mechanical vs homograft(human) valve

[HFK]

Has anyone ever thought about a human valve vs mechanical , as a nurse I did extensive research on the different types of valves and one huge difference in mech vs human was you never have to take coumadin you take nothing, it also has a less than 1% infection rate compatred to the mechanical and you hear no cliking! ttThe one negative is it lasts about 15 to 25 years so if your 40 you may need another operation at 65 or so , BUT no INRS ect. You need a skilled surgeon who knows how to do the proper procedure. I found out like I am sure all of you did they will not guarentee any valve, they can only state how long most of them MIGHT last but every body is different I know some people with mechanical valves that had to be replaced 3or4 times from infection, clotting etc. with this food for thought would this have made any difference in your decion if you had one or knowing this now would it make a difference. Just thought I would ask .hfk

 

[Nancy]

Hi HFK-

That is the biggest question that most people ask, and it is the most debated question. Here is a link that is an exhaustive thread on the subject.

http://valvereplacement.com/forums/showthread.php?s=&threadid=304&highlight=Making+the+choice


There are also a large number of older threads on the subject. This is the way to access the older threads.

Go to the Forum Pre-Surgery,Go to the bottom of the page, see where it says "Showing threads---" , click on the part that says "last 30 days", a drop down menu will appear, then click on "the beginning" you'll then see all the posts from the beginning of the new and improved Valvereplacement.com.

You'll have all the reading you want for a while. Happy reading. When you're done we have a test on the subject that we administer. You better get an "A".

 

[LUVMyBirman]

Most tissue valves last 10-15 on average. That was enough to come to terms with the Coumadin.

All the best to you.

 

[Marty]

? Mitral homograft

? Mitral homograft

Just a little reminder for you fellow mitrals out there. Homografts have been tried mostly in France or India as I remember and have never attained acceptable reliability.

 

[Bill Hall]

Thanks for the information. I have a homograft (Aortic) and Mitral repair and am always looking for new information. When I had the surgery (2001), I went to a big hospital (Clev) and asked and took their recommendation. In retrospect, the coumadin is not a big deal, nor the ticking, nor the blood taking. On the other hand, the surgery was bearable and recovery was pretty quick. I could do it again. So, I am still undecided which was the best alternative. There seems to be some risk both ways. Fifteen to 25 years would make me 62-72 for another surgery.

 

[Bob Bates]

Bill, I am faced with the big question ; tissue or mechanical for my upcoming AVR on Nov. 3, 2003. I am 58 and leaning towards a tissue to avoid coumadin, and risk the 2nd operation down the road. Given your comments and perspective at this point, would you still have gone with the mechanical if you could do it over, knowing what you know now?

I know everyone's situation is different, so your experiences may not apply to me, but I would be very interested in your answer.

Thanks very much.

Regards,

Bob B.

 

[bvdr]

Bob,

While you are factoring things in, do a search on this site for "Exanta". Someday it, or something like it may make warfarin therapy as we know it today a thing of the past.

 

[Granbonny]

Bob

Bob

I was age 61 when I had my VR..Mechanical.. I am blessed with a hubby of 37 years and 2 children in their early 30's..They were here for me for a year. and yes, it does take a year to feel normal again...Hubby cooked, cleaned, drove, all housework and baby me..Children called everyday..and still will...BUT, never. in 15 years down the road..would I want them to take their time off. to take care of me. They would be older and have their own life. Things to ponder? Is your wife your age? Remember she will be older too. Will you want her to sit outside in waiting room for hours..waiting to hear if you are O.K.? Will she feel like taking care of you for weeks and months while you get back on your feet? I am now 18 months post-op..Doing great...but still some days..Get tired..and hubby will still take over cooking, ect. And remember. there will be MANY doctor visits..post-op.. will you have someone then to drive you to all appointments. (15 years from now).. and they do happen every 3-6 months. I have 3 next week..plus jury duty My 3 are Cardiologist, PCP..and a bone scan (just for women ) All 1 hour away. Coumadin is no big deal...fell last week..no bruises. Never bleed.....but as I have always said..any valve you choose will be a good one. Gave me my life back. I only had 3 days from when they found my aneurysm to surgery. I was a ticking time bomb Bonnie

 

[HFK]

Hi Bill , I have ahomopgraft tissue valve and love it am not on any meds, its great.It could last 15-25years.

 

[Bill Hall]

Bob - Just noticed your question of a week ago. I would probably still go with the homograft, especially with the prospects of possible 25 years before resurgery. I don't have a really great reason, as you noted from my previous post.

HFK - Sorry I didn't reply to your e-mail (from a month ago), didn't notice it until last night.

