Just to change the present topic. . . .
I'm also debating valve selection, while hoping my surgeon and I can agree on which path is best for me. At my most recent visit, Dr. Keith Allen (St. Luke's Medical Center, Kansas City) suggested TAVR. He's done a lot of them, but I'm "only" 67 and don't have stenosis--which, I understand, is almost a requirement for this.
I'm a short, thin male, so any trans-arterial valve may not fit. A CT scan will indicate yes/no. If yes, Allen reminded me I'll need a reoperation in 10-12 years, and I'm not excited about that. As it happens, Allen has pioneered a technique called bioprosthetic valve fracture, in which the ring of an existing TAVR valve is "cracked" to allow implantation of another TAVR valve within the broken ring of the defective bioprosthetic.
I'm very unsure about taking that direction, if indeed that's what Allen recommends. (And, who knows; he may not.) Due to the above, I'm leaning toward traditional open-heart surgery and a far more reliable mechanical valve, in spite of the rigors such a procedure will entail. "One-and-done," as they say. Allen will probably try to talk me out of it, but he'll need to have a really good argument, with references.
Anyone here familiar with "valve cracking"? Should I go ahead with the TAVR and assume that ten years of R&D will make any future procedure more predictable?