Tissue versus Mechanical

[ALCapshaw2]

Hey all - I too am struggling with the decision of whether to get a mechanical or tissue valve. Just found out I have a ascending aortic aneurysm and a leaking BAV approximately one month ago after a visit to ER thinking I was having a heart attack. Never knew I had any heart issues or BAV and am now scheduled for surgery July 28, 2010 - which also happens to be my birthday! I am not going to lie - the whole thing is a bit overwhelming. I am 45, female, healthy, non-smoker, not overweight, etc. so I am in shock a bit. I have been reading all your posts and am so confused. First I was thinking mechanical, but I am scared of being on Coumadin for the rest of my life which could easily be 45+ years (my grandmother is 98!) and has anyone had a mechanical valve for that long without reoperation? Heck half the time I cant even remember to take my thyroid medicine! Now I am thinking maybe a tissue valve which may get me to 55-60 yrs old and then do mechanical. But the thought of another surgery scares me. I hear of people talking of hearing the ticking of their valves and irregular heart beats and that is freaking me out!! The only symptoms I have now are some shortness of breath and some chest pains. Maybe I should try to push off surgery a year or two to buy me time - I AM TERRIFIED and CONFUSED!!!

Cherie,

With BAV and an Ascending Aortic Aneurism, you need to BE SURE that your Surgeon has the necessary Knowledge, Skill, and Experience to deal with those issues which are a step or two beyond the Comfort Zone of most Heart Surgeons who typically see only patients with Coronary Artery Disease and an occassional Valve Job. Please look through the Bicuspid Aortic Valve and Connective Tissue Disorder Forum for LOTS of pertinent information on your issues.

Personally, IF I had your issues, I would look for a Surgeon with the appropriate experience at one of the Major Heart Hospitals. Experience Counts!

You need to know that Mechanical Valves are designed to last for Way More than anyone can hope to live (several lifetimes). As an engineer, I am impressed with the technological advancements offered by the On-X Valves. See www.heartvalvechoice.com and www.onxvalves.com for more information. For a Plan B valve, I like the St. Jude Master's Series valves which have a 30 year history and counting. We have members who have had mechanical valves for 30 some years. The Bovine Pericardial Tissue Valves have the longest proven record of durability with several more elderly patients approaching 20 years of service. Tissue Valves wear out faster in younger patients (under age 60).

'AL Capshaw'

 

[Luana]

Hi Cherie,
It is kind of a difficult decision to make. I'm only a bit older than you are. When I first talked to my surgeon, his suggestion was a mechanical valve. I did further research on it and still wasn't sure, but the deal-breaker for me was additional surgeries. So far, I'm glad I took his advice.

Give yourself a bit of time to catch your breath and get your bearings, and ask anything and everything here that you think of. Wishing you all the best!

 

[Lily]

Hey all - I too am struggling with the decision of whether to get a mechanical or tissue valve. Just found out I have a ascending aortic aneurysm and a leaking BAV approximately one month ago after a visit to ER thinking I was having a heart attack. Never knew I had any heart issues or BAV and am now scheduled for surgery July 28, 2010 - which also happens to be my birthday! I am not going to lie - the whole thing is a bit overwhelming. I am 45, female, healthy, non-smoker, not overweight, etc. so I am in shock a bit. I have been reading all your posts and am so confused. First I was thinking mechanical, but I am scared of being on Coumadin for the rest of my life which could easily be 45+ years (my grandmother is 98!) and has anyone had a mechanical valve for that long without reoperation? Heck half the time I cant even remember to take my thyroid medicine! Now I am thinking maybe a tissue valve which may get me to 55-60 yrs old and then do mechanical. But the thought of another surgery scares me. I hear of people talking of hearing the ticking of their valves and irregular heart beats and that is freaking me out!! The only symptoms I have now are some shortness of breath and some chest pains. Maybe I should try to push off surgery a year or two to buy me time - I AM TERRIFIED and CONFUSED!!!

Terrified and confused is not an unusual reaction, Cherie. Welcome to the site.

Remember that much of what you read here will be patients' perceptions of their experiences or patients' opinions. Here's another opinion or two

I wanted to find an excellent and highly recommended surgeon who had great experience and a great success rate with valve replacements. My husband and I ended up consulting with three different surgeons because I wanted to be sure. You also have the added concern of an aortic aneurysm. Although some of us hoped we could push the surgery off for a time, the valves sometimes decline and then the deterioration often accelerates, disproportionate to the earlier rate of decline. I was 42.

Hopefully, no matter what valve you choose, you're going to feel much better than you have in years. Best wishes

 

[manis.garg]

Hi,

Reports of First Eco Done foe my wife...

Impression:
a) Moderately Severe Aortic Regurgitation
b) Mild and Non Calcific Valvular Aortic Stenosis (Peak Systolic Gradient across Aortic Valve= 33mmHg
c) LV Normal in size with adequate systolic Function (LVES = 55%)
d) RV Normal in size with adequate systolic Function

Symptoms are : Short of Breath and Chest Congestion at times.
Need to know the exact state and what time we have in our hand b4 surgery.

