I am in the process of trying to determine which type of tissue valve I would like to have. Does anyone here have a stentless tissue valve either pig or human? What have you seen on research for long term predictions for these?
Opinions on stentless valves?
- Thread starter john79t
- Start date
Help Support Valve Replacement Forums:
David L
Well-known member
You don't state your age, so it's hard to make a decision either way on the tissue valve. I am a 69 year old male. I had the Medtronic Freestyle Porcine valve em placed in me on August 5th of 08. It is the latest design as far as treatment for calcification. My surgeon at Stanford told me it should be good for 20 years or more. However there is not a lot of history on the latest valve, but I believe him as this is their tissue valve of choice at Stanford. Go to www.medtronic.com and read up on this valve!
I have the Freestyle stentless, porcine as well. Reading up on it at the time, it made sense to me -- kind of a seamless solution, so to speak. I understand its track record is good so far, but it doesn't have as long a record as some others. I think if you googled it, or did a search here, you would turn up a bunch of stories and comments on it.
David L
Well-known member
You may have misread my post. I just had OHS last year in August. My 6 month echo showed no problems at all with the new AV. At 61 you may be a good candidate for this valve, however you should talk to your cardio, and surgeon to help you make that decision!
My checkups have been very good, John. No more murmur, no more leakage, heart seems to have remodeled nicely. Lead an active life at age 67 -- in fact, they don't call me Superbob for nothing.
Wishing you the best as you go forward. The Freestyle seems to have been a very good choice for me -- wouldn't presume to tell you how to go, but it's worth considering if you need the combined valve and root replacement.
All best to you....
Wishing you the best as you go forward. The Freestyle seems to have been a very good choice for me -- wouldn't presume to tell you how to go, but it's worth considering if you need the combined valve and root replacement.
All best to you....
Thanks Superbob.
I will know more April 30 after I meet with Dr. Moon. Since I have a root aneurysm as well as the SAS I think the root will have to be repaired as well. Did they repair you root when they put in the valve or did the stentless valve include the root?
I will know more April 30 after I meet with Dr. Moon. Since I have a root aneurysm as well as the SAS I think the root will have to be repaired as well. Did they repair you root when they put in the valve or did the stentless valve include the root?
I just want to wish you a good luck in your choice and search, hoping you become 'Super John'!
John, yes, I had the aneurysm as well as severe leakage, and I opted for the Medtronics Freestyle Aortic Root Heart Valve, the stentless device that replaced both at once. My surgeon left the choice to me, but after I made the choice, he and his staff complimented me on my selection. I needed the total replacement, so it made sense to me to do it with one stentless device.
Good luck to you as you do your research and go forward. There are other good choices as well. Check them all out, talk to the med folks, and decide what's best for you. I am sure you will do well.
The Medtronic Freestyle is an excellent, stentless tissue replacement valve. If I were having part of my aorta (such as the aortic root) replaced, I would absolutely choose this model for myself. It now has anticalcification treatments and no-damage fixation techniques applied to it. The Toronto stentless was its main tissue-based competition, but it's not treated and doesn't have as good a track record as was hoped when it first came out.
Most people who want to choose stentless valves do so because they believe there is less restriction for bloodflow. It seems a natural move for the smart consumer.
However, it's not that simple any longer. For instance, the Edwards Perimount Magna bovine pericardium tissue valve is mounted a bit higher up, in a natural notch that keeps its stent out of the bloodflow's way. It has an outstanding record of lasting in those over 60 (20 years and still counting). The Medtronic Mosaic porcine valve uses a half-thickness stent to avoid restricting the bloodflow, and is also an excellent valve.
Unless you need to have part of your aorta replaced, I wouldn't close the doors on all other tissue options without careful consideration. The bloodflow gap that existed some years ago between stentless and stented valves has been largely obviated.
Best wishes,
Most people who want to choose stentless valves do so because they believe there is less restriction for bloodflow. It seems a natural move for the smart consumer.
