Hi Heartburst,
My thoughts at 45 prior to my first AVR were along the lines of "I don't want to be on warfarin". Getting a mechanical the first surgery seemed like a much better idea 7 years later as I was being wheeled into my second surgery to get a mechanical.
For me, pellicle's list is spot on regarding second surgeries:
pellicle;n863129 said:
- if they make a mistake during surgery you may end up on a pacemaker, the chances of this escalate significantly at reop
- if you get an infection during the surgery (and its more likely on the redo) you may not die within the 60 day mortality that they measure against (70 days later its ok to die) and you may just need a full sternum removal ... but that's ok, you won't appear on the stats because you didn't die
- most of the data against warfarin and AC therapy is not from valvers like us, its the full spectrum of fundamentally ill people who are on warfarin because of a stroke history.
- most of the people on warfarin are elderly and began warfarin elderly and do not manage themselves because being elderly they're confused easily and make mistakes
- most people have zero idea about operations and what the surgeon faces with scar tissue
Pacemaker: check
Infection of the sternum: check. I had 3 surgeries after my second AVR to deal with the infection. Losing my sternum was my biggest fear. Fortunately the 3rd surgery worked and I'm infection free. But it was a nuisance for 3 years.
No problems with warfarin at all the last 7 years
Scar tissue. It make the the 2nd surgery much more difficult. Dr. Miller and team at Stanford took more than 4 hours just to get through the scar tissue to begin my second AVR.
Ultimately the problem with second surgeries is your rolling the dice, again. Some have an easier time with them, some like me, have a pretty rough go the second time. Also, I've only been a member of VR.com since 2001, but I have yet to see anyone on the site claim to have had a tissue valve last 20 years.
Best of luck with whatever you decide.
