I Need Your Help!

[rrobison7]

My name is Roger Robison, I am a 56 year old man facing aortic valve replacement. I am in good health otherwise and active in doing machines for aerobics, walking, some high rep low weight weightlifting, basketball two times a week, and golf. The decision I need to make is whether I am going to have a mechanical or a tissue valve. I have three opinions from doctors ? one for tissue and two for mechanical. I?m concerned about being on coumadin for the rest of my life, but I?m told it is better than another operation. I would like to hear your opinions. Please let me know what you think.

 

[geebee]

Roger,
Welcome. You should look at the threads and posts in the Valve Selection Forum. There are a great number of very recent discussions on this very matter as we have a number of member having surgery in the next couple of weeks. You will find equal arguements for both valve types. It is a very personal choice.
I will mention that I have been on coumadin for 24 years and have had no problems. Personally I would take coumadin over more surgeries any day but, as you will find in the various members statistics, that there are never any guarantees.
Good luck and keep us posted.

 

[gadgetman]

Roger,

As you will see from the posts you will receive and others that have asked the same question before is you will have to make the final decision. Each valve choice comes with their pros and cons. Tissue valves usually help you to avoid the fear of "blood thinners for life" but I met one person that went that route because of that and wound up on blood thinners anyway. Tissue valves have a "life" of 7 to 12 years and might have to be replaced. Mechanical valves offer longer operating life (15 to 20 years) but you will be on blood thinner for the rest of your life. I had already decided to go mechanical to try to avoid future operations but they were able to "nip and tuck" my Mitral Valve and I avoided the artifical valve altogether. I was lucky.

You will receive very helpful information from members here that have "been thru it". That information along with your own thoughts will determine which way you finally go.

May God bless you and your family while you start down this bumpy road. It is so much better on the other side.

Danny

 

[starkone]

answers...

answers...

I hate to say that the answer here comes from within. (I think?!)
I am facing the same situation and my decision on this aspect has been made for a long time. I know I do not want a mechanical valve. I have read many posts and I can't tell you exactly why...I just know. One of the threads stated it very simply....I do not want to be a patient for the next 15-20 years. I know I may end up on coumadin eventually but I would like to put it off as long as possible and hope that something better will come along.
This is a very personal decision....just get well informed and make your choice from the knowledge you gain that fits you the best.
Good luck to you!

Karen

 

[ALCapshaw2]

Most people end up deciding on which set of negative aspects they can best live with. At just a little over your age, I asked for a Bovine Pericardial Tissue Valve made from the pericardium of a Cow's heart. These have an excellent track record and many recipients are approaching 20 years with them. The latest study results I recall reading showed approximately 90% were were still working well at 15 years. 'Standard' Pig valves typically last only 7 to 10 years or something like that. Mechanical Valves 'should' last 'forever', or at least as long as any of us would need them to last.

Whenever I am faced with an invasive procedure (such as my ingrown toenail, or a colonoscopy, or another heart cath, I REALLY wish I had received the tissue valve I requested instead of the St. Jude Mechanical valve I have. Unfortunately, my surgeon decided that with all the scar tissue he found after opening me up, that a replacement was not viable and he went with the more durable mechanical valve. The valve works fine, living with coumadin has not been as bad as I thought (my INR is pretty stable), BUT I hate the idea of having to come off coumadin every time I need an invasive procedure.

If you come from a family of long livers, then the mechanical might be the wiser choice. If you don't expect to make it beyond age 70 anyway, then a good tissue valve should do the job. It IS a very personal choice. Your 'gut' should tell you in due time.

'AL Capshaw'

 

[Ross]

Roger do I hear a cry in your post saying I'm active? I do believe I do.

Hey, if you went mechanical, there is no reason that you could not do any of those things, except perhaps the weight lifting, it depends on what you mean by low weight. I have a mechanical valve and I'm on Coumadin. I want to tell you that you will hear so much bogus information about Coumadin, and much of it will come from the very people you trust to know better, your Doctors! They have not grasped the concept of how this drug works even though it's been on the market for years.

Valve choice is personal and even then, sometimes you do not get what you want. My advice is for you to choose what you'd want first, second etc,. and then be happy with what it is. Looking at your age, how would you cope with another surgery 10 years or so down the road? I know that's hard to answer when you haven't been through it once yet, but I'm here to tell you it is very hard and you may not want to go through it again. You may not have a choice either. What I'm getting at is that having this surgery one time is too much. Multiple times borders on insanity.

People hinge their bets on what the future may hold. Well that's fine if your a betting person, but your problem has to be dealt with today or there might not be a future. It's true heart surgery and valves have come along way in just the last 7 years, but don't look to the future to hold anything stellar in terms of significant gains in technology. It's your life, do you want to gamble with it?

 

[McCln]

I am now 40, had replacement at 36. I have no problems working out in the gym, I go for the cardio workout also. I don't much esle except eplitics and little weight training. Much of you activity will be determined after surgery. Since you are relatively fit, you should be too restricted from what you are already doing. There are those here who also have mechanical valves are very active, you just work and coumdin is worked around you. Just go with what you feel and hope that it what happens. I had no real choice, being young, not wanting to go back to surgery in ten years. So, I am happy with the St. Jude's valve. Just get knowledge of both options and go from there. Come in anytime when you have a question or just to vent. Welcome.

 

[MarkU]

Welcome Roger,
I had a St. Jude valve installed four years ago at age 47. Like Ross, Coumadin has not been a big deal at all for me. I am fortunate to get my testing done at a full-time anticoaguation lab where they understand how to manage it (they have also gone to bat for me when I get into disputes with my dentist and others who want to suspend my Coumadin in order to make their lives easier...).
Both my cardiologist and my surgeon advised me to choose a mechanical over a tissue valve, mostly due to my age in order to minimize the probability of repeat surgeries.
I think I made the right decision for me. One thing I do know is that the surgery and following recovery period is not fun. Although I was back at work in a couple of weeks, it took me 8-9 months before I really felt "normal" again. It was bad enough going through it at 47 and I don't want to think about doing it again in my 60's or 70's.
There is quite of bit of longevity in my family, and I am healthy otherwise, so I hope to be around for a while.
I have always been active in sports and was an avid weightlifter/bodybuilder prior to my surgery. Afterwards, my cardiologist advised me to go the light weight/high reps route, but did not restrict me from doing anything.
I did make a decision to do more aerobic exercise, which eventually led me to getting hooked on competing in triathlons a year ago.
I had developed some left ventricular hypertrophy (enlargement of the left ventricle wall) prior to my surgery. Fortunately that has now reversed itself with my new valve in place. I just had my annual physical and both my resting heart rate and blood pressure are lower than a year ago.
There are a lot of good folks here who can share their experiences and opinions. My best advice is to do as much research as you can in order to make an informed decision.
In the end, you need to make the decision that you think is best for you, not what others might think.
Good luck,
Mark