Agian
Well-known member
This came out in May
http://www.newswise.com/articles/mi...ortic-valves-successful-in-high-risk-patients
http://www.newswise.com/articles/mi...ortic-valves-successful-in-high-risk-patients
TAVI Valve in valve
- Thread starter Agian
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Thanks, Agian. That is good to see, considering that I have a tissue valve and could be needing another during my life. I hope they continue the study and continue the development of the materials and technique so that some of us have additional choices when the time comes.
Agian
Well-known member
I really hope so as well.
pellicle
Professional Dingbat, Guru and Merkintologist
as always ... I wish I was younger and had had less surgeries.
Agian
Well-known member
I hear you Pel. I've got my fingers crossed that there will be progress all around. An invincible valve with no anticoagulation requirements; a retrievable valve inserted through the groin; a convenient replacement for warfarin, complete with antidote, world peace, yada yada.
Sounds good to me.
As a side note, the other day i had an appointement with a renowned cardiologist (in my country) specialized in valvulopaties. Among other things, i asked him about the benefits of what is currently called "early surgery". He said that you must be careful with many published works, because, in his own words, "surgeons tend to report about successfull cases and not so much about the other ones".
Regards.
Regards.
There have been successes with TAVI reported for the last couple of years for high-risk patients. Some studies show an increased risk of stroke post surgery. No doubt it's a viable option for high-risk patients, but the likelihood of it being the preferred way for VR one day, still seems a bit off in the future to me, and, even then, not everyone will be a candidate for it.
Shellbell
Active member
Makes me very happy to read this, especially the last sentence:
" Dr. Ihlberg even suggests that initial valve replacements should be done in ways that set the stage for future Valve-in-Valve repairs."
I spoke with my surgeon about this, wanted him to make this as viable an option for me as possible next time, he suggested my Hancock valve as a great candidate, and I was also thrilled to hear that I apparently have a big annulus for my body size, as a 140 lb female it seems rare to see a 25mm valve, most of the girls on here seem to be 18-21mm, but that larger size makes the valve-in-valve easier. As my siggy says, fingers crossed.
And i have to say that without this site, I might not have heard about any of this without much more extensive research. The hospitals really should note VR.org in their patient resources. I turned quite a few patients at Toronto General to this wonderful community.
" Dr. Ihlberg even suggests that initial valve replacements should be done in ways that set the stage for future Valve-in-Valve repairs."
I spoke with my surgeon about this, wanted him to make this as viable an option for me as possible next time, he suggested my Hancock valve as a great candidate, and I was also thrilled to hear that I apparently have a big annulus for my body size, as a 140 lb female it seems rare to see a 25mm valve, most of the girls on here seem to be 18-21mm, but that larger size makes the valve-in-valve easier. As my siggy says, fingers crossed.
And i have to say that without this site, I might not have heard about any of this without much more extensive research. The hospitals really should note VR.org in their patient resources. I turned quite a few patients at Toronto General to this wonderful community.
Rachel
Well-known member
I'm with you sister! I'm 115 lbs with a 25MM – my surgeon was also thinking ahead…..although I think I'm ready for anything....you just never know - there are no guarantees in anything!
Lets hope for the best - prepare for the worst as they say....
clawie1
Well-known member
Thanks Agian,
Before I had my AVR in July 2013, I had an extensive interview with one of the surgeons heading up one of the TAVI trials in LA. I was hoping that maybe I could be a candidate but like Luana mentioned above, as of now, the surgery is reserved for high risk patients because of the higher than normal stroke risk after surgery. The high risk patients are those who cannot undergo any kind of surgery due to age or their general health. I understand we will see the trials extended to include people who are asymptomatic and not necessarily high risk in the near future.
