valve. He informed me that he has used it in the past, and that it is as good as the SJ. I like the possibility of being on low anticoagulant or even aspirin. The two issues that were a concern as why not to go to Columbia were just out-weighted by wanting the On-X valve. One was where to stay; my family is making hotel reservation in a place (part of Columbia, I guess) for a week. The second was how to get home; I decided to take a limo home and another for the one follow up visit.

I just recently got a CT Angiogram to determine of the aortic root needs to be replaced. Here is my question...if the aortic root needs to be replaced, and knowing that the On-X valve does not come with a root attached, the doctor will have to attach it to the valve (outside of the manufacturing process), would that present a big unknown risk? What do i need to know/consider? Need your experience/knowledge to know what to ask when I speak with the surgeon.

 

[kodi]

Farid,
I can't answer your question but do want to wish you the best of luck on making your decision and your upcoming surgery. I think once you make the decision, the wait becomes longer and you still have lots of questions to ask. There are a lot of people here definitely more knowledgeable than me who will definitely have answers. I'm always happy that I can learn from others experiences too.
Mel

 

[Phyllis]

Congratulations, Farid. I am glad you made your decision and that you are getting the valve that you want. I can't answer your question, but hopefully someone will come along that can. I put you on the calendar for the 21st with best wishes!

 

[Karlynn]

if the aortic root needs to be replaced, and knowing that the On-X valve does not come with a root attached, the doctor will have to attach it to the valve (outside of the manufacturing process), would that present a big unknown risk? What do i need to know/consider? Need your experience/knowledge to know what to ask when I speak with the surgeon.

Did the surgeon say that can be done? I know we have a few members who didn't go with the On-X they wanted, because of the root issue. If he says it can be done, I'd want to see some stats on who's had it done and what the outcome was. Otherwise, you may want to go with a valve with the root already attached.

 

[tobagotwo]

The two major valves that come with the root already attached are the St. Jude Masters Series, a carbon (mechanical) valve which comes with a fabric root, and the Medtronic Freestyle, which is a root-inclusive, anticalcification-treated, porcine tissue valve.

The assumption I am making is that you would prefer the more permanent carbon valve. The SJM valve is an excellent, proven valve, and the fabric technology is also well-tested, and lives successfully in the chests of many of the people who frequent VR.com.

The surgeon can attach a graft sleeve himself, as he works, effectively manufacturing his own combination valve and root. Most surgeons won't do this. It means more of their time, more time for the patient on the pump, and some possibility of them making an error.

However, surgeons are capable of surprising craftsmanship. One Brazillian VR.com member had a valve fashioned from stainless steel wire and dura mater, which lasted for many years. Several of our members were very particular about which tissue valve they received, and talked their surgeons into stitching together their chosen valve with a porcine or fabric root replacement while in flagrante chirurgia, on the pump.

You'll need to ask your surgeon what his thoughts are about this. He will be the final arbiter of whether he will create you your own FrankenValve on the spot. If he won't, you'll likely have to find another valve choice. you should always have discussed a backup valve before surgery anyway.

Best wishes,

 

[Superbob]

Farid,

I knew ahead of the surgery that I would need the root replacement as well as the valve, so the root-inclusive approach definitely made sense to me. I think tobagotwo offers some excellent advice about having a backup plan if they don't know ahead of time. But I'm wondering: Wouldn't they know about the root's status as a result of a catherization or other test ahead of the surgery?

All best wishes to you,

 

[Magic8Ball]

I discussed this with my surgeon and he said that before the one piece option was there he used to have another surgeon (assistant) stitch the two parts together while he was opening you up.

But sounds like you are getting a bentalls the same as me and i've gone for the one piece st jude unit as i feel the less stitches the better.

I'm also not one to make a choice on a potential promise of low warafin, had this been the case for some time and was proved to be ok it may be a different choice.

Good luck with your decision.