Interview with surgeon #3

[savysmommy]

Today I met with surgeon number 3. I am pretty sure my mind is made up as to who I will go with. However, the surgeon I met with today said a lot of things contricdicing what previous surgeons and my cardio have said.
First was the longevity of the tissue valve. He said that even though I am young (25), it should last 10-15 years. He also said that taking coumidin is just as risky as having a second surgery... Is that true..??

First I was set on a tissue vavle, then a mechanical.. now after meeting with this surgeon I dont know what I am going to.

We talking about the anerysum (ascending) which is small ( 3.9 - 4.0 ) He said that its hardly an anerysum and its a stretch to even call it that. He normaly dont even worry about them until they are over 5.

Thanks in advance for any thoughts/coments.

 

[Karlynn]

I think the longevity of the tissue valve depends on what valve you get. I don't know that there's any conclusive data regarding this. There are so many changes going on. It's been my understanding that the younger you are, and the more active you are, the shorter time period your tissue valve will have.

My question to you is how many children do you have and what are their ages? As I've said in previous posts, my mechanical valve gave me the ability to participate in my children's growing up years, without having to put up with a failing tissue valve, another OHS and recovery. I just wouldn't have had time to mess with that when I had 2 very active, very involved children to raise. No matter if or when I have to have another OHS due to my mechanical valve, I will never regret having those years without surgery interrupting them. The way I looked at it, I would have had another OHS right about the time my kids were finishing up high school. I would have missed so much.

This last surgeon's comment on Coumadin being as risky as a second surgery is a hotly debated one. I would be more inclined to disagree with him. Al just posted a thread in the Anti-coagulation forum about the history of evolving knowledge of Coumadin. http://valvereplacement.com/forums/showthread.php?t=11210, Go read it. My guess is that this surgeon is basing his opinion on the first 40 years and not the last 10.

All this being said, your valve choice is one you make, and then live with without looking back. Best wishes!

 

[savysmommy]

Karlynn,
Thanks for the reply. I have one daughter, she is 15 months. I guess, even if my tissue valve last 15 years, my children would both still be in school.. I guess the idea is that in 15 years, there will be better valves and less invasive surgery.

Its so hard because I was set on tissue. Then, I changed my mind and thought mechanical would be ok. Its a hard decision.

Thanks again,

 

[Barry]

... He also said that taking coumidin is just as risky as having a second surgery... Is that true..??

I don't think it is, and for that reason got a St. Jude's artificial valve. Coumadin is kind of a pain in the neck in that you've got to get repeated tests to make sure your clotting is within the appropriate range, getting smashed on alcohol isn't a good idea, and with foods and drugs that interact with the Coumadin you kinda have to either avoid them or take then every day (if you take them every day, your Coumadin dosage can simply be adjusted to accommodate to them). And if you're into knife-fighting as a hobby, you'll have to give it up.

Anyway, I'm on Coumadin and see it as an annoyance, not a danger. But it does place you at greater risk of bleeding out - father of a friend of mine was on Coumadin and died of cerebral hemmorhage after accidentally bumping his head pretty hard on a wall.

 

[catwoman]

I agree with Karlynn's thinking about valves.
I got a mechanical because my late father-in-law went through 2 MVRs in about 10 years' time. I wasn't in the family during his first surgery, but I helped oversee his medical care the second time because he was a widower by then. He had to take Coumadin after the second MVR, so I was somewhat familiar with blood tests being needed, etc.
When I was told I needed valve surgery, I did some research on mechanicals and agreed with my surgeon that, if he could not repair the valve, he would put in a St. Jude. Of course, I was 52, not 25, and I had a total hysterectomy at 34.
Coumadin/warfarin is **not** a big problem for me. I take mine at breakfast, never miss a dose. I home-test. I have to eat so much vitamin K each day and I usually have a green salad. Sometimes I have cole slaw, sometimes some stirfry with broccoli, other times I grill fresh asparagus, have some guacamole with green stuff, etc.
It's the only Rx I have to take for my heart -- no statins, no BP meds, etc.