New valve procedure!?? Could it be possible?

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This procedure called TAVR has been around for a number of years and is used, primarily, in elderly or frail patients who cannot tolerate OHS. It is one of the newer solutions for failing heart valve issues. There are many new procedures in the "pipeline" and hopefully some will make it to the market. Choosing a current valve and/or procedure is kinda like buying a "cell phone".......regardless of what you buy today, it will be obsolete by next week. In my case I still have one of the ancient valves.......and a "flip phone"......and both still work fine. Do your homework, make your decision and "git 'er dun" and let the future take its course.
 
dick0236;n879992 said:
This procedure called TAVR has been around for a number of years and is used, primarily, in elderly or frail patients who cannot tolerate OHS. It is one of the newer solutions for failing heart valve issues. There are many new procedures in the "pipeline" and hopefully some will make it to the market. Choosing a current valve and/or procedure is kinda like buying a "cell phone".......regardless of what you buy today, it will be obsolete by next week. In my case I still have one of the ancient valves.......and a "flip phone"......and both still work fine. Do your homework, make your decision and "git 'er dun" and let the future take its course.

TAVR is definitely better than it was a few years ago but still has some risks unlike a valve replacement. Dick0236 is correct by saying it's generally for older patients. Your surgeon should be aware of this. Choose wisely. You should get a 2nd opinion if you have ANY doubts. Make sure you have a list of questions to ask.
 
Does anyone know why TAVR isn't recommended for "Low Risk" patients? I've tried to resarch this.. It seems like there are a few complications with TAVR like possible leaking around the valve and risk of heart block (requiring a pacemaker). And that the valves they put in degrade quicker than standard valves (or new generations don't have any kind of track record).. I guess given all that, if you are a low surgical risk, that would make TAVR not a good option despite the crazy recovery from OHS. Any other downsides to TAVR I missed?

I am also going in (about 3 weeks).. I'll likely go mechanical, but do wonder if TAVR will continue to improve making future replacements not such a big deal (and thus tissue more attractive). In the end I don't think I can bank on future stuff, too hard to predict.
 
CazicT;n880004 said:
Does anyone know why TAVR isn't recommended for "Low Risk" patients? I...<snip>... Any other downsides to TAVR I missed?

I am also going in (about 3 weeks).. I'll likely go mechanical, but do wonder if TAVR will continue to improve making future replacements not such a big deal (and thus tissue more attractive). .
I would say the two downsides to TAVR that I know of are that the calcification of the 'old' valve that it is placed against can break off and lead to strokes, and that there are no long term studies on it in 'younger' (that is younger than very elderly and inactive) patients who are still quite active.

Re tissue valve being more attractive, next year I believe the new Edwards Inspiris Resilia valve will be availble in the US. It's currently available in Europe. It is a tissue valve that is disgned to last as long as mechanical so making it suitable for much younger patients: http://heartvalvevoice.com/index.ph...t-valve-implantation-procedures-performed-hea
 
CazicT;n880004 said:
Does anyone know why TAVR isn't recommended for "Low Risk" patients?

for the same reasons "life jackets" aren't worn immediately when you board a plane.

They are still quite (ten or more times) associated with risks. (BTW, if you actually compare the numbers you've been researching and write them down in two columns, "TAVI" and "Regular OHS" this will become evident. Research is aimed at a target audience, doesn't usually pitch to "the public" ... so you have to think like a medico)

How old are you? They have much shorter lives. There is enough data existing to show that it lasts about 1/3 the time of a conventional tissue prosthesis (and a joke short time compared to a mechanical). Think 3~5 years and then if you wish a "valve in valve" (which will make your aortic aperture smaller again) that can be done once (to my knowledge), leaving you with a smaller aortic aperture (bad) and also needing vanilla OHS some years (and with more issues) down the track. The cost of kicking the can...

(importantly) No matter how good you think medical imaging is, when a surgeon get "in there" and "sees for him/herself" they may make a different decision.


I encourage you to verify all the points I've made. If you do find something contrary to what I've said please do post it. I confess that I have not looked this up in a serious manner for about 3 years. Then (if you are inclined) we could discuss your findings.

Lastly on psychology: by and large everyone who learns that they need surgery instantly goes into a blind panic (even if they put a blanket over it to conceal it from outside the car). Every possible angle is examined to avoid doing the surgery (or minimising it). TAVI was developed for a specific case group : those who are so frail they would not survive a surgery which has excellent survival rates (read that again).

It is my observation (backed by others in discussions I've had), that people think with a tight tunnel vision to only the surgery (and interestingly I just bumped into a fascinating man while out camping at Mt Perry in Queensland who was a pharmacist, MD, Psychiatrist and widely published in journals cardiac specialist)... ask yourself what you want to be doing in 20 years from now ... if you want to be doing anything or if you want to be increasingly visiting hospitals in perpetuation of your current condition or if you just want to be doing more or less what you're doing now.

My advice is that if you are not deemed high surgical risk to go with the literally called "gold standard". My wife always said "be careful what you ask for; you may just get it"


Best Wishes
 
When I needed my valves to be replaced in 208, my surgeon recommended tissue valves. Being scared to be reopened again, he promised me of replacing the tissue valves with TAVR. He assured me of it saying he was on the Committee Board experimenting TAVR. I was so scared, I could not find any news about on Internet, so I somehow didn’t believe him and opted for mechanical! Three years later, it was done on an elderly woman who did very well after the surgery. Last year, one of my sisters (82 and healthy) had her aortic and mitral replaced by TAVR.

Im sure one day this procedure may work on all patients!
 

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