Warranty? Never heard of one coming with any valve, tissue or mechanical. As for those having a bovine valve 30+ years, they were approved in the US in 2000, don't know about Canada, but kind of doubt that they've been in use for 30+ years.
Tissue vs. Mechanical - terrified and confused
- Thread starter Cherie'
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Warranty? Never heard of one coming with any valve, tissue or mechanical. As for those having a bovine valve 30+ years, they were approved in the US in 2000, don't know about Canada, but kind of doubt that they've been in use for 30+ years.
hook
Well-known member
I am in my 6th week with a MVR, and I was given a mechanical valve. My surgeon was one of those world renowned guys who doesn't tell you much, but does what he wants to do. I figured I would trade conversation for the experience of a guy who has done over 10,000 of these procedures.
I struggled with this same decision, and after the procedure was very glad I went mechanical. I don't want this disruption to my life again. Even if you go tissue, you will be on Coumadin for several months anyway as you recover. Since the first couple months are the biggest pain with blood draws, it is about the same out of the gate with both valve types. If you are one of those people like me who develops a post surgery arrhythmia, once again you will require Coumadin to prevent Arial pooling clots. If I would have gone tissue, I would have still been put on Coumadin anyway. It would be unfortunate that you would base your decision mostly on Coumadin, and ended up having to take it regardless.
Once you get your dosing figured out, you can get a home testing devise. This will allow you to test once a week at home with a painless finger prick, much like a diabetic check their sugar. I have had minor cuts and my bleeding stopped almost as fast as before. After all you’re INR levels only add a few seconds to your clotting time. The most common misconception is that blood thinners turn you into a free bleeder; that simply is not true. I will miss my sword fights with terrorist though; that cracked me up.
Another thing to consider is medical advancements. There will be a replacement for Coumadin in the next 3 to 5 years. There are also tissue valves that will soon be approved by the FDA that drop in like a stent. My Vanderbilt surgeon told me they should be doing this cath based valve replacement by late fall.
I struggled with this same decision, and after the procedure was very glad I went mechanical. I don't want this disruption to my life again. Even if you go tissue, you will be on Coumadin for several months anyway as you recover. Since the first couple months are the biggest pain with blood draws, it is about the same out of the gate with both valve types. If you are one of those people like me who develops a post surgery arrhythmia, once again you will require Coumadin to prevent Arial pooling clots. If I would have gone tissue, I would have still been put on Coumadin anyway. It would be unfortunate that you would base your decision mostly on Coumadin, and ended up having to take it regardless.
Once you get your dosing figured out, you can get a home testing devise. This will allow you to test once a week at home with a painless finger prick, much like a diabetic check their sugar. I have had minor cuts and my bleeding stopped almost as fast as before. After all you’re INR levels only add a few seconds to your clotting time. The most common misconception is that blood thinners turn you into a free bleeder; that simply is not true. I will miss my sword fights with terrorist though; that cracked me up.
Another thing to consider is medical advancements. There will be a replacement for Coumadin in the next 3 to 5 years. There are also tissue valves that will soon be approved by the FDA that drop in like a stent. My Vanderbilt surgeon told me they should be doing this cath based valve replacement by late fall.
I didn't read this post very closely before now. Penny, I'm really surprised your surgeon has not strongly advised a tissue valve for you because of the celiac. How are you supposed to manage the ACT with celiac? I could just about pick my jaw up off the floor. Sounds really irresponsible on the doc's part, in your case, not to steer you towards a tissue valve; your decision is far more than a "personal" choice. I'm a bit surprised by the attitudes of some docs in letting the patient decide, especially in situations where one clearly seems advised over another, seems reckless to me.
As far as how bad the surgery is, well, I wish I could define just what is so bad about it. All the tubes, and this and that and being in ICU, not really that big of a deal, certainly not fun, but not a terrible experience. Pain? Geesh, I rate it about a 2 on a scale of 1-10, with 10 being the worst, so it's not pain that makes it tough. (I did not have a sternotomy, so not sure of the difference in pain.) I spent about 7 days total in ICU and the care was outstanding. My doctors were wonderful, so no problems with either of these, but every day just seemed like such an effort. If you don't know the story of Sisyphus, look it up, because that's kind of how I felt every day in the hospital. It got much better the first week I was home, but then I had lots of SOB and and some INR problems. Rolling the boulder up the hill again every day. It was a good few months before I felt even modestly good.
