mitral valve repair vs replacement

[Polcat]

New to site, getting a ''valve job'' in May. Looking at TEE the doc says he can fix the valve rather than replace it. I know there are alot of factors and he won't know untill he gets in there and actually sees the valve to be sure. Just curious how long the repair will last and will it need to be changed out at a later date. How many of you have had a valve repair and than later need a valve replacement. I know there are a lot of factors but is a repaired valve as good as a replaced valve. I know getting off blood thinners is a big plus.They said mechanical valves would origionally last 10 to 12 years but now I'm hearing that they actually last longer. What is the estimate for repaired valves, is it as a general longer or shorter than a mechanical valve. Thanks Gordie

 

[Nancy]

Mechanical valve last a very, very long time, unless there is a structural defect, which is very rare, or unless you get endocarditis or throw a bloodclot. My husband has one that's been in place for 26 years and still clicking along. I don't know whoever told you 10-12 years, but they were wrong.

 

[Karlynn]

My guess is that they were referring to tissue valves not mechanical valves. Many doctors will tell you that they hope to repair the valve and then when they get in, end up replacing it. So make sure you let the surgeon know your choice of valve before you have the surgery.

There is lots of information on this site about tissue and mechanical valves. Both have drawbacks, the main one for tissue is repeat surgeries and needing to take Coumadin for the mechanical.

There are many many people here, living great lives with both types of valves, so it's a very personal choice, based on your lifestyle and age.

Welcome to our group.

 

[Bill Hall]

Gordie - Welcome to the site. I have a mitral valve repair and homograft aortic replacement. I don't know how long they will last, but I expect to have a resurgery some day. I was age 47 in 2001 when I had the surgery. My decision was based on the recommendation of Cleveland Clinic Dr Grimm, who did my second opinion. He said that I was better off keeping my own valves versus the mechanical. Anyway, good luck with your decision.

 

[RCB]

Read the valve section

Read the valve section

Gordie, Welcome to the site. I had valve surgery over 43 years ago and have been researching the topic over the last severals months. The valve section has some great post over there- I think the best on the net. Take some time to read them and you will find it very rewarding. Good luck!

 

[Marge]

Gordie, I want to wish you good luck no matter what procedure you end up having, and welcome to the site! I found this site shortly before I had my mitral valve surgery and I count it as a blessing, I learned so much and got so much reassurance, it made the whole experience so much easier to deal with.

I had a mitral valve repair two months ago. I'm very glad that my surgeon was able to do a repair rather than a replacement.

When I was doing my research during the weeks after I learned that my valve was leaking, one thing that popped up in just about everything I read was that if it is possible to do a repair, it is much better than doing a replacement (whether with a tissue OR a mechanical valve). It's not just the coumadin thing.

Here are some of the advantages that I have seen cited for mitral valve repair:

Lower mortality at the time of operation.

Significantly lower risk of stroke, and a lower rate of infection.

Improved long-term survival. Patients who receive a valve repair stay on the same survival curve as the normal population.

Mitral valve repairs are said to be very durable and there are studies have shown that 95 percent of patients will have a perfectly working valve 20 years after mitral valve repair surgery.

 

[M&M]

Question about the 'area' of repair

Question about the 'area' of repair

HI Everyone, I hear so much about mitral valve 'repairs' - but not to much mentioned about the actual area that was damaged to begin with.

My leaflets are normal - but my 'base' and chordae are not. So I wonder if this makes a less chance for a good repair. As I dont' have a 'true' valve problem but more or a under the valve and base problem - caused by a scar from my heart attack. So its dead tissue - which doesn't sound like you can really repair that.. Has anyone had a repair in this area of the mitral valve?

Thanks
Runner

 

[Christina L]

It really just does depend on what the surgeon finds when he gets in there, but usually a surgeon can tell 95% before the surgery from a TEE if he can repair the valve or not. Dr. Cosgrove was positive that he could repair my valve and he did.

