Medtronic Freestyle Root Bioprosthesis

[Wendel]

@Daniel758 It's good to read normal people who think normally, without any disturbances. I am absolutely sure that many of you here do not write to avoid problems with these people. Time is too precious to spend with fanatic people.

@dick0236 Even though they deleted my post, I still don't believe that your valve is 56 years old and you are 90 years old. Sorry, I don't believe it.

Currently, despite continued issues with durability (1), biological prosthetic valves are increasingly chosen over mechanical valves for surgical aortic valve replacement (SAVR) in adult patients of all ages, at least in Western countries. For younger patients, this choice means assuming the risks associated with a redo SAVR or valve-in-valve procedure.

Mechanical prosthetic valves (MPVs), for which oral direct Factor Xa inhibitors failed to be a valid option (2, 3), are not generally considered in patients above 65 years-old, even if a long-standing anticoagulant therapy is required and despite the fact that acceptable outcomes with a MPV may be achieved in selected elderly patients (4). To avoid imposing to a young patient a life-long anticoagulant therapy whenever a Ross procedure or an aortic valvular repair is out of reach, a BPV in aortic position is often perceived to be the best second choice. Thus, in Western countries and despite consensus recommendations (5–7), BPVs are nowadays implanted in a significant proportion of young and middle-aged patients requiring SAVR (8) therefore assuming the risks associated with a subsequent redo SAVR or with a valve-in-valve trans catheter aortic valve replacement (ViV-TAVR). Concerning TAVR, lowering the age-threshold and extending indications towards low-risk patients will further amplify this global move towards BPV with an exponential rise (9).

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10493300/

Regards...

 

[Timmay]

The fact is this …

There IS a medical recommendation for a longer life when replacing your aortic valve at a younger age. Period. It’s that simple.

Many young tissue valvers get their feelings hurt when this MEDICAL FACT is reiterated to young people.

Those same people only focus on the threads with the younger people. And therein lies the disconnect. Why? Because I have seen pellicle recommend tissue valves many times. He does so according to the medical guidelines combined with the individual’s circumstances.

It’s as simple as that. If you have a tissue valve and you got it implanted while you were young - ok. But you went AGAINST the medical guidelines for a longer life. Again - that’s just a fact. Even Adam’s site, Heart Valve Surgery, just admitted that fact in their latest video that they just released. Younger people have an edge in longevity when using a mechanical valve and if they choose to get a tissue valve then they’ll need a reop, on average, in 10 years.

Now with all of that said - everyone here with a replacement valve is living a longer life than if you kept your original, God-given bio valve. We’ve all been blessed with extended time here on this planet and that’s great.

 

[Timmay]

“a BPV in aortic position is often perceived to be the best second choice. Thus, in Western countries and despite consensus recommendations (5–7), BPVs are nowadays implanted in a significant proportion of young and middle-aged patients requiring SAVR (8) therefore assuming the risks associated with a subsequent redo SAVR”

No argument from me on any of this statement. Let me break it down …

“often perceived to be the best second choice”

Correct. A tissue valve is the best second choice. Key word - SECOND. It is not the best first choice.

“despite consensus recommendations”

The consensus recommendation for longer life is a mechanical valve.

“assuming the risks associated with a subsequent redo”

If you get a tissue valve you’ll need a reoperation Key word “need”. You will require a reop. Period. Yes, a Mech valve may need a reop later. But that’s a rare situation compared to the “need” of a reop for a tissue valve in younger patients.

If I had been 65yo when I needed my aortic valve replacement I would have EASILY chosen an Inspiris Resilia tissue valve without a second thought. But I wasn’t. I was 50.

 

[Daniel758]

“a BPV in aortic position is often perceived to be the best second choice. Thus, in Western countries and despite consensus recommendations (5–7), BPVs are nowadays implanted in a significant proportion of young and middle-aged patients requiring SAVR (8) therefore assuming the risks associated with a subsequent redo SAVR”

No argument from me on any of this statement. Let me break it down …

“often perceived to be the best second choice”

Correct. A tissue valve is the best second choice. Key word - SECOND. It is not the best first choice.

“despite consensus recommendations”

The consensus recommendation for longer life is a mechanical valve.

“assuming the risks associated with a subsequent redo”

If you get a tissue valve you’ll need a reoperation Key word “need”. You will require a reop. Period. Yes, a Mech valve may need a reop later. But that’s a rare situation compared to the “need” of a reop for a tissue valve in younger patients.

If I had been 65yo when I needed my aortic valve replacement I would have EASILY chosen an Inspiris Resilia tissue valve without a second thought. But I wasn’t. I was 50.

Again, Wendel asked for very simple and specific information about his specific valve AND he specifically mentioned he DID NOT want to debate Tissue vs Mechanical.

What exactly is it that you do not understand about Wendel's very simple request?

What is it about Wendel's request that made you, or anyone else, think he was looking to debate when Wendel specifically asked people not to turn his request into a debate?

And why was it necessary for Pellicle to jump in and start yet another bashing of a tissue valver over nothing but a simple request for information by Wendel about Wendel's valve?

Was Pelicle having a bad day and he needed a boost?

Was Pellicle popping up from under his bridge and scaring children not enough that day?

