Medtronic mosaic lifespan

[havasu ed]

Hello folks. New to this group. First post. In 12-5-05 I had my mitrel valve replaced with the medtronic third gen Mosaic. I moved from Ca to havasu a couple years ago. When I left Ca the docs said I was good to go for probably 15 years. I began having shortness of breath about a year ago but the job I was at lost thier insurance. The economy and lack of work qualified me for Arizona Acchss. Found out my thyroid was way hyper and I was in A-fib. The first tought was the thyroid was the cause of the A-fib. Then they did an echo and noticed the leaflets on the mosaic were not opening as far as they should. There was very little regurg on the valve so at least thats good. The left upper is enlarging though. I go in for a TEE in a week so they can get a better look at the valve. So finaly I get to my point. How many of you folks have a mosaic and how is it doing. My new cardiologist said the mosaic has not been living up to medtronics projected time lines. Now my thyroid condition pulls calcium from the bones and puts it in the bloodstream for fuel. The mosaic is apperently sensitve to calcium this way. He (cardio) said he has heard of these mosaics failing in 7 to 8 years. Scaary. Let me know your thoughts folks.

Ed

 

[Luana]

Unfortunately, the life span that others get from a valve, may not be what you will get. It's impossible to say you will get x-amount of years. I don't know how old you are, but generally the younger you are, the shorter the valve will last.

 

[kfay]

Ed, Hi and Welcome! Unfortunately, there are others on here who have or are experiencing what you are with this particular valve. If you do a search, you will find a couple of threads on this subject. Some have also posted links to published reports regarding the early failure of this valve. Sorry you have to go through this earlier than expected.


Kim

 

[ALCapshaw2]

Ed, Hi and Welcome! Unfortunately, there are others on here who have or are experiencing what you are with this particular valve. If you do a search, you will find a couple of threads on this subject. Some have also posted links to published reports regarding the early failure of this valve. Sorry you have to go through this earlier than expected.


Kim

If you do a Search (titles only) on VR for keyword Medtronic you will find links to two threads dealing with Medtronic Failure rates. Scroll down to the lower left box and select "Any Date" to get the complete listing.

This patient had a failure after 5 years: http://www.valvereplacement.org/for...-Medtronic-mosaic-porcine&highlight=Medtronic

Here's another: http://www.valvereplacement.org/for...3-Medtronic-failure-rates&highlight=Medtronic

Member and prolific researcher, Tobagotwo, also had to replace his Medtronic Mosaic Tissue Valve after 5 years. (See "Community", then "Member's List", then click on "T" and scroll down to "tobagotwo" to view his personal profile. Click on "About me". You can find links to all of his threads and posts in the profile.

Untreated (straight from the Pig) Porcine Tissue Valves were notorious for a Short Lifetime (8 to 12 years), especially in younger patients. It's beginning to look like the "anticalcification" treatments aren't living up to expectations based on the number of "early failure reports" we are seeing.

'AL Capshaw'

 

[Lynlw]

If you do a Search (titles only) on VR for keyword Medtronic you will find links to two threads dealing with Medtronic Failure rates. Scroll down to the lower left box and select "Any Date" to get the complete listing.

This patient had a failure after 5 years: http://www.valvereplacement.org/for...-Medtronic-mosaic-porcine&highlight=Medtronic

Here's another: http://www.valvereplacement.org/for...3-Medtronic-failure-rates&highlight=Medtronic

Member and prolific researcher, Tobagotwo, also had to replace his Medtronic Mosaic Tissue Valve after 5 years. (See "Community", then "Member's List", then click on "T" and scroll down to "tobagotwo" to view his personal profile. Click on "About me". You can find links to all of his threads and posts in the profile.

Untreated (straight from the Pig) Porcine Tissue Valves were notorious for a Short Lifetime (8 to 12 years), especially in younger patients. It's beginning to look like the "anticalcification" treatments aren't living up to expectations based on the number of "early failure reports" we are seeing.

'AL Capshaw'

You can narrow the search even more by just searching for mosaic and not medtronic

 

[tobagotwo]

Just a note...

One well-publicized early calcification paper - the same one quoted in the Science Daily link in the first thread in Al's post above - (http://www.theheart.org/article/986119.do) generated a reply from Medtronic: (http://www.medtronic.com/mosaic/response/) which offers a very plausible response, including:

In reviewing the Lawton paper we found the data to be incomplete. With the benefit of our patient implant registry, we identified that Washington University physicians only implanted 2 of the valves referenced in this article. The other 2 patients were implanted at different hospitals, by different surgeons. Correcting for this, a total of 545 patients is likely the appropriate number to be used as a patient denominator. This reduces the occurrence rate of early explant to 0.7%. These data were not available to Dr. Lawton and her colleagues due to patient privacy issues.