 

[MikeB]

My initial decision for my valve replacement was the tissue valve, because I did not want to deal with coumadin and getting blood tests. Due to my body size there was not a gaurantee that I could receive the tissue valve. After surgery I found that the doctor had to implant the mechanical due to the size of my valve. I was actually glad, because I would not want to go thru the surgery again unless I had to. Coumadin and blood tests are not that bad afterall, it is just part of your routine.

 

[Bob Bates]

Mike-thanks for your comments. It seems for every person who has chosen a tissue valve, there is someone like you who is adamant that they would not want to go through the second surgery, and glad they chose the mechanical valve.

This is all good information, but I must admit it is making my decision about a tissue versus mechanical just that much harder (for my AVR on 11/3/03).

But tht's why I am on the site; to gather as many opinions as possible.

Regards,

Bob B.

 

[Joe Parker]

Hey Bob B.
I am new to this site and will have my AVR in January or 2004. I have wrestled with the decision of to go mechanical or not. Looking at everything such as surgery down the road, I am leaning back towards a mechanical valve but not yet fully decided. I am 40 years old very active and really don't want to risk a redo when I am 55 or so (estimated) when I am suposed to be retiring and traveling with my wife. I understand the risks really arent' that much more while being on coumadin but the risks are higher having a second or third surgery. Who knows in time they may have a mechanical valve alternative that will get rid of coumadin or an alternative medication that is better to take.
Joe Parker
[email protected]

 

[Bob Bates]

Joe;

The age at which you have the initial valve surgery is one of the major factors involved in the decision in my opinion.

At my age of 58, I would not expect to have a third valve replacement, and would not want to under any circumstances. But at 40 , yes that would be a distinct possibility.
So that would make the mechanical vs. tissue choice that much harder.

I would probably still opt for the tissue for the first valve, for the same reasons I want it now;but then go for the mechanical the second time. But that's me. Its been said dozens of times on this site; the valve choice is a very indivualized decision.

Regards,

Bob

 

[Joe Parker]

Bob B.
Your are definately correct that valve choice is individualized. That it what makes it the more difficult and why I am glad to have found this board and listen to everyone who has been through this. I was thinking along the same line, tissue first then a mechanical on the redo or a newer improved model of the time, I am just not so sure I want to go through another surgery.
Joe Parker
[email protected]

 

[Bob Bates]

Joe;

Yeah, that second surgery is one big elephant just siting out there. Its an especially hard choice because we haven't even gone through the first surgery yet (I am due 11/3/03)! I may wake up from that and kick myself for my decision.

But on the other side of the coin, you are facing a lifetime of coumadin . For most people, coumadin seems to be very manageble. For me and my lifestyle, I don't want to worry about going backpacking for a week , 30 miles from the nearest road (as I used to do and want to do again), and having a bleeding event. Or not being able to travel to certain places with my wife in our retirement due to concerns about testing, diet, poor medical facilities, and counterindications with other drugs.

Good luck.

Bob Bates

 

[Joe Parker]

Bob B.
More questions to ponder. I did find out recently that my Father (parents divorced when a baby ) had his aortic valve replaced in 1995 and is doing fine. He had a pig valve put in at the naval hospital in San Diego, CA.
From what I understand, unless you fall off a building or something the bleeding events aren't really anything to worry about. We are planning to back pack next year and I do bicycle and plan to do that again. I also hunt and fish and stuff but none of those extreme sports.
Have you heard if the activity level (the more physical you are) you do accelerates the deterioration of a tissue valve?
MY real big issue with the Coumadin is that I like to eat greens and spinach and brussel sprouts and fish. I think I was a southern boy put in the wrong place (California, home of the Latte', yuck).
I would like to keep up with you as you recover from your surgery.
God Bless
Joe Parker
[email protected]

 

[Bob Bates]

Joe;

Regarding your concern about greens and coumadin: my understanding is that its not that you can't eat these foods, you just have to be relatively consistent in the amount you eat. Apparently ,these food effect the level of the drug in your system, and to maintain a certain measure of coumadin you have to keep the things that can affect that level constant.

Yes instances of excessive bleeding are probably rare. But out in the middle of nowhere, if in did happen, you would be in big trouble. I don't want to ave to worry about it, or let it inhibit me from doing the things I want to do. By that's me.

Also, yes I have read somewhere that higher levels of activity can accelerate the calcification process on a tissue valve, especially in younger fokls.

Regards,

Bob

 

[Ross]

As a side note for you guys...I keep spinach, brussel sprouts, asparagus, and salad handy all the time. If I test high on INR, I indulge in some greenies for a day or two. You should maintain a consistent amount of Vit K each day, but if your anything like me, it's next to impossible.

 

[Joe Parker]

Hey Bob
Thanks for putting me in a category of "you younger folks"
Joe Parker
[email protected]