I have a tissue valve, and I am 100% positive I will need a replacement in the future however, as some have pointed out on this site, as of now you need to have at least a 23mm valve and mine is 21 mm. I am hoping that as the years pass and new technology comes into play, the techniques will be refined to include all of us with smaller valves. Also, once the surgery has been refined to bring down the risks, I believe TAVI will be the gold standard in the future. Nita
Before I had my AVR in July 2013, I had an extensive interview with one of the surgeons heading up one of the TAVI trials in LA. I was hoping that maybe I could be a candidate but like Luana mentioned above, as of now, the surgery is reserved for high risk patients because of the higher than normal stroke risk after surgery. The high risk patients are those who cannot undergo any kind of surgery due to age or their general health. I understand we will see the trials extended to include people who are asymptomatic and not necessarily high risk in the near future.
I have a tissue valve, and I am 100% positive I will need a replacement in the future however, as some have pointed out on this site, as of now you need to have at least a 23mm valve and mine is 21 mm. I am hoping that as the years pass and new technology comes into play, the techniques will be refined to include all of us with smaller valves. Also, once the surgery has been refined to bring down the risks, I believe TAVI will be the gold standard in the future. Nita
Agian
Well-known member
It will, the question is 'when?'
There may also be developments in anticoagulation and hybrid valves, with a mechanical frame.
There may also be developments in anticoagulation and hybrid valves, with a mechanical frame.
pellicle
Professional Dingbat, Guru and Merkintologist
and early device issues ... in software we jokingly call it the bleeding edge ... in medicine it has other names.
Personally I would wait for a robust and demonstrated history.
Agian
Well-known member
Of course. That goes without saying.
mcsf
Well-known member
I am in the process of decided on what type of valve I will have in my upcoming surgery (no date set yet). My cardiologist, like many, is generally conservative. However, this is one bit of technology my doctor talks about as a matter of fact -- it will a normal option. It's pretty exciting if you ask me.
clawie1
Well-known member
Hi mcsf
Yes, TAVI will revolutionize OHS and I hope to see it in my lifetime. What type of surgery will you undergo? We will be happy to see you on the other side. Nita
Yes, TAVI will revolutionize OHS and I hope to see it in my lifetime. What type of surgery will you undergo? We will be happy to see you on the other side. Nita
"TAVI will revolutionize OHS"
We hope.
The purpose of clinical trials is to determine if the procedure is safe, effective and better than existing treatment. From the link it was "45 Valve-in-Valve surgeries performed in elderly patients". This has no bearing on people in their 20s to 60s, other than to provide hope...possibly false hope.
If these elderly patients are like my mother-in-law, she passed away due to other things only 3 years after her VR. How do you tell a valve's long term viability with "elderly patients?" You cannot. Just because it works with elderly high risk patients, does not mean it will be proven better in low risk people in their prime of life. There is still a lot of work and years ahead.
We hope.
The purpose of clinical trials is to determine if the procedure is safe, effective and better than existing treatment. From the link it was "45 Valve-in-Valve surgeries performed in elderly patients". This has no bearing on people in their 20s to 60s, other than to provide hope...possibly false hope.
If these elderly patients are like my mother-in-law, she passed away due to other things only 3 years after her VR. How do you tell a valve's long term viability with "elderly patients?" You cannot. Just because it works with elderly high risk patients, does not mean it will be proven better in low risk people in their prime of life. There is still a lot of work and years ahead.
Yes, so far only uses of this is among elderly and high-risk who could not withstand traditional surgery. Five years ago, I heard the same thing here: oh, they'll all be catheter replaced in the future. Five years later, there's no change in TAVI being used only for elderly and high risk.
The problem is we don't know when that future will be, and even if it is common, my hunch is not everyone will be a good candidate.
I would not base my decision of valve choice on what might be available when next one is needed and if I might be a candidate for that.
clawie1
Well-known member
Agreed, we cannot predict the future, but I am an optimist. I am not a cardiologist but I believe minimally invasive open heart surgery was not an option perhaps 15 years ago, but it has evolved into an alternative surgical approach today provided the candidate meets the requirements -- I hope the same for TAVI. Nita
