Valve Choice for 30 Yr. Old

[Dustin]

Thanks all. This definitely gives a better idea about the risks involved. I just want to confirm that my interpretation is correct. If we go with the 1% scenario , it appears that while it may not be cumulative, the risk still increases with time.

10 YEARS = 9.6%

20 YEARS = 18.2%

30 YEARS = 26%

Is that correct? I understand that it is still important to note that the risk is not cumulative, but just wanted to see if I was understanding the article correctly.

Thanks.
Masterji.

Yes. Suppose the risk of a stroke is 1% per pt-year (assuming On-X) then the chance of an event free year is 99% per pt-year. Hence after 30 years 0.99^30 => 74%. Don't let warfarin scare you, it is a non-issue.

Worry about your mortgage, not your mechanical valve and warfarin

 

[fencemeister]

coumadin

coumadin

Masterji,

I'm New To This As Of 2 Days Ago. I Am Getiing An On-x Aortic Next Thurs. Morn. First One For My Dr.. They Are Sending Two Coaches To Assist Him! He Is A Great Young Man And Feels Very Comfortable With This.

The Only Thing I Know About Coumadin Is A Friend Of Mine Has Been On 8 To 10 Mgs For Over 30 Years And Is Doing Fine.

My Dr. Says There Is A New Drug Coming Out Very Soon That Will Be A Lot Better Also. Hope This Helps You. I'm 62 Yrs. Old And Am Really Cranked About This New Lease On Life...can't Wait!

Fencemeister

 

[Ross]

Masterji,

My Dr. Says There Is A New Drug Coming Out Very Soon That Will Be A Lot Better Also. Hope This Helps You. I'm 62 Yrs. Old And Am Really Cranked About This New Lease On Life...can't Wait!

Fencemeister

Don't hold your breath, there is nothing tabled now for heart patients. Stroke victims yes, valvers nope.

 

[MDS]

The exact quote he used was that the risk of a stroke with coumadin increases by 1%/per year. So, at 2 years it would be 2% and in 15 years it would be 15%.

Both my cardiologist and my surgeon told me statistics like this back in 2001. That contributed to my desicion to go with a bioprosthetic valve.

Mike

 

[Karlynn]

Both my cardiologist and my surgeon told me statistics like this back in 2001. That contributed to my desicion to go with a bioprosthetic valve.

Mike

Unfortunately they gave you very wrong information. I hope it wasn't a big contributor to your decision and I wish you longevity with your tissue valve.

 

[ALCapshaw2]

Both my cardiologist and my surgeon told me statistics like this back in 2001. That contributed to my desicion to go with a bioprosthetic valve.

Mike

Your Doctors need to take a course in STATISTICS.

Let's use 3% as the risk level for the first year.
IF the risk was cumulative, that would result in a 99% chance of a Bleeding event after 33 years for EVERYONE, EVERY YEAR.

At 40 years, the risk would be 120% per year for EVERY Patient on Coumadin.
What does THAT mean?
It is TOTAL NON-SENSE

We KNOW from case histories that is NOT TRUE.

Review the calculations provided by Bradley White if you want to know the risk of having ONE Bleeding event in the time periods used for his calculations (10, 20, 30, 40, 50 years). I concur with his mathematical analysis.

'AL Capshaw'

 

[MDS]

I'll look at the positive side of this... it may be a good thing that I went with a tissue valve. With advances in valve technology, it may give me options in a few years that don't exist today. Heck, the On-X valve was not an option for me in 2001. Maybe in the big plan, it is a good thing!



Mike

 

[MarkU]

Unfortunately there is no 'perfect' choice. But anything that keeps us alive and kicking is a good choice in my book.

Mark

 

[Ross]

Unfortunately there is no 'perfect' choice. But anything that keeps us alive and kicking is a good choice in my book.

Mark

Yeap your right.

We just want to be sure someone doesnt' base their choice on misguided misinformation concerning Coumadin. So many people have been spooked by total BS that they turn away from perhaps a better thing. God only knows how many young people went with a tissue valve and multiple reops vs Mechanical and ACT because of misinformation. The ones that really hurt---the people who chose tissue to avoid Coumadin and ended up on it anyway and now will be looking forward to reops too.

 

[Susan BAV]

Yeap your right.

We just want to be sure someone doesnt' base their choice on misguided misinformation concerning Coumadin. So many people have been spooked by total BS that they turn away from perhaps a better thing. God only knows how many young people went with a tissue valve and multiple reops vs Mechanical and ACT because of misinformation. The ones that really hurt---the people who chose tissue to avoid Coumadin and ended up on it anyway and now will be looking forward to reops too.

There is a great deal of misguided misinformation concerning a lot of things, based on older stats and such, including the longevity of, and complications related to, various valves--including all valves.

Even the presentation of opinions and accurate facts and personal experiences and helpful information would be better served if everyone kept in mind it shouldn't be a competition between mechanical valves and tissue valves.

The blanket declaration and assumption that "young people went with a tissue valve... because of misinformation," is not particularly balanced in my opinion.

