Trending toward tissue?

[Lisa in Katy]

As I've said before, I didn't choose a mechanical valve. I didn't know there was a choice. I was 36 at the time, thought tissue valves were "old school", and let the doctor do exactly what he thought was right. If I had it to do over again, knowing what I now know, I would do the exact same thing. However, if this valve fails, I'm hoping I will be close to 70, if not older, and I will seriously consider a tissue valve. The difference being that they have advanced, risk of re-op isn't so great at that age, and I know that older people may have more issues with Warfarin. My grandmother, who wasn't on Warfarin, had very thin skin as she aged and by 80, any little bump or scratch would cause massive bruising and/or bleeding. I feel that Warfarin would have made it worse.

 

[JeffM]

Tissue versus mechanical

I believe this will be a hot topic for as long as VR exists. Lots of good theories, high hopes and valid logic being expressed...and, of course, no guarantees with any choice. Perhaps some day, the choice will be very clear. I love the concept of growing valve tissue from our own cells.

I went with tissue at 53. Similar reasons to Chou Doufou. Although, I'm not planning on going into the bush any time soon. I am very athletic and workout, bikeride primarily, at a very high intensity level and so I wanted a valve that would, for as long as it serves me, operate as close to a human valve as possible. If I can keep myself in excellent shape, a second OHS will be that much less risky coupled with continued improvement in results among the general population. I wonder on what electronic medium we'll be communicating about valve selection 20 years from now.

 

[Bina]

For a while I thought that maybe my crappy recovery was, in part, due to my mech valve choice. I now know that my St. Jude isn't to blame. I know of someone who recently received a tissue valve and she is having just as bad a time as me.
I'm not in any hurry to get hit by that "son-of-a-B" truck again.....

 

[luvsgod]

Edward's pericardial bovine tissue aortic valve

Edward's pericardial bovine tissue aortic valve

This is negative input, but it may be something you want to consider. I also had a tissue valve at age 56. I did not want to take blood thinner the rest of my life and I am very active. I thought by the the time I needed a replacement, medical technology would have discovered and approved a much less invasive way to replace the valve. I began having problems 4 months after implant and 1 year after implant the valve was leaky so severely I needed surgery to replace the tissue valve. The surgeon who did my first surgery sent a copy of my TEE to Edwards to try to determined why it failed but all Edwards reported back was the valve "malfunctioned." We already knew that!! A couple of doctors stated I could have been "too active physically" for the valve. I did tell my surgeon at consult that I was very active. As I said, it's negative input but it did happen to me.

 

[dick0236]

It makes little difference to me as to what type of valve another chooses. However, from a personal perspective, and with a lot of experience, I do take issue with some of the reasoning:

1. Surgery will be very simple in the future.
From what I read here, surgery has improved but it is still surprisingly the same as it was 42 years ago. Don't count on it being out-patient anytime in the near future.

2. Warfarin is a killer, so avoid it at all cost.
This drug is NOT a problem if it is managed correctly, which in most cases, is very simple. I have three golfing friends who are also on warfarin...one plus me for mech valves and two for Afib. The vast majority of people on warfarin are not valve patients.

3. I am too active to be on a "blood thinner".
I have never let my valve or ACT play a dominant role in my life or activities....and I have done a lot of things, many of which were pretty dumb.

 

[Ross]

One other thing that is most often missed when it comes to Anticoagulation. If you should, for some reason, develop chronic Afib after replacement, you'd be on Coumadin anyhow, so it's something else you need to be aware of. It happens, albeit not very often.

 

[neil]

ross that is very true,after my op i went into af,it was mentioned i might have to go on coumadin, but the good news was there managed to get my af sorted phew,so yes you might finish up on it regardless,but also remember people who have had mech valves can still have re ops,although very rare,as people say.......you takes your choice,some people dont want to be hit by the truck more than once,others dont want blood thinners,hopefully in the future there will invent a valve which will last forever and need no blood thinners, then again what would we discuss on here lol

 

[Woodbutcher]

I was wondering when our man in the grim north would pipe up !?
Ps... I cut myself today and my blood definately isn't any thinner ! It looked lovely, a nornal consistency and tasted fine too. No more or les runny than it ever was and it stopped pretty quickly too ! So, what do you mean by "Blood thinner" ?
Oh and when are you coming to Cornwall ?

 

[Ross]

"Blood thinner"

Blaphemy! Anticoagulant. Calling it a thinner gives the impression that your blood is or runs like water. I haven't found that to be the case even when I'm way over range.

 

[palmaceae]

Blaphemy! Anticoagulant. Calling it a thinner gives the impression that your blood is or runs like water. I haven't found that to be the case even when I'm way over range.

I know I said blood thinners in my post, wrong choice of words, I know it does not thin the blood, it is a common way of saying it, of course it being incorrect but even the doctors say it.

 

[Mike C]

Hobbysdad, you are in the age range where you could make arguments to go either direction. It looks like you are doing good research and thinking it through.


to all...I would think tissue people would stick around more than mechanical because they are most likley going through it again and I would think you would want to be up to date on knowledge

 

[neil]

sorry ross woodcutter wrong choice of word,mike c i agree hence am always making a nuisance of myself on here lol,

 

[lilteach3234]

Being 4 weeks post op and only 49 years old, I am 100 percent happy with my mechanical valve. I am at one of the greatest medical centers in the world and I have one of the best surgeons in the world, so I trusted their opinions and once they opened me up, I had some very major major problems.

