Prognosis after valve replacement

[LUVMyBirman]

I extracted this from an article Nancy posted. Can anyone explain
these statistics? I would only hope we all have more that 5-10 years after valve replacement. If I were to guess... this study was done on older folks. I was fairly young when my surgery took place.

"Among patients who undergo surgical treatments for heart-valve problems, the prognosis is good. For example, at least 77 percent of children older than age 1 with congenital aortic stenosis live for at least 20 years after a valvotomy. In adults, 80 percent to 85 percent of patients survive for at least five years after aortic-valve replacement, and 60 percent of patients live for at least 10 years after mitral-valve repair or replacement."

 

[Kevin M]

Don't worry. I've seen similar numbers for adults and usually you'll find there was a very small sample size or the sample includes the elderly and patients with other health complications.

Those numbers do not sound typical of what we can expect these days.

I'm not a doctor, but I know there are many people on this forum who have already hit the 20 year mark and they don't sound like they are going anywhere soon!
Kev

 

[Phil]

Gina

Gina

I posted this link a while back which has some interesting info about heart valves, maybe you didnt see it before.

http://www.emedicine.com/EMERG/topic797.htm

Phil

 

[Ross]

I've seen similar numbers for adults and usually you'll find there was a very small sample size or the sample includes the elderly and patients with other health complications.

Exactly. I know when I first went over those numbers, I thought to myself, "Gee, I went through all of that for a short time extension?" It can be unsettling until you realize what was counted.

 

[JimL]

I saw similar things in the mortality article posted elsewhere. It seemed that the major complications after surgery that tended to bring the numbers down, other than a total disintegration of the valve, were INR-related, mainly getting a clot.

That has led me to think more directly about getting my own machine so that I can measure at least once a week; that seems to be the main thing for avoiding complications.

I have literature from Coaguchek because that's what I get tested with now, but I've only started the insurance run-around.

 

[Nancy]

I think the operative words in the stats from what I posted, are "at least". That means that that is the baseline, and things improve from there. Please remember that there are many, many very ill people who have this surgery, plus there are other diseases which can happen to enter into that stat.

My husband has had a mechanical for 25 years, so he's doing well. However, with each succeeding year, other things do crop up. Most are related to his heart problems.

 

[John Cochran]

Here are the primary contributors to serious problems with implanted heart valves; in almost all cases, the patient can make a huge difference in outcomes:

-PVE (Prosthetic Valve Endocarditis): This has high mortality when it occurs within the first 60 days post-op. After that, the mortality is about 43 percent for bacterial PVE and over 90 percent for fungal PVE (rarer). What can you do about it? If you have an unexplained fever, or feel ill without obvious cause, call your doctor. Early immediate intervention can make a big difference. Make sure you take prophylactic antibiotics for dental procedures and surgeries.

-Thromboembolitic events: The incidence of clots forming and breaking off, and then causing a stroke, is higher for mechanical valves than for bioprosthetic (tissue) valves. The risk can be lowered substantially by careful and conscientious monitoring; just as important is watching one's weight, getting regular exercise, and AVOIDING SMOKING.

-Bleeding events: Coumadin and other blood-thinning drugs can help prevent thromboembolitic events, but can also result in a serious bleeding problem in event of injury. Careful monitoring of blood levels, a fundamental knowledge of first aid, and rapid medical intervention for continued bleeding can make a huge difference.

-Valve failure: Bioprostheses and mechanical valves have different failure modes. Tissue valves tend to degrade slowly, but have, in general, less durability over time than mechanical valves. On the other hand, highly durable mechanical valves, which can last for decades, have an instantaneous fairure capability (very rare). The ticking sound of a mechanical valve is a good thing; when the ticking can not be heard, a problem is usually present. Sometimes, the suture line can separate and cause problems. Any sudden change in how one feels, unexplained change in blood pressure, fainting episodes, etc., should be reasons to seek immediate medical help.

The above are the major issues that can affect longevity for valve recipients. There are other causes as well, but much lower in incidence.

The question I ask myself is, "How long would we all live without valve surgery?" The answer is that we've all had our lives greatly extended, and the quality of our lives improved immensely. Can we have a normal life expectancy after valve surgery? Yes! But, taking care of ourselves becomes even more important, as well as staying on top of issues affecting our health.


--John

 

[Nancy]

GREAT answer, John!

 

[Les]

John,
Your post should be published as a flyer and handed out to all valve-surgery patients. Outstanding...
_____________________
Les AVR '93 / '95

 

[sylviayasgur]

i agree!
john you said that so perfectly!!
thanks!