The Old Valve

[tobagotwo]

I've been asked a few times about my old, Mosaic valve. Rather than ignore or repeatedly answer the same questions, I figured I'd post this. I still don't have any results from the analysis yet, and I don't know when they will be forthcoming.

Although the initial echo in the hospital was good, they noticed there was a return of stenosis a few weeks later. At the time, it seemed most likely to be a patient-prosthesis mismatch, but it still made no sense to anyone (a 25 is a normal sixze for an adult male). The other thought was that it just might be a "tight" valve that would loosen up over time. Plus, they couldn't explain why my heart kept beating so hard, when it should have gotten easier (the stenosis was less at that point).

When they took the valve out two weeks ago, they discovered that an "unknown substance" had glued two of the leaflets together. Apparently (at least at the beginning), my heart was still beating hard enough to force the leaflets open, so the appearance in the echoes was that the valve was opening properly. Instead, there was tremendous force being directed by my heart to slide the gluey leaflets apart for each beat.

This makes sense, as the normal echo reading in the hospital was probably because the leaflets hadn't begun to really stick together yet. By a few weeks, they were beginning to cling to each other, so it began to show up then. The surgeon had no way to tell that the valve was turning bad.

The valve opening was listed as 1.3 cm² before I even returned to work at six weeks, although, as pointed out above, the valve appeared to be opening properly. It remained that way for about three years, then started to slowly calcify and close up.

The report isn't back yet on the valve, so I don't have any further answers.

Best wishes,

 

[Karlynn]

"unknown substance" Hmmmmmm - were you being slowly overtaken by the Body Snatchers?

Whatever the cause - sure glad you got all fixed up. I hope you have many many problem free years ahead for you.

 

[Ross]

Maybe it was made by LG. Seems they put bear poop on weather seals in my air conditioner and sloppily allowed it to drizzle over the seal and installed the unit into the cabinet. Well needless to say, the unit was stuck to the weatherstrip which ripped upon removing the unit from the cabinet.

 

[Marguerite53]

Rotten luck. I should think it will be very interesting to get those reports, and then possibly, you won't be talking about them to us very much..... if you get my drift. Surely, don't compromise any action that might be available to you.

You seem to have borne this event quite elegantly. Good for you. Here's wishing you a worthy recovery this time!

Warm wishes for success.

Marguerite

 

[BAVD John]

Bob,

Interesting post. The unknown substance you mention that glued two leaflets together. Do the doctors have any guesses if this unknown subtance is from the manufacturing process and if the same substance has shown up in bovine valves?

I was fitted with a 23mm bovine valve. I'm a pretty good sized male at 6'2'', and 195 lbs at the time of surgery, I'm just 184 lbs as of this morning. I hope my valve is sized correctly.

I've followed many of your post and have not seen what valve replaced your porcine valve. I believe you were looking at a St. Jude bio valve. May I ask what valve you now have? If you care not to answer, I'll understand.

I'm just 6 weeks post op myself and start cardic rehab today. Good luck with your recovery.

 

[Lynlw]

Bob,

Interesting post. The unknown substance you mention that glued two leaflets together. Do the doctors have any guesses if this unknown subtance is from the manufacturing process and if the same substance has shown up in bovine valves?

I was fitted with a 23mm bovine valve. I'm a pretty good sized male at 6'2'', and 195 lbs at the time of surgery, I'm just 184 lbs as of this morning. I hope my valve is sized correctly.

I've followed many of your post and have not seen what valve replaced your porcine valve. I believe you were looking at a St. Jude bio valve. May I ask what valve you now have? If you care not to answer, I'll understand.

I'm just 6 weeks post op myself and start cardic rehab today. Good luck with your recovery.

He got the st Jude biocor its in the 2nd part of his post here. http://www.valvereplacement.com/forums/showthread.php?t=32518

I haven't heard any any problems with early failure of bovine valves like this

 

[TXWildflower]

I've read both the posts about your surgery and your story of how you got there the second time. You are a real take charge kind of guy! I like that! Your story was very impressive and inspires me to not stay silent if I disagree with the care/advice I'm getting. Especially if my gut tels me something just isn't right. As someone said, no one knows our own body and how we should be feeling better than ourselves. Really Bad luck on the lemon valve and will most definitely be interested in what they have to say about that unknown substance (if you can talk about it.)

I hope your new fancy schmancy St. Jude Biocor valve will do the trick for a long, long, long, long time to come. I am going to have to do some research on that valve. I gather it has been used in Europe or somewhere and just now offered in the U.S.?

Best of luck to you during your recovery. Sounds like you are on the road again.....

Rhena

 

[tobagotwo]

The new valve is a #23 St. Jude Biocor, Model ESP100 23 00. It supposedly has an actual valve annulus opening that is as large as the Mosaic #25 I had previously.

It has been in use in Europe for over twenty years, so there is actual, long-term data for it, comparable to that for the bovine Carpentier-Edwards Perimount series (such as the Magna). It's a mixed-grille valve, with porcine leaflets and bovine pericardium buffers between them, at the base of the cusps.

They were apparently allowed for use in the US a couple of years ago, but the St. Jude website was silent about it, as far as I can tell, until recently. I believe it may have had to do with issues from their mechanical valve marketing conflicting with marketing any kind of tissue valve at all. The recent rebalancing of valve sales that now favors tissue valves may have made it essential to get into that market, even at the risk of injuring their own mechanical valve sales.

They can now take a significant percentage of tissue valve sales from Medtronic and Edwards, and also compete on more levels with mechanical companies like On-X Life Technologies (formerly MCRI), who have no tissue options. Hospitals and other institutions like one-stop shopping.

Best wishes,