I am so thankful also that my valve was repaired. My cardiologist told me he thinks my repair will last my "lifetime" whatever that means. I am just trying to learn to live one day at a time and enjoy the moment - because our future is not guaranteed - heart-wise or otherwise. My mother died of breast cancer at 64, so I also have that fear hanging over my head.

Runner, it sounds as if your valve could easily be repaired but I am not a heart surgeon. I know they can repair chordae and they put that ring around the orifice - which sounds like it would help you - especially since your leaflets are normal.

Christina L.

 

[Sherry]

Hello, Gordie,
Welcome to our cool site. I was scheduled for a mitral valve repair almost seven years ago; My surgeon, one of the finest cardiac surgeons in Indianapolis, felt confident he could repair it based on the TEE. He actually did attempt the repair but ended up having to replace it at the last minute because of continued leaks. I didn't have a choice of valves; he chose the most durable one for me: the St. Judes. My sister-in-law, an RN at that hospital who sat in on the surgery, said my old valve looked like "cauliflower" and that most of the chordae were broken loose. She felt very secure that the mechanical was ultimately the right choice for me. I totally agree with Karlynn, however, make sure that you communicate your preference with your doctor beforehand. Please keep us informed as to your progress.

 

[dawnwit15]

Welcome

Welcome

Gordie-welcome to the site. This place really helped me prior to my surgery this past January. I was scheduled for a mitral valve replacement but once the surgeon opened my chest he decided to do a repair instead. His reasoning was that the valve I chose was a tissue valve (because I did not want to be on coumadin while trying to get pregnant). I had just gotten married and we did not get to have kids yet. His belief was that a tissue valve would last about 10-15 yrs thereafter I would need another surgery to have a mechanical valve put in. He believes the repair he did can last at least 10-15 yrs and maybe I won't have to return at all for another surgery. My surgeon advised the amount of physical strain you put yourself under can effect the successfulness of the repair. I am very active and like to exercise and run everyday. I don't know for sure how long the repair will last but I have my fingers crossed. My surgeon told me I will not have any problems with a pregnancy now that it is repaired.
Runner-I had the mitral valve repair because of rhuematic heart disease which caused alot of scar tissue. The scar tissue caused mitral stenosis which is why I went into congestive heart failure. So, yes a repair can be done on scar tissue. Your surgeon will be able to make that judgement based on your individual circumstance.
Best of luck to you both.
Stick with this site you will learn alot & will learn how to cope with your heart disease.
Dawnwit15

 

[weekycat]

My card said the same thing...

My card said the same thing...

It really just does depend on what the surgeon finds when he gets in there, but usually a surgeon can tell 95% before the surgery from a TEE if he can repair the valve or not. Dr. Cosgrove was positive that he could repair my valve and he did.

I am so thankful also that my valve was repaired. My cardiologist told me he thinks my repair will last my "lifetime" whatever that means. I am just trying to learn to live one day at a time and enjoy the moment - because our future is not guaranteed - heart-wise or otherwise. My mother died of breast cancer at 64, so I also have that fear hanging over my head.

Runner, it sounds as if your valve could easily be repaired but I am not a heart surgeon. I know they can repair chordae and they put that ring around the orifice - which sounds like it would help you - especially since your leaflets are normal.

Christina L.

I was also told that my repair (5/30/02) would last me a lifetime. I'm not sure what that means either, but I was very glad I could keep my own valve.
However, I also have Breast Cancer issues to worry about. My sister died of BC almost a year ago at age 43.

As far as my mitral valve goes, both leaflets were badly in need of repair, and I had two ruptured chordae tendenae. My surgeon also used an annuloplasty ring to repair the valve.

Because of the ring, I was on Coumadin for a short time, I believe it was about 2 months. I'm very thankful NOT to have to be on it forever, even though many people here are on it for life, and seem to manage just fine with it for the most part.