There are also ten-year and 12-year progess studies available.
10-year study: http://ats.ctsnetjournals.org/cgi/content/full/71/5_suppl/S269
12-year study: http://www.shvd.org/documents/BERLIN ORALS/C035.pdf

These more general results (created without an end in mind) show the Mosaic to be on track with its peer valves to this point, with some rather positive notes regarding its use in the mitral position.

I did indeed only get five years from my Mosaic, and I believe it to have been the valve's fault. Part of me would love some vindication in that (and a little revenge, I guess). However, being one of those who gets the short end of the statistics, the "Friday afternoon valve," doesn't make it appropriate for me to ignore the larger picture in favor of my personal disappointment.

If I do see a failure pattern, if I can deduce a pattern, I will jump in wholeheartedly. I am watching what comes up. So far, I'm not satisfied that there has been anything other than well-intentioned, but hurried, ill-conceived scares, based on flawed or improperly isolated data.

While I don't agree that all failures are pannus or infection, as Medtronics seems to sputter every time things come up (surgeons know when it's pannus or infection), the fact is that the numbers do seem to keep rolling up into the proper and reasonable failure percentages for a third-generation valve.

Always interested to hear anything new about this. Would love to help tip the scales on this, if something more solid comes up. I have a great lawyer, and would love to add to my retirement fund, as long as it's justified.

Best wishes,

 

[havasu ed]

Thank you all. I had forgotten to mention I was 49 When all of this went down

 

[Todd]

Mr. Ed,
I am 7 years with my Mosaic in the Aorta position and we are just about out of time... 6 months ago I had an echo and at that time it was 0.6cm… 2 weeks later I went in for a cath and the numbers were 1.2cm !
6 months later this past week another echo, my number were the same at 0.6 cm... Hummm.
Anyway, calcification and narrowing have set in and I am in the process of planning for my next whenever that might be.
The Medtronic’s porcine has not lived up the life span that was projected, especially in the younger patients.
Good luck with your health...

 

[mitchner9g]

Hi Ed - I'm sorry to hear about you having difficulty with your mitral valve there. I hope it gets resolved soon.

I presently have 2 mosaics in me. One implanted in 2006 in my aortic position during my second surgery, and then the year following I received a Mosaic valved conduit for my pulmonary reoperation. I'm now 38.

Both valves are now failing, however it's unclear if it's the valves proper, or the environment around the valves. For my aortic, there's a significant paravalvar leak that was first noticed 2 years ago. The pulmonary valve and conduit is also failing, but here it seems like the conduit has somehow narrowed significantly along it's entire length as seen on CT scanning. There's a significant gradient measured on the right side, anyway, which they're having a hard time explaining as the surgical notes indicate that the conduit is dacron fabric (acron from what I understand does not shrink, but perhaps surrounding scar tissue is somehow a contributing factor in the narrowing).

I'm now scheduled for my fourth surgery in 3 weeks, which will be a complete reconstruction of both pulmonary and aortic outflow tracts, and if they end up having to implant new valves (likely), I'm very doubtful that a mosaic valve will be the first choice! You, me, and others here have had unfortunate luck with them for whatever reason and I can't see me giving a mosaic another chance. Now, that said, and it's been voiced on this forum before by Tobagotwo quite well, internet forums are not a good basis for extrapolation since the people who are just fine are not checking in here but rather are moving on with their lives. Chances are we're a small minority, though I will be very curious to read the long term follow up on this valve in younger people!

best of luck to you,
Adam

 

[ALCapshaw2]

Mr. Ed,
I am 7 years with my Mosaic in the Aorta position and we are just about out of time... 6 months ago I had an echo and at that time it was 0.6cm… 2 weeks later I went in for a cath and the numbers were 1.2cm !
6 months later this past week another echo, my number were the same at 0.6 cm... Hummm.
Anyway, calcification and narrowing have set in and I am in the process of planning for my next whenever that might be.
The Medtronic’s porcine has not lived up the life span that was projected, especially in the younger patients.
Good luck with your health...

Are you speaking of the Valve Cross Sectional Area (expressed in Square cm or cm^2)?
or some other (linear) measurement expressed in cm? If so, WHAT measurement are you referring to?

'AL Capshaw'

 

[Todd]

Al,
valve area cm^2.

 

[havasu ed]

Thank you all (Ya'll) for the replies and positive input. Todd and mitchner best of luck to you. Seems the enemy is calcium in the blood. I am hyperthyroid which pulls calcium from the bones so your body can use it as fuel. However,, talked to another valver here in havasu (he's 42 with mitrel replacment) with a mosaic. He said when he was in A-fib after a check up his valve showed improper flow on an echo. After shocking they gave him a good to go. He didn't know when he went into A-fib and said He felt fine. So my question is could the A-fib make the valve look like it was getting stiff?? despite the reason for the A-fib?? Just reaching for some sence and answers. Oh, plus my BP been running 140/100 for the last month and a half. The Bystolic doesn't seem to help much. Blaming that on the Thyroid.