It was much more difficult than I anticipated and I've been through a fair amount of doctor/hospital stuff in my life as an adult and child. I certainly feel it's all worth it and am grateful to have had something that could be fixed, but it's just not all lollipops and rainbows after surgery.
ross what about falling over running to the bar to get me that drink?.....i would never suggest you picking any valve, that is your choice only,
Have Tissue, never on coumadin.
Have Tissue, never on coumadin.
Just to put my oar back into this stream for a moment, Hook made the comment that one must use anti-coagulant therapy after receiving a tissue valve. This may sometimes be the case but, as a tissue valve recipient, I can say that my Surgeon does not put tissue valve patients on anything other than aspirin unless they have some other health issue that requires it.
Larry
Have Tissue, never on coumadin.
Just to put my oar back into this stream for a moment, Hook made the comment that one must use anti-coagulant therapy after receiving a tissue valve. This may sometimes be the case but, as a tissue valve recipient, I can say that my Surgeon does not put tissue valve patients on anything other than aspirin unless they have some other health issue that requires it.
Larry
Along the lines of this comment, Penny, I was wondering if your surgeon might also have concerns about your health in regard to the aspirin therapy which most tissue valvers are required to take post-op. (I take coated aspirin with my breakfast each morning.)
I'm not a medical professional of course and have never looked into it seriously, but I think there are some other things, like real Vitamin E and garlic, which can also cause a person to clot less, though I would think the results could be unpredictible and I don't know if those things are acceptable for a person with celiac. But anyway, I have a friend who doesn't have valve problems, who developed a bleeding issue related to too much Vitamin E and garlic -- so that's how I developed my opinion about those two suppliments. Long story, but her husband had to take her to the ER and later they finally figured out the suppliments exacerbated her problem. Anyway, it might be worth looking into and asking your surgeon and cardio about before surgery, if they're concerned about the celiac and possible aspirin therapy [IF your choice was a tissue valve].
Larry - Whoops, sorry, you must have posted while I was trying to figure out how to word my post.
Hi Cherie,
I know these are difficult decisions that we have all struggled with. You have received some great responses from both the tissue and mechanical valvers.
I also wanted to chime in along with Mentu to share that I that I did not take coumadin post-surgery, but was on aspirin for 3 months post op (along with other meds).
I am now 8 months post-op and am not on any medication at the moment. As I am under 50 and a female with a low risk profile for coronary artery disease, my surgeon felt that aspirin would not be of any help to me.
All the best with your decision! Am thinking of you...
Cherie'
Well-known member
Ottawagal,
What made you choose tissue or mechanical? Did you look at On-x valve?
What made you choose tissue or mechanical? Did you look at On-x valve?
Ross
Well-known member
Don't bet the farm on it. We've heard this for years now and it may still be years away. Dabagitran is the so called replacement and it costs 10 times more then Coumadin. Not too many insurance companies are going to cover that. The catheter based replacements are currently only for high risk patients and that's not likely to change.
hook
Well-known member
A man can dream right
Ross
Well-known member
Nothing wrong with that. I've learned to hear what they tell you, but don't always take it as gospel. If it does happen, GREAT. I just hate to see people get their hopes up and have them dashed to pieces.
I hate to see anyone terrified over valve choice. I worried myself and probably was close to being terrified too. Two days before surgery I was still wondering what to do. At 57 years old, the choice was at the crossroads in my life. I struggled for 2 months before the surgery, then I made my choice, felt peace about it and have gone on with life. What I pray for anyone making this choice is too seek peace. After the surgery is done, and a recovery time, you will have your life back. Now only 6 weeks later, I am beginning to feel like me again. Am I a 100% ?no, but working on getting there and the new valve has made me feel so much better. I live with the pretty scar and a trip to the clinic every three weeks but the main thing is I am alive today and I hope I have lots of tomorrows ahead of me.
Medicine will change, it will get better, new drugs will be developed, and life will go on. I cant go buy a new model valve, like a new car, so I hope my valve works well!! LOL
I pray for peace for anyone facing heart surgery.
