Hello,
I have not visited this site recently, but before I had my AVR, I did some research on this issue. I am an economist, so I deal with statistics and data all of the time.
I have read a lot of articles before I made my choice. So Let me summarise my view on this matter, especially since I needed a root replacement as well, all at the age of 34. In statistics there is something called sample selection bias. In plain language this means that a result is driven by the underlying population you are studying. That is, if your sample includes very sick people, then you cannot use the results to make conclusions for the life expectancy of people, who asides from AVR are healthy. Unfortunately this is something that even experienced statisticians can get wrong and therefore any data that you look at in terms of life expectancy has be interpreted with great caution.
Indeed, the whole debate about the Ross procudure is precisely about this. Lots of studies show that the Ross results in near normal life expectancy. But this could be because the patients chosen for this procedure have very strong underlying baseline health. It is only offered to people who have no other medical problems and whose hearts are in relatively good shape because of the strains that a double valve replacement puts on the patient. On the other hand, mechanical and tissue valves are offered to everyone. So the underlying populations of treated patients are different.
This issue has been explored by the following article:
http://circ.ahajournals.org/content/123/1/31.full.pdf
Note that once you compare Ross procedure patients to mechanical valve recipients, who baseline health is identical to the Ross group and whose INR is optimaly regulated, individuals in both groups have normal life expectancy. Indeed, individuals in the mechanical valve group are slightly less likely to die. Now Look at the authors of the article: Hans Sievers is one of the Worlds foremost Ross procedure surgeons. You can google him and see that over a 20 year period, his sub coronary approach yields excellent results in terms of re-operation and survival. Heinrich Koertke, on the other hand, is the Man who introduced INR home monitoring in Germany and also the world. When I interviewed surgeons around the world for my operation, I spoke to Dr. Sievers and he fully agreed with the conclusion of the article. He told me that he thought that the prothesis does not make a difference in terms of survival. So I suppose that this pretty good proof that, so long you are healthy otherwise, you can expect a normal life expectancy even after AVR.
Indeed, if you look at this paper
http://www.ncbi.nlm.nih.gov/pubmed/17888968
you can see normal life expectancy following the Bental procedure which is what I had. and the most senior co-author on that paper, Randal Griepp help developed the first heart transplant programs in the US.
So studies from some of the most reputable experts in the field suggest that AVR does not affect your life expectancy, so long your baseline health is fine.
Indeed, when I was discharged from the hospital, I could see that I was probably the only person in my discharge class that did not have significant other health problems.
And the data support this hypothesis. This is precisely why it is important to interpret all of these life expectancy numbers with respect to the sample population. After all, if you there 60 elephants and 20 mice in a study, you would not be able predict what happens to the mouse just based on the average, would you?
I hope that this helps clarify things.
