Life Expectancy after Valve Replacement

[Nocturne]

THIS is the article I read that freaked me out about probably not living to see 75:

http://heart.emedtv.com/m/aortic-va...xpectancy-after-aortic-valve-replacement.html

Just in case anyone was curious.

 

[Paleowoman]

Hi Nocturne - The article didn't actually say exactly what those people died from. And it wasn't totally clear that the deaths were specifically related to the valve replacement. They could have died in a car accident, died from a respiratory problem, died from a heart attack or stroke related to something other than their valve replacement, died from cancer, and so on. I would have liked to see the figures of causes of death. Certainly saying that a 75 year old having mechanical valve replacement has an average life expectancy of 7 years takes them to average of 82 which is a pretty good innings for anyone, valve replacement or not. And with a 65 year old with tissue valve, average life expectancy 11.3 years, takes them to average age of 76 - simply loads of people die in their 70's, valve replacement or not, from various illnesses unfortunately. The average life expectancy of the 35 year old with mech valve of only 16 to 22 years is a surprise, but again I'd like to know exactly what they died from.

The article also didn't say how many people were 'studied', nor did it give the name of the studies.

What a person can do with statistics.

 

[neo]

The author doesn't site any examples or studies, kind of odd. Also doesn't say exactly "why" people got valve disease to begin with. The "why" could lead others to lower life expectancies and have nothing to do with the valve itself.

Hi Nocturne - The article didn't actually say exactly what those people died from. And it wasn't totally clear that the deaths were specifically related to the valve replacement. They could have died in a car accident, died from a respiratory problem, died from a heart attack or stroke related to something other than their valve replacement, died from cancer, and so on. I would have liked to see the figures of causes of death. Certainly saying that a 75 year old having mechanical valve replacement has an average life expectancy of 7 years takes them to average of 82 which is a pretty good innings for anyone, valve replacement or not. And with a 65 year old with tissue valve, average life expectancy 11.3 years, takes them to average age of 76 - simply loads of people die in their 70's, valve replacement or not, from various illnesses unfortunately. The average life expectancy of the 35 year old with mech valve of only 16 to 22 years is a surprise, but again I'd like to know exactly what they died from. What a person can do with statistics.

 

[neo]

Here is another source of life expectancy info. See the quote below and the original article link:

"Long-term survival following aortic valve replacement is close to that observed in a control population of similar age. Numerous observational studies have consistently demonstrated that corrective surgery in symptomatic patients is invariably followed by a subjective improvement in quality of life and a substantial increase in survival rates."

http://rossscience.org/ARTICLE/OJCAR-4-1.php

THIS is the article I read that freaked me out about probably not living to see 75:

http://heart.emedtv.com/m/aortic-val...placement.html

Just in case anyone was curious.

 

[dick0236]

A good example of "garbage in - garbage out. I googled the doc who wrote the article. He is a GP who founded that emedtv web site and only has a 2.5/5 patient grade......very average. Probably spends most of his time trying to get ad revenue for his web site rather than treating patients. BTW, I shouldn't be able to type this as I am well beyond his life expectancy numbers. Long term heart valve longevity stories are only now becoming statistically relevant since OHS is only about 55 years old.

 

[W. Carter]

A good example of "garbage in - garbage out. I googled the doc who wrote the article. He is a GP who founded that emedtv web site and only has a 2.5/5 patient grade......very average. Probably spends most of his time trying to get ad revenue for his web site rather than treating patients. BTW, I shouldn't be able to type this as I am well beyond his life expectancy numbers. Long term heart valve longevity stories are only now becoming statistically relevant since OHS is only about 55 years old.

And thats on a 1967 Starr-Edwards valve. It may be better than the newer ones.

 

[JulienDu]

I think Dick says it all.

And thats on a 1967 Starr-Edwards valve. It may be better than the newer ones.

Yeah I have a Dodge Diesel Truck with an old generation Cummings engine and it outlasts the last generation one. This **** is unkillable.

 

[pellicle]

Nocturne

*The article didn't actually say exactly what those people died from.
*it wasn't totally clear that the deaths were specifically related to the valve replacement. They could have died in a car accident, died from a respiratory problem, died from a heart attack or stroke related to something other than their valve replacement, died from cancer, and so on.
*The article also didn't say how many people were 'studied', nor did it give the name of the studies.
*What a person can do with statistics.

yes yes and yes ... read critically (meaning examine what is said and then check the rest of the paper to verify that their conclusions are the obvious ones not just "well , we can't fault them on that conclusion even if its a weirdo reading of the data"

also, try reading "peer reviewed" journals, not just any fluff. Peer Review picks up a lot of garbage but that does not make it immune to weird conjecture. I think dick0236 is bang on with his estimations there

 

[Warrick]

Hi, I totally agree with everyone's responses, its pretty easy to find stats like this that put us on the slippery slope.

We are all born terminal.

I've google how long a number of times after surgery and it's easy to get scary answers,
I can't find anything just now looking for out of 100 people how many live to 55, but I bet if you were 54 and found the answer you'd be worried too.

the "how long have I got" question, we will know on the day.

 

[honeybunny]

All I know is that I will live longer with my AVR than I would have without it. I'm blessed my severe aortic stenosis was diagnosed in time or I'd probably be dead in a year.

