just in case....

[Marcia58]

I talked to Mom's diagnosing cardio--a very cut-to-the-chase guy--and it boils down to "quite severe regurg, possible ruptured chordae, needs surgery".

They're talking repair, but I know we need a plan B just in case, so....

Woman in her late 70s
Occasionally forgetful
Easily distracted
VERY unorganized

I'm thinking tissue valve as plan B, yes? I shudder to think of her trying to keep track of her INR and warfarin dosing!

 

[Lynlw]

That would be my plan B for a person in their late 70s even with out the other things. But what does she prefer?

 

[Bina]

If it was ME at an older age, after surgery there would be a nice soft "moo" coming from my chest

 

[Marcia58]

Lyn - Quite often, she prefers not to talk about it. She gets very stressed/anxious and shuts down. Then, when crunch-time arrives, she turns to me and says, "What do I do?" So I try to think through as many scenarios in advance.

By the way, she also has a clotting disorder, which I assume could play havoc with her INR....

 

[Adrienne]

I know what my plan B would be in my late 70's - a biological valve without a doubt!

 

[Jkm7]

No question about it IMO....... A tissue valve is the most sensible choice in the event a repair is impossible.

I can't think of any good reason to request a mechanical valve given the description of your Mom you have provided.

 

[dick0236]

Woman in her late 70s
Occasionally forgetful
Easily distracted
VERY unorganized

I'm thinking tissue valve as plan B, yes? I shudder to think of her trying to keep track of her INR and warfarin dosing!

Tissue would be my choice for anyone in their 70s.

 

[Nancy jane]

I'm not a dr & I don't play one on tv & I haven't slept at holiday inn. - but isn't the new transcatheter - thru wrist (sp?) Suppose to be for the elderly. Or still testing.?

Nancy Jane 29 days & counting.

 

[chaconne]

I'm not a dr & I don't play one on tv & I haven't slept at holiday inn. - but isn't the new transcatheter - thru wrist (sp?) Suppose to be for the elderly. Or still testing.?

I don't think they are doing it in the US except in clinical trials. There are still unknowns that need to be explored. That would be a really nice option (as it is in Europe) for your mom, if it were available. Definitely tissue for option B though, no need to mess with a mechanical over age 70.

 

[Lynlw]

I'm not a dr & I don't play one on tv & I haven't slept at holiday inn. - but isn't the new transcatheter - thru wrist (sp?) Suppose to be for the elderly. Or still testing.?

Nancy Jane 29 days & counting.

You are probably thinking of the Sapien, They are thru the groin or chest, and yes it has been approved for some elderly/higher risk patients but it is for the Aortic valve, I think Marcia's Mom need work on the mitral valve.. The other percutaneous valve that is approved in the US and pretty much everywhere, is the melody valve that is for the pulmonary position.

 

[AgilityDog]

I'm a big proponent of the mechanical valves, but for your mom, I'd absolutely go tissue.

I think you have an overwhelming majority vote for that as plan b

 

[Luana]

I agree that tissue would be the better choice for her.

 

[Ovie]

I don't think they are doing it in the US except in clinical trials. There are still unknowns that need to be explored. That would be a really nice option (as it is in Europe) for your mom, if it were available. Definitely tissue for option B though, no need to mess with a mechanical over age 70.

Exactly what my Surgeon at Mayo told me. Sounds like they're getting closer to having it down.

 

[Lynlw]

Exactly what my Surgeon at Mayo told me. Sounds like they're getting closer to having it down.

Right now (IN US) the sapien is approved for highest risk patients without taking place in the trials (sapien Aortic) trials are still going on for lower risks. The Corevalve started their trials in 2011, but right from the beginning people at the highest risk, did not have to get divided into cath valve or meds, since the highest risks patients in the sapien trials did so much better with the valve than meds, they (FDA) felt it wouldnt be fair to make some have the meds instead.

Then there is the Melody pulmonary valve, it has been approved in the US and elswhere for a few years now, it is mainly used in children and young adults who already had their pulm valve/conduit replced or got one in cases of kids like justin who never had a pulm valve until he got his when he was 17..(since pulm valves are the 1 you can do relatively fine without

 

[Marcia58]

Thanks for the input everybody!