Pulmonary Valve

[Debbie]

Hey everyone, well my surgeon appt. is on Jan.9th and I want to get as much info. as possible before the appt. on the different kinds of valves that are my options. Does anyone know of the different options for the pulnomary valves?? I've been serching but it's hard to find pulmonary valve replacements. So far with most of the Ross people they seem to get homografts. Anyone with any info. I would appericate a post, thanks alot Debbie. P.S. I'll be out of town till the 2nd, but I'll repley then thanks.

 

[Lynlw]

YesSusan is right, they use Aortic valves. Actually one of your earlier post has the most info on pulm valves I've seen here. http://valvereplacement.com/forums/showthread.php?t=22671
Justin has a Bovine

 

[Guest]

I'm on my 3rd pig's valve.



Cort:34swm."Mr Monte Carlo.Mr Road Trip".pig valve.pacemaker
WRMNshowcase.lego.HO.model.MCs.RT.CHD = http://www.chevyasylum.com/cort
"It's coming on Christmas" ... Robert Downey Jr ... 'River'

 

[Bryan B]

Just to clarify...if a homograft valve (which is what I recieved when I had my Ross Procedure) is used to replace a pulmonary valve it is most definitely a donor pulmonary valve. When using a xenograft (tissue) valve they most likely use an aortic valve...I'm not even sure if they make a pulmonary xenograft valve. A mechaical valve is also an option but most surgeons don't feel the risks of a mechanical valve in the pulmonary position makes it feesable. Studies show that the pulmonary valve is more suspeptible to clot formation do to the fact that the blood coming out of the pulmonary valve is not so much pumped but just flows through the valvle as it opens and closes. Also, since the pulmonary valve is under less pressure than the other valves homograft and tissue valves generally last a lot longer in the pulmonary position.

 

[Bradley White]

A cadaver pulmonary, not aortic, valve is the most common option used in replacement of the pulmonary valve. In fact, studies suggest significantly worse reults when using an aortic cadaver valve in the pulmonary position as compared to a pulmonary cadaver valve.

However, when using a bovine or porcine valve to replace the pulmonary valve, a valve intended for the "aortic" position is used because there are no pig or bovine valves produced specifically for the pulmonary position. It is for this reason that most surgeons replace pulmonary valves with cadaver pulmonary valves. Short term results (less than 20 years) are very, very encouraging for the durability of pulmonary cadaver valves in the pulmonary position. If I had to have one valve replaced and got to "pick" which one it would be, I would go with the pulmonary in a heartbeat.

Best of luck

brad

 

[Lynlw]

Brad, I'm curious where you found this, "It is for this reason that most surgeons replace pulmonary valves with cadaver pulmonary valves" I haven't seen stats, but non scientifically, from people I know that got have pulm valve replacements (Not ross, just pulm) in the past few years, most have gotten bovine.(actually looking back it is a pretty even mix of bovine or pig)

 

[Lynlw]

Actually I believe current studies show PV's do a better job at replacing PV's. They used to use AV for PV.

I have a donor PV. And it's the only valve I have that does not leak at all so you can tell it's not mine, all my other have mild leak.

I was talking about made valves, or they don't make specific pulmonary valves, Justin's pulm valve is a CE bovine aortic valve.

 

[Bryan B]

I think there is some confusion between those of us who have had a Ross Procedure and those who are just having their pulmonary valve replaced. Before they refined the Ross Procedure they used to replace the pulmonary valve transplanted into the aortic position with an aortic homograft (cadaver) valve because they were more easily obtained at that time. Over time they found that aortic homograft valves in the pulmonary position did not last nearly as long as a homograft pulmonary valve. But for a patient recieving just the pulmonary valve they actually have the choice of a pulmonary homograft, tissue valve, and possibly even a mechanical valve. I'm guessing that with a Ross Procedure the harvested pulmonary valve was functioning perfectly so they opt to replace it with a pulmonary homograft valve. But with patients who are having pulmonary valve replacement due to defects or deterioration of the pulmonary valve a tissue valve might last longer in that position. That's just my guess...I'm not a heart surgeon...but I did stay at a Holiday Inn Express last night.

 

[Debbie]

Thanks

Thanks

Hey everyone, thanks for the replys I've been out of town and just got back.

Brad, could you direct me to your source of info regarding the studies that you

referenced?? I would love to hear from Al and Phyllis, you guys are a

wonderful source of information. Thanks Debbie