 

[SHerrin Hutt]

Valve

Valve

Wecolme,
I am one of thoses that had a Crovgove ring put in 5/99 and was told it would last 10 yrs. But I have never did anything they have said was normal.So 2 yrs. later I started having trouble breathing and walking & passing out alot. I had a stoke in 1/02 aand my replacement in 3/02. And having been doing great! Don't let my experience scare you. I have always had the hard road to follow. But with the grace of GOD I have made through and till ticking. The second surgery was a breeze compared to the first one. Good luck and my prayers will be with you.

 

[KathyH]

Hi, My surgeon thought he could do a repair on my aortic valve. He told me if he couldn't fix it to last my whole life he wouldn't fix it. I ended up with a ST Jude mechanical at age 49. I wouldn't want to go thru this surgery again, so it was the right choice for me. Everyone is different, so check out the threads and decide what is best for you.
Kathy

 

[Bob]

Repair or replace

Repair or replace

I had this choice and went for the repair based on the premise that my own tissue is better than a pigs or mechanical. My chordae was shot on two leafs but the base was OK. That was 16 months ago and all is well. I am 68 and expect to live a long time.

 

[BillCobit]

Hi Gordy -

Just one thing to add to good advice/info you are getting from others. Valve repair requires more skill than replacement, so your chances increase w/ the skill and experience of your surgeon. I had local surgeons tell me that my valve was likely to be unrepairable. An artificial valve wasn't attractive to me because of my relative "youth" and lifestyle, so I decided to go to the Cleveland Clinic, where I managed to get a successful repair.

I'm only two years out from surgery, but doing well and enjoying a very active life.

Good luck to you!

 

[Polcat]

Less than a month away, going in for some tests on May 15th and surgery on th 26th. I'm am going to U of M, in Michigan. They do 6 to 8 a week and over 350 valve jobs a year. Eleven week wait to get surgery performed. Found out I had a heart murmur at 40 ( had since birth ) mitral valve leaking at 44,and now leaking more and heart starting to enlarge at 48. Guess its time to get it fixed while my heart and myself are realitivly healthy. Not looking forward to it but know it needs to be done and get more nervous day by day. This is going to be the longest month ever! Gordie

 

[fdegranville]

Welcome Gordie

Welcome Gordie

HI Gordie and welcome to vr.com,

You have found the best place for support and information. It is very natural for you to be stressed out. But the waiting is the worst part. After you've read some of the posts you will see that the members here are the most strong-minded and now strong-hearted group of people on the net. Everyone also has a great sense of humor which always helps when you are facing serious issues such as these.

Again welcome, and others will be along to greet you soon I'm sure. Ross (the moderator) may move this post and start a new thread to make sure everyone sees it.
You are among those that have climbed the same mountain! So ask as many questions as you like. I'm sure you have a few.
fdeg

 

[SJJ]

Gordie,
Don't know how I missed your posting before but I did want to join the others in welcoming you to the site. If you could use some knowledgable, compassionate, supportive and fun folks in your life just about now, you've definitely come to the right place. If you haven't already, do some serious browsing of past posts in the pre surgery and post surgery forums. You'll find lots of useful information that will help you prepare for the big event both emotionally and practically. Of course, you've got a lot of brains available to pick in this group as well,l so have at it if you have any specific questions or concerns......I can almost promise you that someone will have a helpful response.
Sue

 

[Marty]

Repair is always best if they can do a good one i.e. have something to work with. While I was still in the recovery room shortly after they took the tube out my surgeon stopped by. I said "what did you do?" He said my valve was so beat up that if he attempted a repair he could guarantee I would be back on his table inside of two years.Im happy with my St. Jude mechanical and would not look forward to more surgery at my age (78). The Coumadin is no problem for me because I self test and self dose using the Coaguchek.If I was 35 or 40 years old at surgery and they couldn't do a repair it would be a tougher choice and I might then go with a tissue valve.