Actually my Montreal surgeon was more than happy to install a tissue valve, but I was 46 and
already freaked out beyond belief, so we agreed on a St. Jude mech.
Luckyguy17/Gil - 28 days post op status - life is good
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already freaked out beyond belief, so we agreed on a St. Jude mech.
Adrienne, you may be onto something for cardiologist and his thinking, or it may simply be that he has personally seen good results with mech valves and may have seen less good results with bio, we/they are human after all and it is likely that bio patients tend to be older and therefore may have more complications...
My surgeon had no real problem with bio, as long as i understood that risk of possible reduced longevity, likely less than mech, but also did agree that on a 10-15 year horizon, there was a possibility of further advances and possiblt more options with bio for less invasive intervention with bio.....but am 56 and therefore only a few years off the 60ish median for one way or the other. Not completely sure but believe I had read that by about 2005, there had been a gradual swing to mech 60%/ bio 40%, but also read what i thought might be statistics of the balance coming back towards a 50/50 split. So many factors and reasons possibly for that, are they doing more older patients and at an older age, or are the young and middle age also indicating greater preference for bio.
Have to wonder out loud, if in countries like Canada/UK, possibly Australia, Scandanavian and France, where mostly medicare, there is a stronger leaning to mech than the coutries where the patients pay?
Expect there is some fluidity, based on past year(s) of experience and new possibly better products, both mech and bio?
Bina, good to know on your 3 months post op echo , maybe settling of all the innards is required before getting a good assessment, like breaking in a new engine in the older days...it is just that i have time now for all of those tests and in 3 months, am likely back to normal rat race and having to make time...not so evident today...but if a must tehn will redirect priorities
My surgeon had no real problem with bio, as long as i understood that risk of possible reduced longevity, likely less than mech, but also did agree that on a 10-15 year horizon, there was a possibility of further advances and possiblt more options with bio for less invasive intervention with bio.....but am 56 and therefore only a few years off the 60ish median for one way or the other. Not completely sure but believe I had read that by about 2005, there had been a gradual swing to mech 60%/ bio 40%, but also read what i thought might be statistics of the balance coming back towards a 50/50 split. So many factors and reasons possibly for that, are they doing more older patients and at an older age, or are the young and middle age also indicating greater preference for bio.
Have to wonder out loud, if in countries like Canada/UK, possibly Australia, Scandanavian and France, where mostly medicare, there is a stronger leaning to mech than the coutries where the patients pay?
Expect there is some fluidity, based on past year(s) of experience and new possibly better products, both mech and bio?
Bina, good to know on your 3 months post op echo , maybe settling of all the innards is required before getting a good assessment, like breaking in a new engine in the older days...it is just that i have time now for all of those tests and in 3 months, am likely back to normal rat race and having to make time...not so evident today...but if a must tehn will redirect priorities
From my limited personal experience, it seems to be surgeon dependant. (but what do I know 
). For example, I talked to two guys who underwent AVR at the same Heart Institute as me and around the same time. We are all in the same age category and both guys had the same surgeon who recommended to both of them a mechanical valve. One guy didn't even know that tissue was an option.
I know of 2 other gals around the same age as me who had my surgeon and when they asked him, he suggested tissue (although all of us either had babies and/or pregnancy was not an issue). Maybe it is a gender thing? Just an observation...
). For example, I talked to two guys who underwent AVR at the same Heart Institute as me and around the same time. We are all in the same age category and both guys had the same surgeon who recommended to both of them a mechanical valve. One guy didn't even know that tissue was an option. I know of 2 other gals around the same age as me who had my surgeon and when they asked him, he suggested tissue (although all of us either had babies and/or pregnancy was not an issue). Maybe it is a gender thing? Just an observation...
Originally Posted by Adrienne
"Gil, I think that in Canada they don't like to put in tissue valves unless the patient is very old because it costs too much on our public system to do another OHS."
From my limited personal experience, it seems to be surgeon dependant. (but what do I know). For example, I talked to two guys who underwent AVR at the same Heart Institute as me and around the same time. We are all in the same age category and both guys had the same surgeon who recommended to both of them a mechanical valve. One guy didn't even know that tissue was an option.
I know of 2 other gals around the same age as me who had my surgeon and when they asked him, he suggested tissue (although all of us either had babies and/or pregnancy was not an issue). Maybe it is a gender thing? Just an observation...
"Gil, I think that in Canada they don't like to put in tissue valves unless the patient is very old because it costs too much on our public system to do another OHS."
From my limited personal experience, it seems to be surgeon dependant. (but what do I know
). For example, I talked to two guys who underwent AVR at the same Heart Institute as me and around the same time. We are all in the same age category and both guys had the same surgeon who recommended to both of them a mechanical valve. One guy didn't even know that tissue was an option. I know of 2 other gals around the same age as me who had my surgeon and when they asked him, he suggested tissue (although all of us either had babies and/or pregnancy was not an issue). Maybe it is a gender thing? Just an observation...
Gil, I had an echo done after, and I agree - they owe it to ya after all you've been through.
