While everyone here advocates that patients should be actively involved in these types of decisions, I submit there are major limitations to patient involvement in the selection of the replacement valve. In my experience, it became evident that the surgeon would make the final choice based on factors far beyond my control.
He said he would not make a final decision until he had the old valve out, sized a new one, looked at different elements related to fitting and sewing procedures, and considered any other newly discovered factors which could affect his decision. I got the impression, there would be at least a half dozen different valves, ready for implantation in the operating room or nearby.
We did discuss mechanical vs tissue valves because of the obvious ACT issues. We agreed that a tissue valve would be best for me. My second concern was that whatever valve was selected, that it not inhibit the possible use of a trans-catheter re-valve technique for a future second valve replacement. He said he always tries to up size the valve so a second valve-in-valve replacement would have as large an opening as possible. One of the ways he does this is through a sewing technique he uses which allows for a thinner sewing ring marginal and larger valve ring.
After the aforementioned discussions, I felt comfortable in letting him make the final decisions on brand, model, sizes, etc.
PS. I would also like to add that I am now two weeks post surgery, and there have been no major complications or setbacks. As many before have said, it was not nearly as severe a process as I was prepared to endure. So if your anxiety level has gotten the best of you, please know that many of us have not had any problems with this procedure. gordo
