Test results in: I need surgery

[alicia]

I dont mean to sound morbid, but since my life expectancy is 5-10 years with this cardiomyopathy and CHF, Im leaning toward the non-mechanical valve. I hope I beat the statistics and have to have the surgery again in 10-15 years but the more I think about my situation with the other heart problems I have, the more Im leaning toward the other valve.

Thoughts?

 

[Nancy]

Hi Alicia-

If you have a seriously compromised heart, you might want to reconsider your possibilities.

There are lots of strides being made with various meds for heart conditions. Probably many more strides in meds than there seem to be with heart valve selections. There are some very good chances that you will live a much longer life than you are thinking. But your heart will probably not ever be normal. Having a second or third heart surgery with serious problems already might be something you would like to avoid. If you had an otherwise strong heart, then it would be different. Joe's heart muscle is in OK shape, just bad valves and he still has major problems with the traumas of repeat surgeries.

Just some food for thought.

 

[ALCapshaw]

Alicia,

You may want to update your valve longevity data. Check the manufacturer websites for info.

To the best of my recollection, Pig Valves typically last 8 to 12 years but there are some notable exceptions of longer durability.

The data I've seen on the Carpentier-Edwards Bovine Pericardial (tissue) Valve are 90% durability at 15 years and counting. This is the 'valve of choice' by some of the Cleveland Clinic Doctors.

Hands down, the St. Jude Mechanical valve is good for way more cycles than any normal human being can count on. It is without question, the most reliable replacement valve going. Yes, you will need to be on Coumadin with this valve.

'AL'

 

[[email protected]]

Hi Alicia, Whatever your decision, get all the best info that you can as to the pros and cons and then you can relax knowing that you have chosen wisely. I am 56 yrs old and had my AVR replaced about 3 weeks ago. I was told that the biological valve will last on average 17 years and that the mechanical will go on as long as you do. My choice was bovine and one of my biggest considerations was quality of life for the next 15-20 years. For me that means out to 71-76. I look around and honestly most people that I know that age are leading a pretty sedentary life style. It may be shortsighted on my part but that is my outlook. I also heard and you will want to confirm this on your own that if you go mechanical you can never switch back to biological if you have to in the future. Check with your cardiologist on that point. Whatever you decide I wish you the very best in your future. Dave

 

[alicia]

Hey Dave, Thanks for info and good luck in your recovery. Did they do sternum incision on you or less invasive surgery? My cardiologist told me they could probably do mine thru the right side. Do you have to take Coumadin? How long were you in the hospital? AVR is that aortic valve?

 

[[email protected]]

Hi Alicia, Yeah, mine was thru the sternum. I think how it is performed has a lot to do with what is the popular method where you go for your surgery. My surgeon was the same one who did Larry King, the talk show host and he also did David Letterman. He likes the sternum method because it gives them a better opportunity to examine the heart and not "overlook anything because the opening was minimal". I do not know what your surgery team prefers but it sounds like minimal invasive which will mean about a 4" incision versus a split sternum which in my case meant about a 12" incision. Check out your surgeons credentials and his track record and the record of the hospital where you will be done. Yes, AVR is aortic valve replacement. Mine was defective since birth but I never knew it untill last year during a routine checkup they picked up the heart murmur. No with a bovine valve you don't have to take any medications at all. I went that route versus a human valve cause the cardiologist explained it to me that with any human tissue you are going to have a certain degree of wear and tear and the calve valve is "Fresh". There is a site on the internet that rates the best hospitals in the US for Heart Surgery. It ranks Duke as #5 and that ain't bad. Ross had his done at the #1 hospital which is Cleveland Heart Clinic. With me my HMO only would pay for the providers within our area which for me meant the 21st ranked NY Presbyterian. The surgical team was first rate, the nurses overall were okay but the room sucked! It was like trying to recover in a sauna. The room temp was 79degrees and every day we compalined and every day they said they fixed it but the room stayed at 79 Degrees. Oh the ranking site is usnews.com best hospitals. I hope this info helps. Good Luck in your decision. Dave

 

[[email protected]]

Aicia, I was in on a Tuesday the 12th. Had my cardiac catheterization. and they did my valve the next day the 13th. I was up on my feet the same day and home on Sunday the 17th of Nov. Dave

 

[tomtom]

Hi Alicia. Had AVR surgery at age of 43 in Dec. 1999. Was advised to have mechanical valve because of my relatively young age and was told it should last about 25 years or so. Warfarin (that's what we call coumadin in the U.K.) hasn't been a problem for me. In fact a positive advantage is that the blood tests (on average once every four weeks for me) keep you in regular contact with your local health professionals. I do many sports but have to be alert now to risk of injury so, for example, I've given up football (i.e. soccer) but still play tennis, jog, cycle (with crash helmet!) etc. etc. I haven't changed my diet other than to drink a little less alcohol. Obviously it's your decision but I hope the information helps. Best wishes.