I've got a bunch of records now (angio results from before surgery, detailed play-by-play of the surgery itself - which is pretty cool and you should get yours if you can, and an echo report after the surgery). I think I had an echo (or 2?) while still in the hospital. But know for sure I had one when I went back to the hospital for complications. This "after" echo report I'm quoting numbers from below are from that one when I went back in for complications. Note, the detailed play-by-play of the surgery also mentions the following about an echo they did during the surgery. It's towards the end of the procedure, after they'd warmed my heart back up, I was in sinus rhythm and after the by-pass machine had been slowly stopped... "During this time, the transesophageal echo revealed normal ventricular fucntion, excellent function of the prosthesis and no perivalvular leakage". So even though no numbers are quoted in that report, they must have measured things... Anyway, here's a comparison of my "before and after" numbers. Note, I had a small valve installed (19 mm) for such a big guy (BSA=2.4), which had to do with the size of my aorta (guess I've got a small one - Bina - no comment!). So the improvement for me in Aortic Area is probably less than you'll see in your reports - I'd bet your post-surgery Area is probably 1.7 or so (vs. my 1.3) because you got a bigger valve (you lucky devil).
Again, the "before" numbers are from the angio they did about 5 wks prior to surgery. The "after" numbers are from the echo they did when I went back in for irregular heartbeat issues about 2 1/2 weeks after surgery. And this all assumes I'm interpreting these reports right, but I think I am.
Mean Aortic Gradient: 85 (before surgery); 31 (after surgery)
Aortic Area: .67 (before surgery); 1.3 (after surgery)
I've got a bunch of records now (angio results from before surgery, detailed play-by-play of the surgery itself - which is pretty cool and you should get yours if you can, and an echo report after the surgery). I think I had an echo (or 2?) while still in the hospital. But know for sure I had one when I went back to the hospital for complications. This "after" echo report I'm quoting numbers from below are from that one when I went back in for complications. Note, the detailed play-by-play of the surgery also mentions the following about an echo they did during the surgery. It's towards the end of the procedure, after they'd warmed my heart back up, I was in sinus rhythm and after the by-pass machine had been slowly stopped... "During this time, the transesophageal echo revealed normal ventricular fucntion, excellent function of the prosthesis and no perivalvular leakage". So even though no numbers are quoted in that report, they must have measured things... Anyway, here's a comparison of my "before and after" numbers. Note, I had a small valve installed (19 mm) for such a big guy (BSA=2.4), which had to do with the size of my aorta (guess I've got a small one - Bina - no comment!). So the improvement for me in Aortic Area is probably less than you'll see in your reports - I'd bet your post-surgery Area is probably 1.7 or so (vs. my 1.3) because you got a bigger valve (you lucky devil).
Again, the "before" numbers are from the angio they did about 5 wks prior to surgery. The "after" numbers are from the echo they did when I went back in for irregular heartbeat issues about 2 1/2 weeks after surgery. And this all assumes I'm interpreting these reports right, but I think I am.
Mean Aortic Gradient: 85 (before surgery); 31 (after surgery)
Aortic Area: .67 (before surgery); 1.3 (after surgery)
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Andy,
how the heck do you manage to write such long posts, with no typing errors/or few...have you got a secret spellcheck somewhere? wish i could that and by the way, the "esc" is that darn key that clobbers everything and only happens when you write a really long post and are about to submit...arghhhhhhh
Thanks, did finally get some copies of pre op echos today, so building up and broadening my knowledge in trying to read them
how the heck do you manage to write such long posts, with no typing errors/or few...have you got a secret spellcheck somewhere? wish i could that and by the way, the "esc" is that darn key that clobbers everything and only happens when you write a really long post and are about to submit...arghhhhhhh
Thanks, did finally get some copies of pre op echos today, so building up and broadening my knowledge in trying to read them
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30 days post op
30 days post op
Day 30 met Cardiologist today and it went rather well and I got more value add from meeting than i thought i would....so all good
Echo will be scheduled shorlty for next few weeks and stress test scheduled July 22nd, so I will get my new baseline numbers
Cardio confirms very fast recovery for me
No more murmur, it's gone.
Metropolol now being replaced by Bisoprolol to get pulse down, ok and good i think
Coumadin will become baby asprin soon, yeah but Coumadin was no big deal
Am healed in flesh and all looks good, bone looks strong, but another 30 days to be careful, just to be sure
Certified for weighlifting, his comment forget rehab join a gym and start bench press at half your weight, work it up and yes work on the flab
Take another month off work, keep stress down
In summary am healed or darn close
will post scar once last 3 drain holes pop scabs, likely next few days
Am a lucky one, good healing powers,process/kryptonite, only the shadow knows?
30 days post op
Day 30 met Cardiologist today and it went rather well and I got more value add from meeting than i thought i would....so all good
Echo will be scheduled shorlty for next few weeks and stress test scheduled July 22nd, so I will get my new baseline numbers
Cardio confirms very fast recovery for me
No more murmur, it's gone.
Metropolol now being replaced by Bisoprolol to get pulse down, ok and good i think
Coumadin will become baby asprin soon, yeah but Coumadin was no big deal
Am healed in flesh and all looks good, bone looks strong, but another 30 days to be careful, just to be sure
Certified for weighlifting, his comment forget rehab join a gym and start bench press at half your weight, work it up and yes work on the flab
Take another month off work, keep stress down
In summary am healed or darn close
will post scar once last 3 drain holes pop scabs, likely next few days
Am a lucky one, good healing powers,process/kryptonite, only the shadow knows?
