Johan's Thread

[Johan]

I have not posted before but am an ardent follower since reluctantly agreeing in February 2009 with my cardiologist and surgeon that AVR is now indicated. My surgery date is 1 July 2009 and I was talked into a bovine tissue valve (I am now 66) Carpentier-Edwards Perimount Magna. The usual bit about the dangers of warfarin in older persons. My choice all along was an On-X mechanical. I may still change my mind at the last minute and go mechanical and insist on the On-X but that would entail a change in surgeon and hospital with two weeks to go!! My question really is a tissue valve at my age a wise choice? Johan in Cape Town

 

[Ross]

Welcome Johan and yes, at your age, I'd go tissue. The problem with anticoagulation in older people is that as we age, we tend to bleed easily as is. Add anticoagulation to an already easy bleed situation and you can see where the problem comes in. Now this isn't to say that something such as chronic afib won't creep up and make taking Coumadin something you have to do anyhow, but in older folks, if you really don't need to take the risk, then don't.

 

[Johan]

Thanks Ross, for your valued contribution to this debate. After the turmoil of the last few months, I am now slowly settling down to the inevitable and after much research and input from others such as yourself, am happy with the decision to go the bovine pericardium route. It would of course be really ironic if I develop chronic AF and end up on Coumadin anyway. "We'll burn that bridge when we come to it" as one of our politicians famously once said. I shall now concentrate on the pre-surgery and post-surgery threads.

 

[Johan]

John, thanks to you also! You guys have now finally assited in settling my mind around the bovine tissue aortic valve. My original intrique with the On-X valve centred around having spoken at lenght with Dr Mervyn Williams in Port Elizabeth, South Africa, who wrote a number of papers on the fact that his non-compliant ACT patients with this valve experienced remarkably low incidents of clot-formation, hence the Proact trials now in progress. I would certainly strongly suggest to any younger person to seriously look at the On-X mechanical valve.

 

[dick0236]

Johan, I'd like to throw my support to what Ross and John have said. At an age in the 60s+, a valve not requiring ACT would be my choice. Although I have been on warfarin, pretty successfully, for a long time, I am beginning to question its use in seniors. Compliance is a MUST with warfarin and my docs tell me that their biggest problem with older patients on warfarin is "real" or "inadvertant" non-compliance due to the aging process, drug interactions, and true "senior moments".

 

[Johan]

Thanks Dick, I am new to this blog but at a glance it seems as if you are a real veteran with warfarin. You should know about the problems and nuisances of ACT. It also transpired that in older people tissue valves seems to last longer, less calcification. Some benefit in getting older!! Johan

 

[Ross]

Johan
I am 61 and getting the carpenter Edawards bovine valve. These new ones are expected to get 20 plus years in folks over 60. I agree with Ross at 66 I don't think you want to deal with the problems of C. If the bovine gets you 20 years that would make you 86. None of us are going to live forever.

Moved from previous thread

 

[Megan]

johan! if i were you, i would definitely go with the bovine! another benefit is that it might be able to be replaced via cath if need be in 20 years while the on-x or other mechanical could not. plus, no sounds, no meds (other than baby aspirin) no bleeding risks etc. as close to normal as you can get. Best of luck! if i was 10 yrs older i would have gone that route myself!

 

[hensylee]

just wanted to welcome you to VR. Nice to see you as a new member. Hope you will keep us posted. Blessins...........

 

[zipper2]

Wishing you the best for July 1st and wanted to echo annes post above
Big welcome and hello.

zipper2 (DEB)

 

[COLLEEN S]

Yes, good choice I think. I went mechanical but I am 46.

 

[ShezaGirlie]

My question really is a tissue valve at my age a wise choice? Johan in Cape Town

Absolutely the wisest choice available.. Welcome Johan and I've visited your beautiful Cape Town, but my favorite was all the wineries around Stellenbosch..

 

[WayneGM]

Welcome to VR. Sorry for the circumstances but glad you found us.

 

[ottagal]

Just wanted to add a warm welcome, Johan. Best wishes...