Tests Over - Date Set

[Glenda]

Hi everyone, I just got home from having the angiogram. It went so much easier this time. They are using a new procedure. Thank goodness! ! They also checked all the veins in my neck for blockage and gave me a breathing test. There is not any blockage in any of my arteries. Yeah! My surgery date has been set for June 2, now the count down begins. I am to decide between now and then what kind of valve I want. So I will be so busy reading all the back posts. Because I am such a high risk going into this surgery, I could hear the surgeon leaning towards a tissue (pigs) valve. I mentioned the Ross procedure and he said he had performed a lot of the Ross procedures, but said the surgery itself is a lot longer and my recovery would be more difficult. The percentage of not living through this is 6% where with the pig's valve is 2%. He didn't even suggest the mechanical valve probably because we're not sure how Commadin would mix with the Gleevec that I have to take for my leukemia.

It looks like I've got a lot of praying to do. My next appointment with the surgeon is May 18 and he said be sure to bring all my questions with me. I really liked him besides one of my grandson's is his son's best friend, so he has to take extra care of me. Right ! !

 

[fyrfytr]

Hey Glenda,
Glad to hear everything went OK with the angiogram and that you have a surgery date set. Sounds like you have covered a lot of bases with the surgeon. What ever choice you make on your valve will be a good one.

Now you begin that hike up the mountain and soon you will be on the downhill side on the road to recovery.

I hope you will have someone to keep us up to date on your progress.

You are in my thoughts and prayers.

Take Care

 

[Bryan B]

Glenda,

GREAT NEWS! Now comes the fun part...waiting. I know you will pick the right valve for yourself. Let me know if you want my opinion...I've already decided which one is best for you. But seriously, don't hesitate to lean on us as you prepare for your climb!

 

[SJJ]

Glenda,
Glad to hear the angiogram went well. So June, huh? Well, that gives you plenty of time to get all your questions answered, to pull all your post surgery "gear" together and maybe even cook and freeze a few meals. Stay busy and the time will move more quickly and before you know it, this will all be behind you. And of course, keep connected with your family here so we can support you through the whole process. You've been so supportive of so many at this site, it will be a pleasure to "be there" for you.
Sue

 

[Karlynn]

Glenda,
So so glad everything went well. I look forward to your post telling of your successful, smooth surgery. Keeping you in my prayers!

 

[Glenda]

Thanks everyone. I appreciate your concern and prayers. It's great having so many people care and I'm sure I'm going to turn to you all lots of times throughout this ordeal.

Dave, I'm not sure who will be posting for me. My husband is not into computers at all. It will probably be my husband's secretary, the only thing, her name is Glenda too. She'll probably post under her last name "Hodges."

Bryan, you got me interested! What valve would you choose for me?

Sue, I'll just be so glad to get all this behind and get to the other side of the mountain.

Karlynn, I'm also glad this angiogram went so easy.

You know, whatever happens "I win."

 

[Bryan B]

Glenda,

If you were my mother hen ( ) I would recommend a tissue valve for you, for the same reasons you listed that your surgeon might be leaning that way. I love my autograft, but I wouldn't recommend that surgery for a high risk patient (my surgery was over 6 hours). And since you are also battling the leukemia I would worry about adding Coumadin to the mix. I would go with the longest lasting tissue valve your surgeon is comfortable implanting.

There...my 2 cents. But as long as the one you select keeps you around here for a long time it will be fine with me.

 

[ALCapshaw2]

Hello Glenda,

Glad that some of your 'issues' are being resolved.

I would ask your surgeon about the Bovine Pericardial Valves as they should outlast (ordinary) pig valves by 5 to 10 YEARS ! I believe the Bovine Pericardial is the favorite valve of Dr. Cosgrove at The Cleveland Clinic FWIW. Early recipients of the Bovine Valves are approaching 20 years with 90% durability (i.e. 90% of them are still working after almost 20 years!)

Stentless Pig Valves are 'supposed' to be an improvement but I don't know much about them.

'AL'

 

[tobagotwo]

I agree with Al on the Carpentier Edwards Perimont Magnum (bovine tissue) valve. It should outlast the Mosaic (porcine tissue) valve by 5-10 years.

It does sound like they have concerns over the reactivity of Coumadin with other drugs. Hobson's choice, really.

Surgeons frequently seem to have a bent for the pig valves, because they are actual valves, whereas the bovine valves are cow pericardium which is manufactured into valves. However, their prejudice doesn't seem to be borne out by experience. The stats seem to favor the bovine valves for longevity. The haemodynamics are excellent for both.

The projected lives of these new valves are 20 years for the Mosaic and 25 years for the CEPM, based on the track records of their predecessors and the anticalcification improvements made in the new models. More likely, I would hope for 15 and 20, respectively, as the rest is conjecture.