I have consulted 3-4 cardiologist but each of them have given different opinion in terms of surgery. 2 of them suggested me to go for surgery in next 3 months and 2 others told me their is no rush and can wait for few years...I am confused and very much deppressed getting these from experts..

Is this going to happen in next 6 months Or > 1 Year

Can anyone suggest me here...I am in process of consulting to some more experts here in India.

Regards,

Manish Garg

 

[scott.eitman]

Hey all - I too am struggling with the decision of whether to get a mechanical or tissue valve. Just found out I have a ascending aortic aneurysm and a leaking BAV approximately one month ago after a visit to ER thinking I was having a heart attack. Never knew I had any heart issues or BAV and am now scheduled for surgery July 28, 2010 - which also happens to be my birthday! I am not going to lie - the whole thing is a bit overwhelming. I am 45, female, healthy, non-smoker, not overweight, etc. so I am in shock a bit. I have been reading all your posts and am so confused. First I was thinking mechanical, but I am scared of being on Coumadin for the rest of my life which could easily be 45+ years (my grandmother is 98!) and has anyone had a mechanical valve for that long without reoperation? Heck half the time I cant even remember to take my thyroid medicine! Now I am thinking maybe a tissue valve which may get me to 55-60 yrs old and then do mechanical. But the thought of another surgery scares me. I hear of people talking of hearing the ticking of their valves and irregular heart beats and that is freaking me out!! The only symptoms I have now are some shortness of breath and some chest pains. Maybe I should try to push off surgery a year or two to buy me time - I AM TERRIFIED and CONFUSED!!!

I am 46 as well, same heathy lifestyle, but Male. I am looking at getting my second replacement this year. Even though I have gone through this before, I am also TERRIFIED and CONFUSED!!! I also have the Ross procedure on the table to look at. Luckily I live in Cleveland and take advantage of the CCF. I am having the same symptoms. Re operation is scary, but I knew it was coming 12 years ago when i received this valve. I am also questioning Coumadin the rest of my life.

Good luck. You will get through it.

 

[heartman77]

Ill mark the calendar for the 13th and will be sending prayers and best wishes for a smooth surgery and fast recovery for you Penny......Effective the 13th you will be in the club ...Warm hugs......Michael

 

[Mike6855]

One thing to always keep in mind is your age. In a best case scenario, you'll get 20, maybe 25 years with a tissue valve. So if you're under 60, chances are you will have a second surgery in your lifetime.

Many people, like myself, have valve stenosis due to high cholesterol; specifically our high levels of LDL.

High levels of LDL, in people like myself who have a bad family history of high cholesterol, causes calcification throughout the entire vascular system. A few years back I needed an xray of my back, and the Doctor could not believe the amount of calcification in the major artery along my spine. (kinda scary to look at!)

When I had my recent utlra sound, it looked like a big aspirin was glued to my valve. The Doctor explained that it was all built up because of my high LDL. Y\

My Dad and my Uncle both died shortly after their second valve replacements. I'm not sure that I can explain it exactly right, but both surgeons said that there
was too much calcification and plaque around the valve. The new valve could not be implanted properly.
(Sorry for the poor explaination).

What I'm trying to say is that if you have a lot of cholesterol related calcification and plaque, a second valve replacement could be a problem.

My Doctor has been adamant about my getting a mechanical valve because of my family history.

My family history and experience are probably much worse than the average person, but it is still something to think about.

 

[manis.garg]

Hi,

I think I am heading towards Tissue Valve.

My wife is bad in taking medicines Or not easy going with medicines and she even dont want to make this as an habit. I have to push her for medicines in case of normal problems.

But now , what are the valve available under Tissue value. What are the options.

Is this correct that in Young patients, life of the valve gets reduced?

I need to know the commercials of such valves. Pls provide the inputs.

Regards,
Manish Garg

 

[neil]

mmm it kinda annoys me this tissue v mech thing, as i said before it seems like a boxing match lol,i look at it like which is your fav beer or choccy,hell there both good for you ha ha, whichever you pick saves your life, when i picked mine i cert didnt think of it as one against the other,more like which suited me,imo there both great pieces of science which help us,

 

[Kathy McCain]

Again, I have to say it is a personal choice, one made with your Dr's. It has to be right for YOU.

 

[manis.garg]

Again, I have to say it is a personal choice, one made with your Dr's. It has to be right for YOU.

Hi Kathy,

Thanks !!

I have an appointment for coming Saturday with doctor. Lets see what he suggests.

Me and my wide are bit nervous meeting him and dont know what is store for me.

Regards,
Manish

 

[OldManEmu]

Manish, If you are nervous I suggest you and your wife write down a list of questions you want to ask the doctor before you go.
I also would write down his response to your questions.
This way you will not forget to ask a question you may have thought of before hand.
You will also be able to discuss with your wife the doctors answers when you return home and are more relaxed.

 

[Arthur]

Your problem has to be fixed by the specialist who is taking care of your celiac disease. Absorption modalities of anti-vitamin K is very well known today. There is also means available to check at home the level of anticoagulation (INR). Anti-platelet therapy alone with Aspirin may not be a good option since the mode of absorption is different. I am sure that your specific question can be accurately answered today. The only thing I an say is that durability of tissue valves is somewhat oversold those last years. It is well established that it is much less in young patients for still unknown reasons.