Hi
coryp;n864685 said:
... I was hoping to tavr when i opted for the first tissue valve but surgeon wont do it and says not there yet. If i get another 11-13 years from this 1 then will it be smooth sailing for tavr for the 3rd?
sorry, but how many more times of "not yet" are you hoping to hear? I've read posts like that going back yonks. What no one seems to even address in this discussion is "
will that tissue valve be amenable to a TAVR?" ... they have metal frames you know.
Is it best to opt for mechanical now and hope to never do this again?
unless you have any medical conditions which select against warfarin I strongly suggest yes.
I truly have forgotten most of the recovery time spent from the first, maybe blocked it out of my mind....????
well add to that an increased risk of being told you need a pacemaker (and that's just this time, it will get more risky each time)
Looking at your photo does remind me of those red SORE scar days now looking at mine being all white and almost gone....
That scar has been cut through 3 times ;-)
I'll also strongly suggest you think carefully about things like post surgical infections and the increase in "litter" left behind in your body to make it easier for bacteria to hide in when they get there.
Have a close and careful look at all the objects and left over wires in my xray
they aren't double images there, those are the old wires beside the new ones... and a bunch of staples (as well as my new valve)
Pay careful and close attention to the reports of differences between the medical research on tissue vs valve - primarially they just talk about death.
Death rates between tissue and mechanical ... they talk about that as if that's the only difference. Not commonly other issues like what happens to your health, what other side effects are there (pacemakers, debilitation).
Sure the absolute death rates are similar (only if you consider the poorest of last centuries INR monitoring) ... but everything else (like 'oh you've got an infection we'll just cut out your sternum" or "oh your AV Node was damaged, so you'll be on a pace maker" ) is not of concern to the surgeon because they go home: you in contrast live with it.
so you're 45 now. You've already had one ... and you already didn't get the "up to 20 years" they promised you. So if you pick a tissue and if it fails at 13 years then you'll be 58 and having your third (and have had to suffer health loss as it fails). It may be that you are a candidate for a TAVI at that point, but you know it is not a good thing to be a prime candidate for TAVI.
Of course its up to you, and I would not like to have you complain at me that "I would have picked tissue if it wasn't for your advice" ... but if you choose tissue and report back here in 10 years that it failed and TAVI wasn't ready yet ... well that will probably just make me sad for you.
Lastly, try reading my post here about my 3rd operation:
http://www.valvereplacement.org/foru...ges-disturbing
and perhaps my blog on points of interest for decisions and analysis of "studies"
http://cjeastwd.blogspot.com/2014/01...r-choices.html