Re-repair or replace????

[tobagotwo]

A surgeon can only tell a likelihood of repair, even from a really good TEE. You need to have a backup valve ready before surgery.

In your place, I would want a surgeon with a great deal of successful experience in mitral repair. I would want to know what he thinks is causative (broken or stretched chordae, damage to the papillary muscle, etc.) and his tentative plan for the repair. I would want to know what he thinks caused the failure of the first repair. I would want him to be well versed in determining whether myxomatous changes are happening to the tissue that might sabotage the repair down the road - and maybe even know that it would be checked in the lab while I was on the table, if there were any question.

If his answers satisfied me, I'd vote for the repair again. In my mind, it's still the best option, if the confidence is high that the repair is solid before closing. There are no guarantees for any method.

If you go all that way and spend that money and effort to have it done at CCF, and you wind up with a replacement anyway? You'll be able to have great confidence in that replacement, and know that the smallest toll will have been taken on you by your second surgery, due to you having had a top-knotch surgeon do the job. Still worth it.

Best wishes,

 

[BillCobit]

If you go all that way and spend that money and effort to have it done at CCF, and you wind up with a replacement anyway? You'll be able to have great confidence in that replacement, and know that the smallest toll will have been taken on you by your second surgery, due to you having had a top-knotch surgeon do the job. Still worth it.

Best wishes,

Darn good point! While replacements aren't as technically difficult, you still want a good surgeon and hospital, especially since you've already gone through the trauma of prior surgeries.

 

[cocoalab]

I don't have any advise as to whether to chose to repair again or not but Andrew did go into a very skilled pediatric thoractic surgeon who felt very confident he could repair his valve. He did three attempts and was not satisfied with the results. Andrew's valve was replaced with a St Judes at that point. He was 6 at the time and it lasted 9 years.

If you decide to attempt to have it repaired again just be mentally prepaired if it doesn't work. We knew there was a chance it might not work but it was still emotionally hard for me when I heard it had failed.

All the best to you and I swear the decisions of which way to go are as hard as going through it. At least for me it was.

 

[Randy & Robyn]

Christie,

I am sorry you have to be in such a confusing situation. I know how you feel. I had a repair fail last October and just had the valve replaced two weeks ago. It is such a horrible feeling when you get the news that it didn't take and you have to do it all over again.

I can't really offer any advice since my condition involved the aortic valve, a totally different situation. I wish you all the best with your very difficult decision.

Randy

 

[RCB]

I'm lost

I'm lost

Maybe if irishmiz could give some feed back on precisely what the question is
that is being asked in the thread starter. I really don't think we are all that far apart on our thinking, just we have a different idea about what the real question is.

I think one point we all agree on is this is a redo of a repair and therefore it really deserves a high degree of technical expertise. If there is to be a lasting repair, there is no better place then CC to get it done. I also agree that if you don't have any special problems you can get a perfectly fine replacement, either tissue or mech. in most hospitals.

Until we hear more from irishmiz, I for one will not try to read the mind of the thread starter. I think everyone one here did a wonderful service to irishmiz in presenting a very in depth and probing discussion. I think you all are a great bunch of swell guys. I just wish we could all express our views sitting around a table overlooking
our favorite view with our choice of food and beverage, instead of having to bang away at this stupid keyboard!

 

[Ross]

I think you all are a great bunch of swell guys. I just wish we could all express our views sitting around a table overlooking
our favorite view with our choice of food and beverage, instead of having to bang away at this stupid keyboard!

Can we have pole dancers too?

 

[geebee]

I think you all are a great bunch of swell guys. I just wish we could all express our views sitting around a table overlooking
our favorite view with our choice of food and beverage, instead of having to bang away at this stupid keyboard!

I second (or third if Ross is seconding) the motion.

 

[RCB]

Just stop it now- Ross

Just stop it now- Ross

Can we have pole dancers too?

Why do you always try to give new meanings to my words!

"our favorite view"


We still love you, just make sure you bring a roll of 20s for the view!

 

[Atlanta Sweetheart]

Christie,

Did you consult with the other dr's about re-repairing your mitral valve? What was the result of your consultations? Good luck with this and I will be thinking and praying for you! Cindy

 

[Atlanta Sweetheart]

Christie,

Did you consult with the other dr's about re-repairing your mitral valve? What was the result of your consultations? Good luck with this and I will be thinking and praying for you! Cindy

 

[Granbonny]

Christie

Christie

Please let us know..whatever is decided. And know, that we will be here for you... ...From your posts..sounds like it will be a few more days..before you gather all your information..Then, let us know.. the surgery date, ect.We will post it on our calendar..Then, you can start posting in Pre surgery thread....Most Active members will be here to answer those questions.( places to stay, ect.)for Family members, ect...and we always love to know..if there is anyone that can post for you..after your surgery. If ..not..I will be glad to give you my telephone number to give to a Family Member. Just PM me on my name Granbonny....on this member site. Click on the G's..You will find me. My prayers are with you.. Bonnie

 

[MikeHeim]

Digressing from the topic a bit. Sorry Mike, but I'm going to ask you to back this statement up with fact and let us know the several members who have had their mechanicals fail within a few months . I can think of one recent member who's mechanical of about 6 months needs replacing due to endocarditis - this is not a problem strictly associated with mechanical valves. Not sure why you singled out valve type here. Those that have responded here are pretty much across the board on valve type and are just stating what they would do if in such a situation.

I realize that this thread is pretty much dead, but I haven't had a chance to reply to this part of it. I've spent about 20 minutes trying to search and find some of the threads I was referring to, but I've been mostly unsuccessful. I found the post you mentioned above, and also there was the post last week which referred to someone who died from a mechanical valve that failed a few months after it was implanted (the valve ended up being recalled). Regardless, since I haven't been able to find the specific situations I referred to, I apologize and retract the statement.

On another note, I wanted to explain why I got upset in the first place. The people who responded and said they were only offering an opinion were not the people who I had an issue with. I completely agree that this thread was basically asking "what would you do?" and most folks correctly treated it as such. What upset me was quotes such as "A replacement will last longer than another repair at this point based on your history." That one almost made me fall off my chair.

 

[Mary]

I think maybe you're referring to Bart in Georgia and Kathy Canistro. I believe Kathy's was due to an infection, but Bart had paravalvular leaking.
You can check their threads to see if that's whom you were thinking about.

 

[Karlynn]

You are also referring to Billy's wife who died from the Silzone valve. I don't think anyone will argue the point that there are rare instances when there will be issues with mechanical valves when they fail. Many times, it's not due to the valve, but due to the way it was sewn in (Bart's case?), or if it is implanted when there is infection present (possibly Kathy's). I also don't think anyone will argue the fact that there are rare instances when tissue valves fail shortly after implantation.

We say that mechanical valves last a lifetime - the valve itself most definately can. The unknown is how the individual's body is going to respond to the valve being in place. Most often, when mechanical valves are replaced, it's not because the valve itself went bad, the the person's body is doing things to the valve to cause it to perform less than optimal.

I do think repair is a different story. Repairs seem to fail more often than tissue or mechanical replacements. However, I think this is due to the repair being done by a doctor who doesnot specialize in repair. One of our mantra's here is that if you are going to have a repair - go to a doctor that does nothing, or almost nothing, but repairs.

I understand your passion. I think people who responded here were just concerned that there wasn't a better estimate for success and that another surgery would be in the near future.

I also think I still have Billy's BBC interview on DVD, where he spoke about his wife Myrtle's case. If you'd like to see it, PM me your address and I'd be happy to send it to you. It's already made the rounds 1 time.