Regarding the "people who chose tissue to avoid Coumadin and ended up on it anyway," I'm of the opinion the stats and percentages regarding those experiences may also include those who are on Coumadin temporarily post-op; although I haven't seen specific information proving or disproving that. Also, there are other reasons people choose tissue valves. I've read some Marfans information that recommends tissue valves, although I don't know if that is the current thinking in that regard or not.

There's nothing wrong with taking Coumadin--anticoagulation therapy (ACT). It is a lifesaving medication in many instances. It is also a medication that requires careful monitoring to avoid potentially debilitating complications--debilitating or even fatal complications.

Apparently, longevity of [those with] reop tissue valves versus ACT and mechanical valves, is currently a wash. Please see Tobagotwo's sticky thread for more information regarding that.

 

[Karlynn]

I'd like people to understand that when we post to say that something someone has been told is wrong, or needs to be clarified, we aren't doing so to cause them to feel discouraged or to feel they've made the wrong decision. We do so in order to help the person reading it who might walk into their doctor's office and be told the same thing. I choose to believe that none of us at VR have any personal investment in what each member's decision is regarding their medical treatment. But I think we do care that they have the correct knowledge to use to make their decisions.

Just because I'm happy with my valve and my life on warfarin, doesn't mean there aren't things I wouldn't have done differently as far as my treatment and those who provided throughout the years. What's that old saying "If I'd only known then what I know now."

I think a lot of what we post is just so people can learn now, what we didn't know then. Does that make sense????

 

[Ross]

The blanket declaration and assumption that "young people went with a tissue valve... because of misinformation," is not particularly balanced in my opinion.

This is what I said,

We just want to be sure someone doesnt' base their choice on misguided misinformation concerning Coumadin. So many people have been spooked by total BS that they turn away from perhaps a better thing. God only knows how many young people went with a tissue valve and multiple reops vs Mechanical and ACT because of misinformation. The ones that really hurt---the people who chose tissue to avoid Coumadin and ended up on it anyway and now will be looking forward to reops too.

I don't see a blanket statement. I see a legitmate question.

Susan would you agree on one thing? Would you agree that heart surgery should only been done one time if it can be helped? I realize there aren't any guarantees no matter what we do, but focus is being lost on the severity of the surgery on ones body. In other words, shouldn't a persons choice be meant to put a stop to multiple surgeries from the get go. Hoping the first decision will be the last? This isn't like having your tonsils out or appendix or some other needed surgery. This one is life changing. I guess I don't see why people want to risk future surgery when it's possible, though not guaranteed, to do it only once. I don't see how, if you look at things from my perspective, this can be twisted into Tissue vs Mechanical warfare. Not to scare anyone, but people have died from this surgery. It's a real possibility, though not common. Maybe I just value life more because I nearly died with both of my surgeries, I don't know. I know I do feel quite compelled to make people aware of the reality of it all.

 

[Bina]

I'm totally understanding both sides of the multiple surgery debate.

Some people go through OHS smoothly, recovery is a snap, etc.
They are great candidates for the risk of re-ops.

Others, like me, do very BADLY with anesthesia, surgery, etc.
I'm almost 23 mths post op and still not driving or working.

So, I'm in the same boat as Ross....I'll do everything in my power to avoid a re-op.

 

[xbxb]

Another Option?

Another Option?

One other option is that you might be able to have your own bicuspid valve repaired. I had my bi-cuspid repaired at age 42 - no blood thinners needed.
Many instituitions do not offer this as an option but there are some that do.
Benefits are no thinners needed. Message me if you need more info.

 

[Magic8Ball]

Good thread and good info.

There is only one thing that you can say is 100% certain and that is if you go tissue you will be having more than one surgery in your lifetime.

Even based on a 15year life for a tissue valve which would be unlikely at your young age you would be having another at 45, then 60, then 75.

Its more likely that you would have significantly less time between surgery's before your 50th.

If you are happy with that it needs to form part of your risk assesment.

My risk assessment at 37 said no thanks to certain multiple surgeries and i went mechanical.

Now there is no way to guarantee that i won't need further surgery's but at least i'm happy that its not 100% certain.

Coudamin & home testing is no big issue after the initial newness of it all.

I asked this site so many questions in the first few months and now i'm so calm about it id consider it a none issue.

The only thing i miss is the booze but its a small price to pay for life.

Good luck with your risk assessment and decision, as Ross has said, there is no wrong choice but whatever choice you make should be based on accurate information.

Regards.

 

[PeggyM]

The only thing i miss is the booze but its a small price to pay for life.

I'm still a wine and marguarita girl myself.

 

[Karlynn]

I still have adult beverages - just in moderation. (I won't say a thing about New Year's Eve )

Peggy - I'm sorry dear, but you're going to have to fight Geebee for George.

 

[PeggyM]

I still have adult beverages - just in moderation. (I won't say a thing about New Year's Eve )

Peggy - I'm sorry dear, but you're going to have to fight Geebee for George.

LOL...We can share! We can move to Utah and both be his wives!

 

[Natanni]

Nathan also will have a couple of beers or wine. We even split a bottle of wine at dinner on our cruise We were well....quite happy But yes yes....not a good plan but at least he had a full tummy before hand

 

[Ross]

I love my Bloody Marys on occasion and Rum and Coke now and then. Nope, the little Coumadin pill doesn't stop me here.