Longevity of Prosthetic Heart Valve

[mafaldas]

I am still reeling from a very disappointing yearly visit, during which I found my pulmonary valve (porcine) is failing. My replacement surgery was only three years ago, but the valve is apparently already calcifying. I can already be classified as having moderate stenosis. The news took me completely by surprise because I have been feeling amazingly well since my pulmonary valve replacement.

Although my cardiologist said that if I continue on the current trajectory a valve replacement is still two years away, it appears to me that a heart valve longevity of only five years is extraordinarily short. The cardiologist said this shorter duration is common with younger adults, like myself, who have more robust immune systems.

I am curious if others have also gone through this. Did your heart valve last only a handful of years? And if so, do you have any encouraging news about subsequent interventions/valve replacements?

I could use any encouragement you can throw my way, if only to know that I am not alone in experiencing what is likely to be early heart valve failure.

 

[pellicle]

I have heard this also (about early calcification in younger patients).

May I ask if you were advised about the likely hood of this outcome? Were you offered a mechanical prosthetic as well?

 

[epstns]

I'm not a doc, but I seem to remember that for some reason very few (if any) surgical centers use mechanical valves in the pulmonary position. The other member I know who has a prosthetic pulmonary valve also has a tissue valve there and has had to have it replaced once more already.

 

[pellicle]

I'm not a doc, but I seem to remember that for some reason very few (if any) surgical centers use mechanical valves in the pulmonary position..

Thanks Steve, from your semi question I expanded my knowledge

http://m.ejcts.oxfordjournals.org/content/30/1/33.full

 

[Jkm7]

My bovine valve in mitral position is five years and so far is doing fine.

I am very sorry to hear you are possibly facing an early re-op. You never know but that your valve could stabalize and not calcify more for some time. I certainly wish that for you.

 

[kfay]

I also have a tissue valve on the right side of my heart, although it's the tricuspid, not pulmonary. You'll find that the majority of people on this site have had either their aortic or mitral valve replaced and maybe don't fully understand that mechanical valves aren't usually recommended or offered to those of us who need a valve replaced on the right side of our heart. Usually, because the pressures are lower on the right side of the heart, a tissue valve will last longer than it will on the left, however, unfortunately, occasionally there are people like you who still quickly calcify a tissue valve even on the right side of the heart. Hopefully, your dr is wrong about the rate at which it is happening and you'll get more than a few more years out of it before it has to be changed, and if not, have you looked into the possibility of the Melody valve? It is a cath delivered valve for the pulmonary valve and I believe has been the longest of these types of valves in use and is used in young patients (as most people who need their pulmonary valve replaced have congenital heart disease that is caught very early). You don't say how old you are, but maybe you could have a Melody valve or two to save you from a few OHS? Worth having a discussion with your drs about.

 

[carolinemc]

kfay, You are right about the mechanical valve, I have only heard used for the aortic valve, which I have the St. Judes valve. But it is not the only kind out there now. There is a new one out there, I can't remember the name if it, but other people might know of other valve out there. And medical science is always inventing new things for us, to make us live longer, which is always helps. With the St. Judes valve, supposed to be a lifetime guarantee, but not always. But you do want something lasting longer than 5 years. Good luck in the search. Hugs for today.

 

[Bryan B]

I also have a tissue valve on the right side of my heart, although it's the tricuspid, not pulmonary. You'll find that the majority of people on this site have had either their aortic or mitral valve replaced and maybe don't fully understand that mechanical valves aren't usually recommended or offered to those of us who need a valve replaced on the right side of our heart. Usually, because the pressures are lower on the right side of the heart, a tissue valve will last longer than it will on the left, however, unfortunately, occasionally there are people like you who still quickly calcify a tissue valve even on the right side of the heart. Hopefully, your dr is wrong about the rate at which it is happening and you'll get more than a few more years out of it before it has to be changed, and if not, have you looked into the possibility of the Melody valve? It is a cath delivered valve for the pulmonary valve and I believe has been the longest of these types of valves in use and is used in young patients (as most people who need their pulmonary valve replaced have congenital heart disease that is caught very early). You don't say how old you are, but maybe you could have a Melody valve or two to save you from a few OHS? Worth having a discussion with your drs about.

kfay is right about the lower pressures. Also due to these lower pressures there is a lot bigger chance of clotting. I have a homograft pulmonary valve. It was explained to me that this is basically an open and shut valve allowing blood to flow from the right ventricle into the lungs. Since the pressures are low there is not much "washing" as the valve opens and shuts so it would be easy for blood to clot on / around a mechanical valve. I got my homograft valve as part of the Ross Procedure in March 2004 when I was 43. Due to an aortic aneurysm I had OHS again to repair my ascending aorta and have my aortic valve replaced. My surgeon said that my homograft pulmonary valve looked fine and did not replace it. The homograft valve was 7 years old at my 2nd surgery.

I would ask your cardio about the possibility of percutaneous replacement for your pulmonary valve. I don't know your history so I don't know if this is a congenital defect that may be more complicated. My surgeon said that not only did my pulmonary valve look fine, but if/when the time comes there shouldn't be any issues replacing percutaneously. The reason I put "if/when" is because he said that valve will last me an indefinite period of time.