There isn't any way I'd go through this hell again and can't imagine having a tissue and knowing it will give out before the end of my lifespan.

Yes, I am on Coumadin, but have had no problems and yes, sometimes I can hear the valve tick.......but it just lets me know I am alive.

After all my complications in surgery and ICU, I don't think I'd make it through another surgery.

Good luck with your choice and hope your surgery is a success.

 

[geebee]

Hobbysdad,

Congrats on deciding on the type of valve for you. We all have our reasons for our own choices and they are often very researched.

The one thing I think is a questionable statement is:

"It's important I think for us to consider how quickly the technology is changing, and that for someone having had valve replacement surgery even 3years ago, the picture has changed."​

I can tell you that my surgeries in 1980 & 82 did not differ that much from my surgery in 1994. From what I have read on this site, the surgery today is pretty identical to what I had in 1994.

Granted there are minimally invasive procedures but those are not usually used for repeat surgeries and are still not the norm. Besides that I am not sure what has really changed other than more valve choices; the surgery itself has changed very little.

 

[Philip B]

Changes

Changes

I'm with Gina on this one. ..Back in the early eighties, a cardiologist told me I needed immediate AVR surgery or I wouldn't live past my 30th birthday. The procedure he described indicated that they would split my chest open, stick me on a heart/lung machine and replace my bad valve.

When I asked what he wanted to replace my bad valve with he showed me some kind of mechanical valve that looked like a ball in a cage and told me I could have that type or opt for a pig valve. The experience with him traumatized me so badly that I refused to see another cardiologist for over twenty years.

Obviously, valve technology has come a long ways and some of the finer points involved in OHS, recovery and rehab may have been refined, but my 2007 AVR surgery still required splitting my chest, time on a heart/lung machine, and replacement of defective parts.

While I may not agree with the rationale others use when deciding what kind of replacement valve they choose, I applaude everyone who makes the choice to live. We all know the outcome if defective parts are ignored too long...it's not good. Congrats on making that choice.

By the way...thank God that 1980's crystal ball that cardiologist was using was off by over twenty years.

-Philip

 

[Lionheart]

Either valve choice has associated risks and many people decide which valve they want by deciding which risks they want to avoid; but in that process they must also be willing to accept the risks associated with the other valve. Hopefully we make that decision based on knowledge of those risks and their affect on our lifestyle, but I found that during my decision-making process it was difficult to find good information to help me expose the actual risks of each choice based on my lifestyle.

We need to do a better job of helping people to understand the associated risks of each valve type and how their lifestyle might be affected by those risks. This is not an easy task because it seems that even discussing those risks may appear to be an attack on people who have already made their choice. The last thing we need to do is have people second guessing their choice, but we do need to provide others with useful information so that they can make a reasonable choice.

One of the beautiful things about this site is that it does a very good job of helping its members manage and minimize the risks associated with a particular choice by providing advice and tips. We need to find a way to provide the same service to those making their valve decision.
John

 

[pamela]

Well, one change that has come about in the 3 years since I needed AVR2 was the choice of filtering material on the Heart/Lung machine. They've learned better and more effective ways of treating the blood as it comes back into our bodies to give us improved recovery with smaller possibilities of TIAs and other blockage/clot caused difficulties.

Take Heart, one small improvement can make a world of difference in survival odds and the risk:benefit ratio of OHS or repeats,
Pamela.

 

[Bridgette]

I think that equal numbers of tissue & mechanical valvers post - I don't think the frequency of posting has to do with what type of valve a person has got. It's more to do with how committed they are to staying in touch and sharing their experience/helping others.
We shouldn't forget people who've had Ross procedures or repairs in all this either.
So, sorry but the person who said mechanical valve people post more because they need more help or whatever, I don't agree.....and "tissue people don't post much after their early (??) recoveries" hmmmmm, lots of them are still posting as far as I can see.
And, Hobbydad, pick whatever valve you like - don't feel you have to analyse your reasons on here because no one will care about, condemn or question your choice - people just want you to get better quickly and let them know how you get on post op.

 

[Ross]

I know I said blood thinners in my post, wrong choice of words, I know it does not thin the blood, it is a common way of saying it, of course it being incorrect but even the doctors say it.

Yeah I know. Rather then call it what it is, the Doctors assume people are too stupid to understand how it really works, so they just say it thins the blood. In reality, it does no such thing, it simply inhibits clotting time of the blood.
That's ok, were working on transforming them too.

 

[neil]

loinheart good post agree with you,we should support peoples choice whatever there pick.people with tissue know we shall properly need a re op ,yet some on here are very very negative towards that,my cardio who is one of the best in the uk,told me,.........if you have tissue you will need another re op..maybe by then who knows it might be easier might not,but its not a thing you wanna go through by choice,then he said theres mech,lasts most properly a lifetime,but you have to take anti coag......and really you dont want to do that lol......he smiled and said really its sods law..........but the good thing is we can save your life WHATEVER ROAD YOU GO DOWN.....as i posted earlier wouldnt it be grat to have a valve which lasts forever and doesnt need meds