Ross Procedure or Mechanical Valve for 29yo?

[Perry]

I struggled with the choices as I looked ahead to my aortic valve replacement. I settled on a Ross Procedure. I even specified that I wanted a manufactured tissue valve to go in the PV position and not the usual homograft. I knew that the final call on the Ross would be made during the operation and would be the surgeon's. Since my situation turned out to be not right for the Ross, the surgeon went down to choice #2 - OnX valve.

The Ross has merits and some drawbacks - like any other valve replacement option. But I know that the area around the AV needs to be pristine or thier is a greater risk of re-op due to the new AV (the old PV) leaking. It's a great choice if your heart is ready for it. But , hey, my choice list changed daily until about 1 week before.

 

[CHDDoug]

In my case, Dr. Stelzer and Dr. Ryan both reviewed my info at no charge. Both called me back the same day I called their office.

 

[Thomas]

I've made a decision...

I've made a decision...

I feel like I have been a part of this forum for three months and it has actually only been one week. After taking advice from many of you and others I decided to consult both a 2nd and 3rd opinion. I was able to contact both Dr. Ryan and Dr. Stelzer who actually had conflicting opinions. Dr. Ryan felt that due to my aortic inseficiency (sever regurgitation) and my dilated aorta (around 45mm) that the Ross was not the right procedure for me. He felt these factors would increase my risk of re-op too much to go through with the procedure. However, upon bringing these concerns to Dr. Stelzer he said, "The dilated aorta needs to be cut down to size or replaced. The regurgitation was probably worsened by the endocarditis, but it really doesn?t impact the long term much. There is some data to suggest that the chances of needing a reoperation are slightly higher if the primary problem is regurgitation as opposed to stenosis, but I have not found that to be the case if appropriate support techniques are used. The Ross would still be my choice at your age." Due to the fact that he has performed 452 Ross procedures to date, along with the fact that this is what I wanted to hear, I have decided to go with the Ross. I spoke with my surgeon today who said he would like to remove the root and utlilize pieces of it (i believe) to support the autograft. At any rate, I do feel better that I have consulted with some of the best, and I guess like so many of you have said...I need to make a decision that is best for me. At this point in my life I have zero interest in being on coumadin...not to mention the fact I was very concerned about the ticking (although I didn't come across one person who said it really bothered them). My surgery is scheduled for this Wednesday nov 26th)...yes I know this all happened way to fast, but I want to get this over with. My wife Jodi will be updating things via her blog.

www.xanga.com/jodela

This forum has truly been a blessing.

thomas

 

[ALCapshaw2]

Be sure to have a Plan B "just in case" the surgeon decides Plan A isn't viable for whatever reason once he 'gets in there'.

I asked for a Bovine Pericardial Tissue Valve and came home with a Mechanical Valve after the surgeon got a close up view of the 'issues'.

 

[Perry]

Great call - run with it. Best of luck and health.

I wholly agree with the suggestion to have a plan "b" - the docs will get thier best view during surgery and things could change.

 

[vprnet]

Best wishes

Best wishes

Thomas,

All the best wishes on your surgery. Stay in touch.

 

[Thomas]

Plan B

Plan B

My plan B at this point is to go with the ATS open pivot mechanical valve...I chose this bc it is suppose to be quieter... anyone have opinions to pros/cons to this choice??

thanks

~thomas

 

[CHDDoug]

Glad you have made a decision and can move on now! In my opinion, you have consulted two of the best surgeons. I know that you will be happy with your Ross! I'm very pleased with mine. I wish you nothing but the best and can't wait to 'see you on the other side of the mountain'. Keep us posted!

I, too, agree that you need to have a conversation with your surgeon about a Plan B. I even had a Plan C that I personally discussed with my surgeon prior to surgery. I strongly recommend that.

God Bless!

 

[laurence]

Hi Thomas,

after the few and very deep researches done from my Beautiful Love, he was also thinking on Ross because no blood thinners to take, but he is 54 years old so already "late" for Roos....but he met Dr Stelzer aul Stelzer, M.D.
Mount Sinai Medical Center
New York, NY
E-mail: [email protected]
and hehas been amazed..beautiful person, and so much experience..I guess it worse a trip there...

and very impressed also from Dr Petterson (biological and mechanical) in Cleveland Clinic (high Tech level!!!!!) Gosta Pettersson, M.D., Ph.D
Appointments: 216-445-6860
or 800-223-2273 ext. 56860
Weekdays from 8am. to 5pm.
Office: 216-444-2035
Fax: 216-445-3294

Hope it helps. Good Luck and I'm sure everything will be fine...but I know it's easy to say...
Laurence



Paul Stelzer, M.D.
Mount Sinai Medical Center
New York, NY
E-mail: [email protected]

 

[ALCapshaw2]

My plan B at this point is to go with the ATS open pivot mechanical valve...I chose this bc it is suppose to be quieter... anyone have opinions to pros/cons to this choice??

thanks

~thomas

Jack Bokros, Ph.D., holds a patent on the ATS (and Carbomedics) Valves. He formed Medical Carbon Reseach institute (now On-X Life Technologies). He was also instrumental in designing the leaflets for the early St. Jude Bi-Leaflet valves after his group created Pyrolytic Carbon for an application in the Nuclear Power industry. He has been designing mechanical Heart Valves ever since.

You can call the company at 888-339-8000.

I'm sure Jack or one of the On-X people such as Catheran Burnett, RN, (ext. 265) can tell you how all of the Mechanical Valves compare in every parameter you might be interested in.

The ON-X website, www.onxvalves.com, has some discussion of valve contact noise that may be of interest.

 

[mattwisconsin]

I will add that I had my valve replaced 17 years ago with a mechanical valve and have been on coumadin for that time. Most of the time the ticking is not a problem, but it can be annoying at points. I also have not been a fan of being on coumadin. If I had to make the choice I would do what I could to avoid these two factors. However, nothing is ideal and there are drawbacks with all choices. So really consider your options and take what the doctor suggests seriously.

 

[Phyllis]

Some how we missed putting you on the calendar, Thomas and I am so sorry for that, but for all of us who would like to check on your progress, I am re-posting your blog and am happy to report that you are home and doing well.
http://www.xanga.com/jodela

 

[sknydave]

Hi, I'm in a similar boat and I ended up going with an on-x valve. I had a repair performed last year and it began to leak again a few months later, so I just went with the mechanical valve. The surgery and recovery isn't a whole lot of fun, so I wanted to make sure I set myself up for the least possibility of a re-op. Good luck! Hope everything works out well