My heart valve choice

[DanHill]

Hi everyone!

Hi everyone!

I appreciate all the responses to my post more than I can express. I wish I had known about this forum before I went in for my surgery, because then I might have felt that I didn't have to make the tough decisions alone. Well, not totally alone. My girlfriend and mom helped a lot. That's something I didn't expect- to have to make that kind of decision. When you find out that something is wrong with your heart, and can be corrected with a relatively routine procedure, you assume that everything will be taken care of for you- and you sure don't expect to have such an active choice in what type of operation the surgeons will perform. But have a choice you do, and the deck seems to be stacked so evenly with both pros and cons regarding each choice that the decision takes on the gravity of the 'Riddle of the Sphinx,' for crying out loud. Very unexpected, but I feel I'm a better, stronger person both mentally and physically for the ordeal. A quick question: I took a short walk today, and suddenly felt very dizzy, disoriented, and weak. I had double vision, my lips felt numb, and my arms felt heavy. I came inside right away and laid down. Anyone else experience something similar right after surgery? Is this due to poor circulation, decreased lung capacity, or something else? I'm scheduled to go back to the hospital tomorrow, so I'll tell them about it there too. Look forward to talking with everyone soon!

Sincerely,
Dan

 

[Ross]

Dan that little incident should be reported to your Doctor asap. It could be medications your on or it could be something else, but anytime you have such symptoms, pick up the phone and make the call. It could be nothing, it could be little mini strokes too. Too many little things it could be to guess!

 

[Tom F.]

I would like Heather Fisher to tell us why she feels that she will need another operation if she had a successful Ross Procedure, is that what your docs told you ? Most everything I have read about the Ross describes it as a one time event, with very few needing re-operations. What can you tell us?

 

[Nancy]

Dan-

Second Ross' motion that you call your doctor forthwith. Actually, I would have been much happier if you went to the ER, having someone else drive you.

It could be many things, including a TIA which is a small clot that travels through different areas and does no permanent harm, but can produce the kinds of symptoms you experienced. My husband has had many of them, a while back.

But it needs to be investigated. So call the doc.

 

[Granbonny]

Hi Dan

Hi Dan

I am the Mother-Hen on Vr..when Xmas is over..you will see my avator again..A big fat hen I have a son your age. born in 1969..For gosh sake, you have only been home from hospital for 6 days.. Stay off computer..rest and nap nap..little walks around inside of house.......double vision..I had one or 2 shortly after I came home...Meds, ect...You just had MAJOR surgery...Your body is trying to heal..Let it do it. The more you get up and try to do things like you did before..you will continue to go backwards.. Takes a good 6 weeks before your body even feels like normal..Then a few months..Slow down and let Mom take care of you...Son has a bad cold..and I'm on him everyday on phone. did you take your meds, ect. We Mom's never quit worrying. Don't care how old you are. Bonnie

 

[DanHill]

Lol- you're right, Granbonny. I might have been pushing it!

 

[Heather Fisher]

Hi Tom

Yes, the Ross is supposedly a very sucessful operation. If the pulmonary transplant works the chances are good that the aortic valve will be good for life. The pulmonary homograph I received has a higher chance of needing to be replaced but many have gone for 20-25 years. The Ross procedure is done mainly on children and adults younger than I am and I was not able to find a huge number of studies that included older adults. It is also a relatively new procedure with little in the way of long term studies over 20-25 years. While I hope that I will never need to have another operation, the simple fact exists that no valve choice is guaranteed to work for life. My surgeon warned me that a very real possibility existed that I would have to eventually have the pulmonary valve replaced.

 

[Ross]

Lol- you're right, Granbonny. I might have been pushing it!

Hey you better watch out for Granbonny. She's been known to track people down and force them to eat Possum Pie, that is, if the pickins was good that day.

 

[sylviayasgur]

h dan!
welcome to this site. as you can see we're already taking good care of you.
valve choice, as everyone mentioned, is a very personal one.
i don't believe that there are any guarantees either way. also, there is no wrong valve, all are life saving and do the trick.
please let us know what your doctor says about that little dizziness episode.
have a wonderful holiday and
feel well, sylvia

 

[johnbelloh]

valve choice

valve choice

Hi Daniel

I am a 60 year old runner who just had a redo sternotomy and my first AVR. My surgery was quite complex since I already had 5 coronary artery bypasses on my heart. My aortic valve was also bi-cuspid from birth. Two of my 10 year old bypass vein grafts had blocked one of them 95%. My aortic valve had been stenotic for many years but now it had also developed a significant leak. My local cardiologist wanted me to stay in the hospital after my heart cath and have a local surgeon fit me for a mechanical valve. I had been researching valve options and surgeons for the past few years. I decided to call Dr. Gosta Pettersson at the Cleveland Clinic since he had the skills and experience I was looking for.
We both agreed that my best choice of valve for my life style would be a homograft valve. He operated on 12/17/03. They released me from the hospital Christmas Day ( What a great Chrismas present !!! ). He also took the radial artery from my left arm and replaced 2 of my 5 bypasses. Before they released me from the hospital they took an after surgery echocardiogram of my heart. He had me smiling from ear to ear when he told me that the mean pressure gradient accross my new aortic valve was 5mm Hg. or to quote the doctor "that is as good as it gets!!" He wanted to know if I was going to run the Boston Marathon. I may just surprise him and try to qualify after I recover from the surgery. I know of no other valve solution either tissue of mechanical that had the hemodynamic properties of a natural human valve.

