Second valve replacement

Derek L. Shenefelt · Feb 20, 2012

Hi all,

I am new to the board so here is my heart history. After birth my pediatrician discovered an aortic murmur. After multiple echocardiograms, I was diagnosed with congenital aortic valve malformation (not truly bicuspid, but close). At the time, he suggested I wait to have it replaced until the symptoms get bad and the valve becomes calcified and stenotic. Fast forward to 2005 (21 yo)...the time had come to replace the valve. my cardiologist and surgeon both suggested a tissue valve so that I could live a normal, active lifestyle and the possibility of better surgical options down the road once this new valve needed to be replaced. I finally decided on the the Edwards Magna Perimount pericardial valve and couldn't have been happier. I allowed me to run a marathon, play as much football and basketball as I wanted for approximately 5 years until it began to fail. At the time, I started to back off the more strenuous activities, but remained active with golf, hunting, and enjoying the Utah wilderness.

At my annual checkup with the cardiologist this year he was surprised at how quickly my valve had deteriorated over the past year. I had noticed all of my pre-surgery symptoms had returned so I had a feeling the checkup wouldn't be routine. He strongly suggested I have the valve replaced within the next two months so I'm scrambling on getting things in order to do so. I have tentatively decided to go with the On-X valve and enroll in the reduced anticoagulation clinical trial as my hospital is one of the trial sites.

I have a few questions for those who have had multiple valve replacements: has anyone gone from a tissue to a mechanical valve and if so, how do you feel about that decision now? Is there anything different recovery wise after a second replacement that I should prepare for?

Thank you all in advance!

Zoeey2011 · Feb 20, 2012

Valve replacement #2

Valve replacement #2

Hi, I had an aortic valve replacement in 2005. I opted for a tissue valve as I did not want to be on Warfarin for the rest of my life. I was 60 years old at that time and was told that this valve could last between 10 and 15 years so I knew that I would have to have another surgery if I lived to be 75 but I was okay with that. My first surgery went fine except for some issues I had with my stomache from the meds that they give you after surgery.

Unfortunately the tissue valve only last 5 1/2 years so I had to have another surgery. This time my surgeon opted to give me a mechanical valve as he said that we did not want to do another surgery in another 5 1/2 years if needed. The second surgery I find went better than the first as I did not have any problems with the meds as I told the nurses about my problem with my stomache from the first surgery so they gave me some pills to help.

I am on warfarin now but it has not been a problem for me. I had my surgery on Feb 8/11 and my INR has always been good. I test once a month at a lab. I live in Ontario, Canada so we don't have self testing here.

Good luck on your surgery and I am sure you will be fine.

drivetopless · Feb 20, 2012

I'm only on my first VR, but it is an On-X. Just wanted to wish you luck. ACT is not bad, especially if you can get your own home meter. I really haven't noticed much difference when I nick myself, etc as long as I'm in range. I do bruise just a little easier.

I'm sorry your first valve didn't last as long as planned, but it sounds like you got some really good use out of it.

After surgery, I want to hear how the noise levels of your two valves compare.

Phil · Feb 20, 2012

Hi Derek,

I'm pretty much in the same boat as you, but much older. I had a human tissue valve replacement 10 years ago and am likely to have that replaced later this year. I'm choosing a mechanical valve this time around mainly because I do not want on-going surgeries and also I worry about the build up of scar tissue. I so do not want to be on warfarin or similar, but understand that's the price to pay. I think I feel ok about this decision - I hate the way I currently feel waiting for surgery and know I do not want to be in this holding phase again. This also makes me think mechanical this time around is the way to go.

I wish you luck with making your decision and surgery.

All the best.

Phil.

Superman · Feb 20, 2012

Hi Derek,

I'm just a reminder than choosing mechanical doesn't guarantee lack of re-ops later. I had my firstI AVR in 1990 just before my 18th birthday. My first valve would still be with me, but I had an aortic aneurysm in 2009 that required OHS to replace. As long as they were replacing my ascending aorta, I had them throw in a shiny new valve as well. I elected to stay with mechanical this time. I figure almost 19 years is a lot better then every 10 or so. And, if I have no other complications, this valve should last a lifetime.

I've been on warfarin for nearly 22 years now. No issues. I've ran a 25k and several 5k's. I was a pretty active mountain biker in my 20's. Played a fair amount of pick up basketball and some football as well. Not sure why your cardiologist or surgeon felt a mechanical valve would limit you in these activities. We have several marathoners than post on this board as well and many have mechanical valves.

Good luck with your second OHS. My recovery was more challenging the 2nd time around, but I was almost 19 years older. I was on the table much longer as well due to having to saw through scar tissue again. As you can see from other posters though, everyone is different. Your's could be easier than the first.

Sarah_Louise · Feb 20, 2012

Hi Derek,
i've had a few valve replacements, last one in April, In 2007 i had my AV replaced with a mechanical one, so therefore on anti-coagulants, but i had a few problems with anti-coagulation and ended up needing emergancy OHS to change my valve back to a tissue one, and was told it would last me 5-7 years, (only had it in 9 months and its leaking already!)
I've had 4 lots of OHS (& 1 done via cath) and im waiting for my 6th lot of heart surgery, and honestly my second op was the easiest by far!
Was admitted to hospital Sunday night, op first thing Monday morning in theatre 7 hours, taken to ICU, in there over night, back on a normal ward by Tuesday dinner time, and when the physio came to get me out of bed on Wednesday i was already in the play room! (was 8 at the time) and by Saturday dinner time i was heading home!!

OHS and in an out within a week, compared to my other ops its amazing! (1st op i was in 9 weeks, 3rd op 3 weeks, 4th op 1 month (but needed other ops so in a total of 4 months when all added together)
Good luck to you

Love Sarah xxx