 

[alicia]

Hey Tom and others, Im starting to feel the effects of the extra Coreg and Demedex. Im so tired. I went to my GP yesterday and my BP was 90/60. EKG was okay, chest xray showed and enlarged left atrium. All Ive done since my doctors visit yesterday is sleep. My cardiologist at Duke told me this may happen and if so I need to be seen sooner than my scheduled Jan 29 appointment so we can get the ball rolling on surgery. I think I'll give it another day before I do that.

 

[[email protected]]

Hang in There Kid; our thoughts, prayers and support are with you. Being tired goes with this kinda territory I guess. The good way to look at it is if you have to bump up the surgery you don't have to face the stress of the wait. I was a little taken aback when I thought I was just going for a visit with my heart surgeon and "Maybe" a cardiac cath if there was time. Instead it went 1,2,3 and on reflection I am glad it did. Dave

 

[MarkU]

alicia,

Take it easy and have faith in your doctors. I didn't truly realize how bad I was feeling until after my surgery. Even when recovering from the trauma of surgery I felt remarkably better. Surgery is a difficult step, but you will be better off once it is behind you.
You are in our thoughts and prayers.

Mark

 

[Davidcv67]

Another Surgery...r u nutts?

Another Surgery...r u nutts?

I didn't have a choice either because of the critical nature of the procedure I needed. I ended up with a Jude.. I take coumadin in the morning. (I hope that's OK) and have have no problems. I eat what I want, drink a bout 2 beers a day and on the weekends maybe more. Sometimes a lot more. The only true lifestyle change I have made is my activity. No weightlifting or raquetball.

It amazes me that people would opt to have another surgery instead of coumadin. That was the absolute worst experience of my life and would probally jump off a cliff if they said I had to do it again.

 

[alicia]

David, I thought while on Coumadin your eating and drinking guidelines are so restricted. I thought I heard you have to cut out all foods containing vitamin K and no alcohol, The alcohol is not a problem since I rarely drink but come on, I gotta have my greens.
How long were you in the hospital? This will be my 2nd heart surgery so I know a little of what to expect, but I had a repair last time and figure it takes longer to heal from the replacement.
Oh well, its up to the docs anyway I guess. Take care.

 

[Gnusgal]

You don't want to cut vit. K out of your diet, you just want to be fairly consistant with the ammount you consume each week. Don't go one week with not a single veggie, then the next have cob salads every day. You'll never get regulated that way. If you like your greens, go ahead and eat them!

 

[MarkU]

Alicia,
My doctor told me that the most important thing with the Coumadin was to be consistent and not binge with either foods high in vitamin K or with alcohol. If you're consistent with your diet then they can adjust your Coumadin dosage to keep your INR in range. I eat salads on a regular basis and enjoy a glass or two of red wine with meals. I did give up beer, but am better off anyway for doing so.
Regular physical activity is also important. I try to work out 3-5 times per week on a consistent schedule.
Taking Coumadin has really been a non-issue with me. It really has not affected my lifestyle or quality of life in any significant way.

Mark

 

[Les]

Alicia,
Read again what everyone has stated here. Experience is the best teacher and man, does this group have experience! Thoughts are with you.
_____________
Les
AVR '93 / '95

 

[Davidcv67]

consistancy

consistancy

yep

Mark & Gnusgal said it consistancy. My doctore said if I drink a 6 pack a night just do it EVERY night. He was kidding but was trying to make the point. A lot of people don't understand this and think if they eat one pea their skin will fall off & their guts will liquify.

 

[Nancy]

Hi Alicia-

Joe's been on Coumadin 25 years. We are just "careful" with vitamin K foods. Everyone needs to eat a little green stuff for health. Like everyone else has said, it's moderation which is the key and being consistent.

And we don't agonize about his INR numbers. We always ask what the INR is so we know and can sort of track how it's going for Joe. Only occasionally is he too far out of range. It gets taken care of easily. He has a good doctor monitoring him.

The one situation which is troublesome, is when his regular doctor is not doing the monitoring, i.e. when he's on vacation, or also when Joe has been in the hospital and others are doing the regulation. That's a real watch area, and that's where knowing what his INR is at all times is so important. I've caught many errors, from some pretty surprising sources, people who absolutely should have known better.

 

[Gisele]

Nancy I agree

Nancy I agree

I think the important thing to remember is to understand your med and to ask questions. Know what your INR results mean and if a doc is advising a dose that doesn't seem right, by all means, question it! Mistakes can be made, and in fact I know for certain that mistakes ARE made.

This board can be very useful in providing help.

As for me, I don't restrict myself from eating or drinking anything. I guess I deal with it when I see my INR results. (PS: I don't go crazy-moderation is the key)

Gisele