Tissue vs. Mechanical

[vboesen]

We chose mechanical for my 19-year-old daughter becuase they said it would last longer than the tissue. Can anyone else over any pro's and con's for both. Coumadin is not a con for us.

Thank you

Valerie Boesen

 

[Tom F.]

At that age did you consider a Ross Procedure?

 

[vboesen]

Not familiar with the Ross (could you tell me), but a little bit of history. this was her 3rd valve replacement. The two before lasted 7-years each, tissue.

Valerie

 

[tobagotwo]

Your daughter should be fully aware of the ramifications to her ability to carry a child while on Coumadin, if that is a future goal of hers. Being of legal age, that is a consideration for her.

There are resources on this site for her to view. A couple of things to look at:

http://www.valvereplacement.com/forums/showthread.php?t=12389&highlight=pregnancy

http://www.drugintel.com/physicians/coumadin_warfarin_drug_interactions.htm

Again, that is not to say mechanical isn't the best choice, but patients should try to be as fully informed as possible about how things can change their life plans when determining their future.

Best wishes,

 

[vboesen]

Because of hr heart defect she could/should never have children anyway. Dr. talked with her at length about that. We were fully informed of that side anyway.

Thank you

Valerie

 

[RCB]

Request for more information

Request for more information

Because of hr heart defect she could/should never have children anyway. Dr. talked with her at length about that. We were fully informed of that side anyway.

Thank you

Valerie

Valerie,
As Bob stated warfarin is a con for most people, especially a young women of child bearing age. It is very difficult for anybody here to give good
advice, unless we know more about you daughter's case. All to often, many people have found one doctor's advice is not shared by more experienced
doctors who specialize in that area. Since valve choice is so patient dependant, we have to more about the patient before we can begin to make a recommendation.

 

[Lynlw]

Hi Valerie, Justin got tissue, but since he will need his conduit replaced anyway, longevity didn't really matter, ny concerns about a mechanical, were since is does alot of things from snow and skateboarding to mosh pits, (he got a fat lip there last week) and has broke a few bones, and needed surgery for rods in his arm, coumadine was a concern also, when he went off to college even tho he is a pretty responsible kid, I was worrying about him remeberring to take his meds, since he isn't on any other meds, actually getting his bllod checked and even refilling his prescriptions, also I know it is pretty hard to be consistent and eat right in college. His big concern was h thought the clicking would drive him nuts.
Luckily since he was getting a pulm valve and never had one before all 4 hospitals/ we talked to recomended tissue for him or just not getting one, since he does so well w/out one, I am so glad you are seeming to get the answers you need hear, sometimes I get nervous when I recomend a group to someone ) Lyn www.caringbridge.org/nj/justinw

 

[Tom F.]

The Ross is a type of surgery for the replacement of the aortic valve. But given the history you described, I doubt it is an option. But I wish her the best dealing with all of this.

 

[Shine_on_Syd]

consider the Ross

consider the Ross

Valerie,
Coumadin may keep your daughter for ever having children. The Ross procedure is the ideal procedure for females in child bearing ages.
Getting a cardiologist to agree to a Ross and finding the right surgeon is nothing short of a battle.
Very few heart surgeons have the skill to do a Ross so they will sell you what they have. I had to be very strident and go through a lot of docs before I found a good Ross surgeon. Everyone will discourage you for all the wrong reasons




Info on Ross
http://www.ctvstexas.com/a_rprocedure.html

 

[Karlynn]

We chose mechanical for my 19-year-old daughter becuase they said it would last longer than the tissue. Can anyone else over any pro's and con's for both. Coumadin is not a con for us.

Thank you

Valerie Boesen

For those weighing the pros and cons of valve type - Coumadin seems to be the biggest con for going mechanical, reops seems to be the biggest con for tissue. If you do not consider Coumadin a con, then I would venture to say you are left with only the pros. It should last a lot longer than any tissue valve installed in a 19 year-old. With the technology of the mechanicals out now, I would think that her chances of going a very long time between surgeries is very good. I'm going on 14 years for my St. Jude. Twinmaker has 24 on her mechanical. Joe (Nancy's husband) logs in at about the same time for one of his mechanicals.

The pro for me with my mechanical is having had almost 14 surgery-free years while I raised my 2 very active children. Had I gone tissue, I would have been having a deteriorating valve, surgery and recovery while they were in high school. I barely had time to go to the bathroom, let alone go through another OHS. Part of our "busyness" was traveling to Europe for 2 weeks. Just last year, we went to Paris for a week. I walked my legs into stubs with no problems for my heart. It sounds like your daughter would probably welcome a much longer period between surgeries.

We have some doctors telling young adults that mechanicals will last a life time. We have some saying they'll last 30 years. I think the bottom line is that they just don't know. The newer mech valves hold a better promise of longevity than their predecessors and even the old ones are doing well.

 

[gijanet]

Hi, Valerie........

Hi, Valerie........

We were not really given an option. Dr. Bove said that a tissue valve just doesn't last in children Katie's age due to calcification and the immense pressures under which that common AV valve is working. I have to confess that I really wish that tissue had been an option for us, not for childbearing reasons obviously, but because Katie is such a little hellion and warning her that she has to be a little more conservative now is like telling a dog not to ever bark again................that - and the blasted blood draws.

In the same breath, after our last surgical adventure with such arrythmia issues and the HIT development, I am thankful - and hopeful - that we should not have to have any more surgeries any time in the near future. Then I think of Tommy's valve clotting shut and I panic again...............sigh!

As much as Alexia has been through, though, I think y'all made the right choice. The main reason young women don't choose mechanical is usually due to childbearing, and, for Katie and Alexia, that is not an option. Sometimes I want to just cry when Katie mentions "when I have a baby." UGH! Way too early to break that news to her. BTW, I know Alexia does not have a fontan, but one of the nurses I was talking to said that they have had six patients (that they track/treat at UofM) with the fontan get pregnant. Of those six, two died. The other four delivered four healthy babies, but then two of those moms had to be listed for transplant. Although a small sampling, not good stats at all.

For what it is worth, I think "y'all done good." Much love. J.

 

[Cris N]

Sometimes I want to just cry when Katie mentions "when I have a baby." UGH! Way too early to break that news to her. BTW, I know Alexia does not have a fontan, but one of the nurses I was talking to said that they have had six patients (that they track/treat at UofM) with the fontan get pregnant. Of those six, two died. The other four delivered four healthy babies, but then two of those moms had to be listed for transplant. Although a small sampling, not good stats at all.

I sure hope & pray that between now & when Katie would be logically having babies the medical profession & treatments will have progressed to a point where she can have children with no difficulties!

Cris

 

[Paul_N]

Valerie,

I had a Ross myself. A Ross is essentially removing the defective aortic valve and replacing it with you own pulmunary valve. From there, the pulmunary valve is usually replaced with a homograft ... another pulmunary valve from somebody else. Hospitals that perform RP's, have banks of these valves for this type of procedure. Based on my age and life style, that's why I went this route.

After reading your daughter will be going through a 3rd surgery, if it were me, I'd probably go with the mechanical. I don't know if anybody can tell any of us which procedure or valve type is best for longevity. But when you weigh all the options that are available right now, the consensus is mechanical valves have the longest life. That said, I'd want to avoid a 4th surgery and what ever valve gave me the best chance of doing that, that's the way I'd go.

What I think we all hope for is science and medicine continue to make advacements that offer even better choices than what we have today. If or when the time comes for me to face a second surgery, I hope the choice will be easier.