However, it's not that simple any longer. For instance, the Edwards Perimount Magna bovine pericardium tissue valve is mounted a bit higher up, in a natural notch that keeps its stent out of the bloodflow's way. It has an outstanding record of lasting in those over 60 (20 years and still counting). The Medtronic Mosaic porcine valve uses a half-thickness stent to avoid restricting the bloodflow, and is also an excellent valve.
Unless you need to have part of your aorta replaced, I wouldn't close the doors on all other tissue options without careful consideration. The bloodflow gap that existed some years ago between stentless and stented valves has been largely obviated.
Best wishes,
John, I had my surgery done at Inova Fairfax Hospital in Northern Virginia, just outside D.C. (I was living in that area at the time.) My surgeon was Dr. Alan Speir, who is top-rate. My care at the hospital was also excellent.
Oh and being "scared witless" is par for the course. I know I was. But the rate of success with this in the hands of experienced surgeon is very high.
Sometimes, the surgeon determines that he can "just" resection the root (which is just the section of the aorta closest to the heart). Or resection and cover it. In such a case, the root is not replaced, and your options remain open. Your surgeon or his staff can enlighten you as to their intentions.
Best wishes,
Best wishes,
tobagotwo
Thanks again. The information is much apreciated. The NP told me that the sugeon was under welmed about the anuerysm. So perhaps he has one of the procedures in mind that you mentioned. I guess I will get more answers on the 30th.
I am still scared out of my wits. However, finding this board has been a God send. I feel much better about the choices I am having to make. I also feel more confident about talking with my surgeon about my options.
Thanks again. The information is much apreciated. The NP told me that the sugeon was under welmed about the anuerysm. So perhaps he has one of the procedures in mind that you mentioned. I guess I will get more answers on the 30th.
I am still scared out of my wits. However, finding this board has been a God send. I feel much better about the choices I am having to make. I also feel more confident about talking with my surgeon about my options.
JeffM
Well-known member
Adding to what Bob (Tobagotwo) said, my surgeon and I specifically discussed this beforehand because I made it clear to him I wanted the absolute best bloodflow possible for an athletic lifestyle and expressed my thoughts that stentless would be the logical choice. He told me that a stentless valve's advantages are in the smaller diameter valves; whereas, among the larger sizes there is no stentless edge (all other aspects of the valve being equal). I also read a study reflecting this point of view.
Of course you're scared witless. We all were, if we had time to be (some folks get rushed right through it with precious little time to react). When it happens to you, it's a big, hairy deal. And it doesn't help when those around us make light of it, as if it's nothing. Fortunately, it's also highly fixable. Just scary fixable.
If you have any aneurysm at the time of surgery, even if it's not yet up to the "magic" 5 CM danger level, you should ensure that it will be handled during the surgery.
If not, you will be extremely likely to be back for surgery on the aneurysm further down the line. They don't go away, and they don't generally stop. In fact, they often seem to expand shortly after surgery from the trauma. If he isn't planning to repair the aneurysm, strongly consider looking into someone who will.
One of the things you sometimes see on the forums is someone going in for a second surgery for an aneurysm repair, because the surgeon who did the original valve surgery felt that it wasn't at a point where it needed to be taken care of yet.
Just my opinion,
If you have any aneurysm at the time of surgery, even if it's not yet up to the "magic" 5 CM danger level, you should ensure that it will be handled during the surgery.
If not, you will be extremely likely to be back for surgery on the aneurysm further down the line. They don't go away, and they don't generally stop. In fact, they often seem to expand shortly after surgery from the trauma. If he isn't planning to repair the aneurysm, strongly consider looking into someone who will.
One of the things you sometimes see on the forums is someone going in for a second surgery for an aneurysm repair, because the surgeon who did the original valve surgery felt that it wasn't at a point where it needed to be taken care of yet.
Just my opinion,
Yes I want to make sure he addresses the aorta. It is my understanding that the aneurysm is right where the aortic root comes out of the heart. I wil just have to wait and see what he has in mind. I don't want to do this twice if I can help it. Thanks John