THanks
ED

 

[Kathy McCain]

My Medtronic was implanted in Feb 2008. My last echo was six months ago. At that time there was nothing unusual, or abnormal. I consulted with my cardio yesterday, and told him I belonged to a heart valve surgery forum. I explained to him about some of the early failure rates on the forum. I asked him point blank, have there been reported problems with this valve? His reply was the people that he has seen usuallly are older people, with diabetes or other serious ailments. He does not seem to be concerned about this particular valve.

 

[ALCapshaw2]

Ed,

Have you considered getting yet another opinion?
If so, I would recommend consulting with a Surgeon who has considerable experience with Re-Do's.
It would be even better if he has/had experience implanting the Medtronic Mosaic Valve, especially if some of his patients have had similar rapid deterioration. You don't want to end up selecting a surgeon from a gurney in an ER somewhere!
As the Boy Scout Motto suggests: "Be Prepared".

In case you don't already know, many Cardiologists and Surgeons use 0.8 cm^2 AV Area as their trigger for recommending Aortic Valve Replacement.

'AL Capshaw'

 

[Lily]

...This patient had a failure after 5 years: http://www.valvereplacement.org/for...-Medtronic-mosaic-porcine&highlight=Medtronic...

AL and anyone else interested - I hope I'm saying this correctly: I don't think hers [above] turned out to actually be a Mosaic valve failure.

-------------------------------------

Hello folks. New to this group. First post... So finaly I get to my point. How many of you folks have a mosaic and how is it doing...

Hi Ed - I have one too, in the aortic position. It's seven years old next month. I was 42 when I got it.

My gradients are getting higher as my valve opening gets smaller; and the valve is referred to on my echo report as "abnormal" because of the valve opening size, which has been measured between 1 and 1.13 for the past three years.

I recently saw my cardio for my annual and asked him point blank how my valve is doing, he said it was working very well.

He also volunteered to me, when I asked him how much longer this valve could work for me, that I could get ten or even twenty years out of it but that we just couldn't tell now. I was shocked. And very relieved (because I had feared the worst, as the echo report described the replaced valve as "abnormal").

I am having some other issues, hopefully just more PVCs, and am still awaiting Holter monitor results.

Edited also to add: Several years ago I was diagnosed as hypothyroid. My doctor keeps me on the sluggish end of normal (with thyroid supplement) and his reasoning is to keep the possible calcium leaching at a minimum and also to keep my heart from beating excessively.

 

[Philip B]

Tissue?

Tissue?

It'd be easy to launch into a rant about the longevity of tissue valves here, but that would serve little positive purpose. Hopefully, the time you've had with the tissue valve has enhanced the quality of your life. The reality is that we never really know how much time we'll get with replacement equipment regardless of whether it's tissue or mechanical. Sure doctors can give us estimates based upon the best research data they have available, but a failure is a failure and it's upsetting. No one here wants to see anyone have to face a re-op.

If replacement is looming in the future, remember, there's no such thing as a bad choice it it prolongs your life.

-Philip

 

[havasu ed]

Mr Capshaw. would love a 2nd but my company lost the insurance due to the economy. Have State sponsored insurance so a 2nd is not covered. Going to Ca. for my brothers B-day hoping to talk to my surgeon while there. Thanks
Lily , Thank you. More looking around it seems some of these valves tighten up a little then just stay way for some time. That little thyroid is one nasty little gland when it wants to be.Go in for the uptake test soon. Then they can get the heart rate down see if the A-fib stops then see what the velve is doing.
Phillip. Thank you as well. We could bang these valves around all day. The thing that seems to be forgotten is we ARE heart patients. Is it fair or an oversell to tell you if you have a tissue valve your life will be perfectly normal for X amount of years? I had several years when I forgot that i had my chest cut open till I took a shower and looked in the mirror. But at what price? We are STILL heart patients. I had mine done at 49. The choice for the tissue was based on the fact I had a lung surgery following recovery. The worry was blood thinners (lack of actually) during the lung surgery. The freedom of blood thinners and no lifestyle cahnges were the sell. The sell that you have no worries for X amount of years. Boy when they miss the mark it's at a big price. I haven't hit the sloops since then (to pricy now) and haven't been of a diving board hardly either, but I have been on the bike a bunch. The good thing is we are here yakking about this and thats a lot better than the alternative.

Ed
PS Don't forget about Eddie having a redo tommorow. We'll see him on the other side