I chose the Mosaic because I am 51. Fifteen+ years puts me at 66+ for resurgery. Twenty+ years puts me in my 70s. I decided that I would prefer resurgery in my mid to late 60s, when my surgical chances and recuperative capacity are better.

I would never ask a lady the delicate question of her age, but might suggest that she consider it in her valve choice.

I am so glad you are through this batch of unpleasant testing and have a path to follow and a goal to look forward to. Having all this waiting in the wings must have been driving you to distraction. Of course it's still an enormous amount to handle, but at least you can focus.

We'll be here. If you need us, just whistle...

 

[JimChicago]

That is interesting about the up to 20 years for this newer tissue valves - my Docs told me it was either pig valves with about 7-10 years or metal valves for 20+ years. If I could have had a reasonable chance of 20 years with a tissue valve that's where I would go. Perhaps the news of these new tissue valves doesn't travel fast in cardiology circles.

 

[Abbanabba]

Hey Glenda,

Great to hear your angiogram and everything else went well.

I'm sure you'll be finding plenty of valuable information here about your choice of valve - at the very least, you'll be finding plenty of support and encouragement.

Wishing you all the best.
Anna : )

BTW - my surgeon gave porcine valves a 10-15yr lifespan.

 

[tobagotwo]

The basis for the life of the tissue valves is an average, and is also skewed because of the average age of the population that most uses them. I don't know that average age, but I'm thinking high 60s to low 70s for the average client. Also, the estimates seen most often here are for aortic replacements, which tend to have somewhat shorter useful lives than other repalcement valves.

In younger people, the calcification process that eventually destroys the usefullness of a tissue valve evolves more rapidly. As well, their higher level of activity stresses the valve more. Thus, for some people in their thirties, a "20-year" bovine valve installed in 1996 might only turn out to be a 10-year valve. Porcine valves from the 1990s may make only single digits in some young people.

Those are the results from 20th-century valve technology. For younger VRs, hopefully doctors are lowering the estimates to match the situation, which would reasonably explain the difference in estimates.

But that's not the whole story, anymore...

Counterbalancing this are new functionality-extending processes that have only been in use for months on the porcine and bovine valves. These are processes that reduce the number of sites that calcium can attach to, or disable its ability to deposit on the valve. As well, there are processes used on the Mosaic valve that protect the leaflets from being compressed when they are being treated. Dense or compressed tissue attracts calcium formation.

There has been testing, but there is obviously no track record yet for the improved life cycle expected from these innovations. However, if these have a reasonable level of success, the most marked improvement should be for younger people, because of their critically accellerated calcification. If successful, this might well bring younger users the 15-20 years of use their elders have enjoyed, making the numbers more real for everyone.

Let it never be said that we made any decision simple.

I have a Mosaic, put in about four weeks ago. If you can wait, I'll let you know how well it lasts...

 

[EVELYN]

Hi Glenda

I haven't been posting too much lately, but have been following threads. I'm so glad that you're "on track" with your trip over the mountain. I will put you in my prayers. I'm sure you'll make the right decision about your valve.....I'm inclined to agree with Bryan, but that's just my opinion. When you make your decision, please let us know.

I know you'll be just fine.

Evelyn

(Husband, Tyce, AVR 6/2002.....St. Jude's Mechanical)

 

[Glenda]

Thanks again everyone for the good wishes! I am so thankful that I found this site before I had the surgery. I feel I am so much better informed than most people going into this.

Decisions, decisions, decisions, regarding the valve. I feel like I've already made the biggests decision, and that is to have the surgery. I almost chose Victor's way, to just let nature take it's course. These last four years I have been through soooo much, but I am also a survivor, and I don't give up easy. My tolerance to pain is very high. I always amaze the doctor's how fast I recover. It's from being thrown out in the world on my own at an early age (13) and having to learn to make it or die. I made it! ! My mom & dad were both bad alcoholics and very abusive. My mom was a mean drunk and would beat me unmercifully, my dad was a crying drunk and wasn't around very much. See, God's not through with me yet. He's still got work for me to do. I sincerely believe that. Although all of my immediate family is dead, all before the age of 60 and they all died from heart attacks or cancer. See, I've already beat them!

Bob, I am proud to tell you I will turn 61 in June (the same day as Bonnie's)and plan with God's help and the doctor's to live another 20 years. My husband and I have a wonderful family (three girls and a boy) twelve beautiful grandchildren and I intend to see them grow up.

Al, I will ask Dr. Vetsch about the Bovine Pericardial Valve at my appointment on May 18.

Bryan and Evelyn, I too am leaning toward the tissue valve.

Anna, you are such a sweetie! Thanks for your kind words. I agree with some of the others. You should go into writing. You and Bob have such a way with words. Both of you have a great sense of humor. l ! !

Boy, am I wordy today! Sorry everyone, I didn't mean to write a book! !