 

[epstns]

I'm still hanging onto my surgeon's opinion. . . "Barring other complications or morbidities, your life expectancy after successful valve replacement surgery will be the same as it would have been had you never needed the surgery."

In other words, for most of us, we aren't going to die from failure of our valves.

 

[JulienDu]

I'm still hanging onto my surgeon's opinion. . . "Barring other complications or morbidities, your life expectancy after successful valve replacement surgery will be the same as it would have been had you never needed the surgery."

My surgeon told me the same thing.

 

[dick0236]

When I had the surgery my surgeon told me "that valve has a design life of 50 years and life expectancy is 73 (in 1967)...and since you are 31 now, it should last your lifetime with a few years to spare". That valve has lasted well past my 1967 life expectancy as well as current life expectancy of +/- 79. As was posted earlier, and from what my docs now tell me, I will die someday,..from something...but it will not be from my valve failing.

 

[almost_hectic]

I could get hit by a bus tomorrow or live to be a hundred, nobody can ever know. All I do know is with AVR Im alive, without it I would likely be dead already.

My surgeon actually said I was lucky that I even made it to surgery. I didn't think they were allowed to make comments like that...

 

[Heart2.0]

My ACH dr told me the same thing- my average life expectancy. I am 55 with no co-morbidity . My 2013 AVR is an Edwards tissue and everyone says I will most assuredly
Have the TAVR in the future . But I will not count on anything, I also have an ascending stem replacement. My condition was such a stunning surprise and such
A rapid decline that I believe anyday above ground is remarkable. Though I still feel sad and tired a lot, I am focusing on today and quality. I learn a lot here.

 

[Elsie]

My brother received his mechanical aortic in 1993. I received my mechanical mitral in 1998. We're both still here. This article is very short on details.

 

[Nocturne]

Another bleak study that reveals about 50% odds for people under the age of 65 to make it to the 15 year mark after AVR:

http://circ.ahajournals.org/content/116/11_suppl/I-294.full

Note that this study also revealed no significant difference in mortality rates between AVR patients who received bio prosthetic vs mechanical valves.

 

[Paleowoman]

I have extracted some possibly significant quotes from this study. I honestly don't see how the causes of death could be correlated for sure with either mechanical or tissue valve replacement:

"Thirty-five patients in the cohort died from stroke." (Of course the stroke could be due to anti-coagulant therapy but it doesn't say that.)

"Other causes of death included myocardial infarction in 60 patients, other cardiovascular etiologies including heart failure in 79, cancer in 46, infective endocarditis in 9, pneumonia in 4, and other nonvalve-related causes in 83. There was no significant difference between prosthesis types with respect to the distribution of these causes of death."

 

[epstns]

Another bleak study that reveals about 50% odds for people under the age of 65 to make it to the 15 year mark after AVR:

Maybe so, but I also wonder what the odds are of the same people living an additional 15 years even absent AVR. I'm sure it is less than 100%, and only the difference in survival rate is really important to me.

IIRC, the current US data for average life expectancies indicates that the average individual aged 65 now can expect to live to be 82. To me, that might mean that half will and half won't. If you look at it this way, the life expectancy isn't much different between the AVR cohort and the average group.

 

[pellicle]

Hi

Another bleak study that reveals about 50% odds for people under the age of 65 to make it to the 15 year mark after AVR:

http://circ.ahajournals.org/content/...ppl/I-294.full

myself I'd say another crappy study with poorly designed analysis. For instance:

Conclusions— In our experience, selecting a tissue prosthesis at initial operation in younger adults does not negatively impact survival into the third decade of follow-up, despite the risk of reoperation.

right, so they're both still alive. What about "what are they doing" and what about if you met them would you go "oh , **** he's in bad shape"

and what about if you asked them "hey, you look like crap" and they said "well yeah, after my 3rd redo I had a botched operation and I'm on the list for a heart transplant ... "

Death is not the only issue

Critical analysis of the article is needed ... Something to think about:
Why so much science research is flawed – and what to do about it

Dodgy results are fuelling flawed policy decisions and undermining medical advances. They could even make us lose faith in science. New Scientist investigates
LISTENING to When I’m Sixty-Four by The Beatles can make you younger. This miraculous effect, dubbed “chronological rejuvenation”, was revealed in the journal Psychological Science in 2011. It wasn’t a hoax, but you’d be right to be suspicious. The aim was to show how easy it is to generate statistical evidence for pretty much anything, simply by picking and choosing methods and data in ways that researchers do every day.
The paper caused a stir among psychologists, and has become the most cited in the journal’s history. The following year, Nobel prizewinning psychologist Daniel Kahneman stoked the fire with an open email to social psychologists warning of a “train wreck” if they didn’t clean up their act. But things only came to a head last year with the publication of a paper in Science. It described a major effort to replicate 100 psychology experiments published in top journals. The success rate was little more than a third. People began to talk of a “crisis” in psychology.
In fact, the problem extends far beyond psychology – dubious results are alarmingly common in many fields of science. Worryingly, they seem to be especially shaky in areas that have a direct bearing on human well-being – the science underpinning everyday political, economic and healthcare decisions. No wonder the whistle-blowers are urgently trying to investigate why it’s happening, how big the problem is and what can be done to fix it.