Lu
AVR 5-25-10 2 days before my 58th birthday!
Medicine will change, it will get better, new drugs will be developed, and life will go on. I cant go buy a new model valve, like a new car, so I hope my valve works well!! LOL
I pray for peace for anyone facing heart surgery.
Lu
AVR 5-25-10 2 days before my 58th birthday!
lu....nice post
Kathy McCain
Well-known member
Well, I wasn't going to put my two cents worth in, but (I'm honestly not trying to start anything) how do people that opt for mechanical valves, cope with the ticking?? We have had alot of discussions on the subject of Coumadin pro and con, but I don't believe we have ever had a serious one on this topic. I feel like I'm risking offending some people with this, but I do think this type of open, honest discussion would be EXTREMELY helpful and supportive of people that may otherwise choose this type of valve if it were not for the noise factor. Believe me, that IS a consideration for certain people. Everyone has a different personality. Dr's are not very good with this subject. As a support group, I feel it needs attention. Any help and advice would be very much welcome! Thanks in advance.
That is a good point that you raise Kathy. The ticking certainly factored into my decision (I am an extremely light sleeper and very noise sensitive). I would be most interested in reading what others have to say about this.
not the main reason i didnt have it,but didnt fancy the idea of the clicking
Noise
Noise
Kathy the ticking as a good point. I remember over the years I have been a member there have been a small number of members that have been extremely disturbed with it.
Years out from surgery and still get very little sleep because it annoys them so much.
No one in the medical field ever mentioned the ticking to me without prompting. :frown2:
When I queried the surgeon on this, his comment was you don’t know how silent or noisy it will be until after surgery, I said its bit late then. :eek2:
The cardio I had before surgery said he could hear some of the older tilting disk valves as soon as the patient opened the door to enter his office. :eek2:
Noise
Kathy the ticking as a good point. I remember over the years I have been a member there have been a small number of members that have been extremely disturbed with it.
Years out from surgery and still get very little sleep because it annoys them so much.
No one in the medical field ever mentioned the ticking to me without prompting. :frown2:
When I queried the surgeon on this, his comment was you don’t know how silent or noisy it will be until after surgery, I said its bit late then. :eek2:
The cardio I had before surgery said he could hear some of the older tilting disk valves as soon as the patient opened the door to enter his office. :eek2:
This post got my attention and I am curious if others who have mechanical valves experience valve noise long after surgery. When I had the surgery, and for many years after, I was a small man, 5-9, 145 lbs(now about 165 lbs:frown2
. My valve is basically a "hard plastic ping-pong ball that bounces up and down within a titanium cage". I doubt that there was much consideration given to sound deadening back then. Immediately after surgery, my wife and I were very concerned about the "clicking":eek2: (that was one of the many things they never told me about prior to the surgery). In the beginning, the clicking was comforting, 'cause if I could hear it, it must still be working. The sound became more and more muffled as my body healed and my heart reconfigured and pretty much was gone in 3 to 6 months:smile2:. It has been decades since I heard it click, even in a very quiet room at nite and no one has asked me in years where I am hiding the clock:biggrin2:. I would think that the newer valves have had sound deadening engineered into them and should become quiet after a few months. Do the newer valves stay noisy?I'm a little confused about bovine valves only being approved since 2000
ALCapshaw2
Well-known member
I would suggest that the reason that his has not been a common thread is that for MOST patients, it is NOT a Big Deal.
Several Post-Surgery Patients have commented on a Strong or Pounding Heartbeat that tends to go away as the Heart 'readjusts' to it's new reality, in particular, a lower gradient from a new valve versus having to pump hard to get blood through a Stenotic Diseased Valve.
Others have commented that hearing the ticking (more of a soft thump actually) is Highly Dependent on the patient's body accoustics. Many can hear their valve in very Quiet surroundings and/or rooms with hard walls (such as tiled bathrooms) but not in other environments. Some can hear their valves while lying on one side or the other but not in other positions. And then Many find the (typically soft) sound 'reassuring'.
Very Few are bothered by the sound of a mechanical valve, especially after their hearts have reconditioned.
'AL Capshaw'