 

[Chuck C]

@dick0236 Even though they deleted my post, I still don't believe that your valve is 56 years old and you are 90 years old. Sorry, I don't believe it.

No matter how many times you repeat this misinformation, you can not make @dick0236 disappear. You seem disconnected from reality. Does the fact that Dick is a real person, who has lived a very long time with a mechanical valve, somehow interfere with a personal narrative that you have told yourself to the extent that you need him not to be real?

 

[Daniel758]

“a BPV in aortic position is often perceived to be the best second choice. Thus, in Western countries and despite consensus recommendations (5–7), BPVs are nowadays implanted in a significant proportion of young and middle-aged patients requiring SAVR (8) therefore assuming the risks associated with a subsequent redo SAVR”

No argument from me on any of this statement. Let me break it down …

“often perceived to be the best second choice”

Correct. A tissue valve is the best second choice. Key word - SECOND. It is not the best first choice.

“despite consensus recommendations”

The consensus recommendation for longer life is a mechanical valve.

“assuming the risks associated with a subsequent redo”

If you get a tissue valve you’ll need a reoperation Key word “need”. You will require a reop. Period. Yes, a Mech valve may need a reop later. But that’s a rare situation compared to the “need” of a reop for a tissue valve in younger patients.

If I had been 65yo when I needed my aortic valve replacement I would have EASILY chosen an Inspiris Resilia tissue valve without a second thought. But I wasn’t. I was 50.

One further point for the record to clear up any misconceptions or misunderstandings...

TISSUE VALVERS ARE FULLY AWARE THAT MECHANICAL VALVES LAST LONGER THAN TISSUE VALVES.

We get it, we really do.

So no need for charts, "expert" analysis of "proper" studies, etc., we're good.

Now can this forum allow tissue valvers be happy with their valve, their valve choice and their unencumbered life with their tissue valve?

And maybe discuss their issues and request information about their valves, like Wendel did, without being bombarded into oblivion?

 

[Daniel758]

No matter how many times you repeat this misinformation, you can not make @dick0236 disappear. You seem disconnected from reality. Does the fact that Dick is a real person, who has lived a very long time with a mechanical valve, somehow interfere with a personal narrative that you have told yourself to the extent that you need him not to be real?

Chuck, way to deflect away from Wendel's original simple post request and the unnecessary bombardment that followed, culminating in you now painting Wendel as "crazy" to fit YOUR narrative. Give it a break.

And Wendel, Dick0236 really is the real deal valve hero and an amazing person living with his prosthetic valve for 56 years. He really is an inspiration. He seems like a good and honest guy as well.

Also true is the fact that Dick being a real person has no bearing on the fact that Wendel asked a simple question and that question was twisted into an unnecessary attack.

 

[SatoriFound]

@dick0236


a Ross procedure or an aortic valvular repair is out of reach, a BPV in aortic position is often perceived to be the best second choice.

From what you posted: best SECOND choice. If you could do the first choice why wouldn't you? Ultimately this is YOUR choice though. I am only trying to make the best choice for myself and I don't want to choose the best second choice. I don't have any contraindications to anti-coagulant therapy, and I do NOT want a second open-heart surgery in 10-20 years. PERIOD. I will not rely on the maybe of TAVR or TAVI for a replacement when that time comes. Open-heart surgery is no joke and if I can have a really good chance of it being one and done, I will go with that option. FOR ME. You are making the best decision you can for YOURSELF and that is your right. The personal attacks are unnecessary on all sides.

 

[SatoriFound]

Chuck, way to deflect away from Wendel's original simple post request and the unnecessary bombardment that followed, culminating in you now painting Wendel as "crazy" to fit YOUR narrative. Give it a break.

And Wendel, Dick0236 really is the real deal valve hero and an amazing person living with his prosthetic valve for 56 years. He really is an inspiration. He seems like a good and honest guy as well.

Also true is the fact that Dick being a real person has no bearing on the fact that Wendel asked a simple question and that question was twisted into an unnecessary attack.

He's not replying to the original post, he's replying to a subsequent post. *shrug*

 

[dick0236]

@dick0236 Even though they deleted my post, I still don't believe that your valve is 56 years old and you are 90 years old. Sorry, I don't believe it.

Wendel, you joined this forum Dec. 28, 2023 asking for advice....and, seemingly disappeared in early January, 2024. Now you reappear after your surgery asking for testimonials from other very young people, with tissue valves. You are not likely to find many. You told us that you were 38. Most veterans of OHS, as well as most surgeons, would not suggest tissue valves in people that young.

As far as my history is concerned I don't care what you believe......it sounds like "sour grapes" to me.....because you will not even get close to my history before you need your next cardiac intervention. Actually, I am 88years, 8mos. old and my mechanical valve is 57years, 2mos. old

 

[dornole]

I somewhat hesitate to even try to be helpful to you, Wendell - it’s like trying to stanch the bleeding of a rattlesnake - but if you look for Duffey’s threads you will see one sometime in the past year with everyone congratulating her on her long lived tissue valve - 18 years I think? And some tissue valvers chiming in with their duration to date. If you actually want that info please check it out. I would also recommend folks voluntarily stop replying to this ridiculous thread. That’s my plan.