 

[ddarsch]

Stay strong - recovery is a process

Stay strong - recovery is a process

Dan:

It sounds like you are on your road to recovery. Just to let you know, I had my first MV replacement surgery on November 21st, 1991 in which I chose the porcine. I just had a second MV replacement on September 9th 2003 and had a porcine put in again. While I know there is a risk with each procedure, I have no regrets on my decision(s).

The decision as to the type of valve is a very important, yet very personal decision. I feel that whatever decision a person makes is the correct one for them - - - if it was an easy decision, it would not be hard to make.

Stay strong, and recover quick

 

[DanHill]

Thanks ddarsch

Thanks ddarsch

Thank you! I feel terrific. I'm very happy about my decision to get the porcine valve. Taking the coumadin was not for me, and I would regret it for the rest of my life, I'm sure. It's been over a month now since my operation, and I've finally gotten most of my strength back. I'm glad you're happy with your valve choice as well. Valve choice is very difficult - almost unfairly so. I hope they come up with an alternative to coumadin soon, so that people will have an easier time choosing the mechanical valve. Maybe be the time my valve needs replacing, this will be the case.

Sincerely,
Dan

 

[Granbonny]

Dan

Dan

I believe that most valvers who choose the Mechanical valve do so....to prevent ever having to have open-heart surgery again. Most are willing to take coumadin...compared to having another surgery. I am almost 2 years post-op. Coumadin is not a problem..Just remembering to take it everyday I am age 63 and not even thinking of another med to replace coumadin..Until 1 million coumadin patients have taken it for 5 years. Bonnie

 

[ddarsch]

Good news yesterday

Good news yesterday

Dan:

I am so so glad that you feel terrific, the worst is behind you, and you have the opportunity to look at life in a manner different than most people.

Just to let you know, I just had an echo yesterday, and they said that I had 0% leakage and my heart chambers have reduced back to normal. I wish the same for you

Regards, Dave

 

[ALCapshaw2]

DanHill wrote:

"Taking the coumadin was not for me, and I would regret it for the rest of my life, I'm sure."

Dan -

You've repeatedly stated that after researching COUMADIN you decided you did NOT want to take it for life.

Would you please share the results of your research with the rest of us? It would be useful to know your REASONS for disliking Coumadin.

'AL'

 

[DanHill]

Hi AlCapshaw2!

Hi AlCapshaw2!

Hi! I did a lot of research on both valves, as I've said, and my main reasons for not wanting to take Coumadin, culled from this research, are these:

1. I eat a lot of green veggies, especially spinach. I try to eat healthy, and eating greens is definitely a large part of that.

2. I take some supplements that would interfere with Coumadin, such as fish oil capsules. Also, I eat lots of garlic (I love Italian food.) I might have to limit my intake of these.

3. I'm active (lift weights, etc.), and would always worry about banging myself and bruising, etc.

There are other reasons why I didn't want Coumadin. Perhaps my fears were all unfounded, since I really didn't have a chance to talk with people who have a mechanical valve, like I do now. From what I researched myself, I just got an overall negative feeling about taking a medication that would affect me so drastically, and require lifestyle changes I didn't really want to make.

 

[Karlynn]

Dan, so glad you are feeling so great. Don't push yourself, no matter how good you feel, your body needs a lot of TLC to recover from such major surgery.

I'd like to have Al weigh in on your last post - for those of us who are on coumadin. In particular, I'd like his reaction to #1 and #2.
I was always told to eat consistantly, and that my coumadin would be adjusted accordingly. If you are eating foods consistantly (as in a life-style component) that are high in vit. K - is that something that you would recommend people stop? I love salad - so I eat it 3 - 4 times a week, and always have since being on Coumadin. I LOVE spinach - but it was never a regular part of my diet, so don't eat it now. I eat Italian food a lot and love garlic anything.

So what's the Wise One's opinion here?

 

[Raverlaw]

I, too, would like to hear Al Lodwick's take on this.

I eat a lot of spinach and greens, and take fish oil supplements. I was *planning* to continue on after surgery, and to just be consistent with these things, avoid excesses or omissions. I figured my Coumadin dose would be adjusted to fit my diet and lifestyle.

I don't think those things are incompatible with Coumadin; rather, your intake of them can affect your dose, so you merely need to be consistent. Personally, I will be glad to have a reason to have a little spinach every day.

 

[[email protected]]

coumadin

coumadin

My mother-in-law is about to have mvr, and we need to decide on valve type. She is 61, had a major heart attack at Thanksgiving and is now suffering from congestive heart failure, thus the need for valve replacement. I tend to the bio valves in my short research and limited personal knowledge. My concern is with the long term use of anticoagulants. It seems that eventually they will affect other organs -- liver, kidney, etc. -- but I cannot find any studies or discussions regarding these long term affects. (I've just started my research and found this site - thanks.) Do any of you have an answer or reference for me? Thanks in advance, and I will keep you all with my MIL in my prayers.

Mac

 

[Nancy]

Hi Mac-

I don't have much time to respond right now, but I wanted to say welcome.

My husband has been on Coumadin for 26 years, and for him it has been no big deal. Others might have different opinions, but that's the way it is for him. It also has not done anything to his other organs.

We have a member who is an expert on Coumadin and manages a Coumadin clinic. His name is Al Lodwick. He has a fantastic website all about Coumadin. Here's the link:

http://www.warfarinfo.com/