Tissue Vs Mechanical

[Gail in Ca]

At age 34 and with a 2.9yr old child, I had my 1st aortic valve replacement. My surgeon asked me if I wanted another child, I said I didn't really know. That's the main reason he gave me a tissue valve, so I could have more children. However, I decided not to have any more and have been so happy with just the one. I know it's the AV recipient we all think of, but I also wanted to add that my 2nd surgery to replace that tissue valve 11 yrs later was very traumatic for my then 14 yr old daughter. She remembered it so vividly, seeing me in ICU with my eyes taped shut. It affected her so much that with my 3rd OHS, she didn't want to even be at the hospital. She had her Dad call her when all was over, and she came to be with me only after I got home.

 

[Jkm7]

Sorry it was so upsetting for your 14 year old. That is probably one of the reasons some ICU and especially CICU make recommendations about children visiting. That was probably a bit too soon post op for her to be brought to see you. Many adults cannot handle seeing their loved ones a few hours post op and wait until they are more 'settled'. Your nurses probably should have suggested your daughter be kept away a bit longer.

 

[ElectLive]

Gail - I have worries about the situation you describe with your daughter. My surgery not quite a year ago was when my oldest was 2 1/2 and my wife was pregnant. I did my best to shelter, yet still share...but only in terms a 2 1/2 year old could relate too. Now that it's in the past, I'm amazed how well the whole experience was handled. But I know next time will be much harder, the deeper the understanding of what's actually happening, the harder it becomes. I'm sure there's probably no ideal age for a school age child to have to deal with it, so whenever it happens for us, I'll just have to do my best to have all of us prepared to minimize the emotional trauma. It was good to read your comments, something for me to keep in mind next time.

 

[Duffey]

Dear Bonnie use to tell me that she went with a mechanical valve to spare her family another replacement surgery. When she learned 6 years post-replacement that her aorta was again enlarging and she would need probably need an AA repair, she was devastated. As it turned out, she didn't live long enough to undergo the much feared second surgery.

 

[Marty]

My case

My case

I was 72 when I had my surgery with a mechanical St. Jude mitral. My surgeon said my mitral valve was so beat up a repair if done would be lucky to hold up two years. He told me and we are talking 1998 now , many of the tissue valves were going bad in as little as two years- thus his reasoning to go mechanical. As an old man repeat surgery might not be a walk in the park. I am 85 now and my valve and heart are still doing fine. My cardiologist presribed a Coaguchek for me on my first post op office visit. ( It did fine but finally wore out and I now use INRatio). I self test and self dose. My PCP orders an arm stick once a year and so far we have been therapeutic every time. I think my surgeon was criticised by some of his young associates for not attempting a repair and then for not using the latest tissue valve. However this old man is quite happy with the result.

 

[neil]

firstly marty great that you are doing well.......mind you to say many tissue are going bad in as little as 2 yrs? way of the mark i think....

 

[neil]

might have put that wrong.i didnt mean to imply marty had said that, i mean his surgeon

 

[Luana]

What about the surgeons telling people they can get 30 years from a tissue valve? I think that is grossly irresponsible.

 

[Duffey]

What about the surgeons telling people they can get 30 years from a tissue valve? I think that is grossly irresponsible.

Well of course you do.

 

[Jkm7]

I was 72 when I had my surgery with a mechanical St. Jude mitral. My surgeon said my mitral valve was so beat up a repair if done would be lucky to hold up two years. He told me and we are talking 1998 now , many of the tissue valves were going bad in as little as two years- thus his reasoning to go mechanical. As an old man repeat surgery might not be a walk in the park. I am 85 now and my valve and heart are still doing fine. My cardiologist presribed a Coaguchek for me on my first post op office visit. ( It did fine but finally wore out and I now use INRatio). I self test and self dose. My PCP orders an arm stick once a year and so far we have been therapeutic every time. I think my surgeon was criticised by some of his young associates for not attempting a repair and then for not using the latest tissue valve. However this old man is quite happy with the result.

Happily, the life of tissue valves has increased dramatically since 1998 if it was the case they weren't lasting but two years back then. Certainly never heard that before but.......

 

[neil]

yep between 2 yrs and 30 yrs you will proberly get the right time scale 16 yrs :thumbup:

 

[Julian]

I know with tissue valves everyone is different but I always like to use Arnold Schwarzenegger as a real life example 14 years and going strong, I truly think the guy is going to get at least another 10 years out of the valve. Getting awfully close to that 30 year mark. Future looks bright for tissue valvers. Of course if you're under 50 years old mechanical is still the best bet for longevity.

 

[Marty]

10 t0 15 years ?

10 t0 15 years ?

I sort of like this answer to the question from a trusted site on the internet:
Tissue valves only last 10-15 years. In spite of chemical treatments to improve durability, tissue valves typically last about 10 to 15 years. They usually fail because of the same calcification process that affected the original valve. Tissue valves can also tear and become infected.

Tissue valves are most appropriate for people who are less likely to outlive their valves, which includes people who:

Are older than 65.
Are younger than 60 and have lung disease.
Have heart failure.
Have coronary artery disease.
Have kidney disease.
Have a life expectancy of less than 10 years.

I was 72 and I'm still here at 85. I'd not look forward to more surgery at let's say 87. Maybe we should raise the recommended age for tissue in a healthy person to 75 or 80. People are living longer these days and I feel taking warfarin is no big deal and possibly good for you. Waht do you think?

 

[neil]

dont know where you got that, but never ever heard that from all the experts i have spoken to,75 to 80 are you joking? warfarin good for you ? yea thats why everbody experts included are trying to and hopefully will do get another drug to use instead of it, marty sorry my friend but you way of the mark

 

[Luana]

Well of course you do.

So, I guess that means you don't?

 

[neil]

dont what? like dark choclate ?

 

[dtread]

After surgery that almost killed me at healthy 58, I think Marty makes some good points. If the surgery wasn't so risky and debilitating I'd be more favorably inclined to consider tissue. The problem is that the surgery is just so bad that its not worth the risk, expense, and "wear and tear". If you're a sedentary person that doesn't exercise I guess it may not matter as much. But for anyone that wants to maintain any kind of fitness level the surgery takes a long time to recover from to get back at or near pre-op levels. I was back near about 75% fitness level within about 3 - 4 months of surgery. But it took about a year to get that 20% - 25% to get back near 100% of pre-op levels. So, that is something to consider for those that want to maintain fitness. Also, what Marty was alluding to regarding benefits of Coumadin is that it is similar to Aspirin in that it makes your blood a bit more "slippery" so that it helps prevent blood clots, not just from the mechanical valve, but in other parts of your body as well. Why else would there be so many older folks taking baby aspirin? To prevent blood clots, of course. Well, what do you think Coumadin does - a very similar function.

 

[neil]

i am not a sedentary person at all,my cardio knew me as the gym man,we all recover at different speeds, so you agree that anybody under 75 has a tissue? theres a lot of experts and i mean experts who are qualified cardio consultants who would laugh at that remark, maybe you have a point about coumadin but if any other drug came along how many would stay on it? not many,the drug world is hopefully getting a replacement for it, we all choose what we think best for us and as ive said many many many times before either is better than the old one we had, but sweeping statements like that are utter rubbish,

 

[neil]

whoops i mean anyone under 75 has a mech..............sorry folks

 

[Duffey]

So, I guess that means you don't?

You got it.