valve choise for radiation damaged valve

[mac]

just got back from 2 days at Mayo. Had another Eco to confirm that I have sever aortic stenosis. My surgeon is adamant about using a mechanical valve, since I had radiation to my chest back in 71 for Hodgkins. Said he doesn't want to see me back in 10 years or sooner. He said he has had tissue valve people back sometimes within a year because of the complications due to healing and etc from issues with tissue valves placed in people who have had radiation damage. I would like to hear some other opinions from people who have had radiation damage and have tissue valves I really do not want to be on blood thinners the rest of my life, but also the second operation 15 years down the road is very high risk with radiation damaged hearts. Also is it really that hard to regulate blood thinners?

 

[Bina]

Hello and welcome.
We do have a couple of members who have had VR after previous radiation damage, they will be able to discuss this with you.
Regarding anticoagulants, the majority of us don't have any issues with them at all.
The trick is to be consistent in your lifestyle and eating habits (whenever possible) and be tested regularly.

 

[dl_mooney]

I have a On X valve in the Mitral Position (ITS GREAT). Surgeon wanted INR level of 2-3. I take take Warfarin 3Mgs Monday & Friday & 4 Mgs all the rest of the week.My insurance has a Coumadin clinic. Was thereThursday level was 2.3 so was pleased. Dont have to go back for a month.Will go on home testing likely after the first of the year,& work through the clinic.So its not bad at all.Best wishes.

 

[LuckyGuy]

Hello Mac,

I too had Hodgkin's Disease and had radiation therapy (in 1980). I had both my mitral and aortic valves replaced three months ago.

My surgeon (Dr. Bruce Lytle at Cleveland Clinic, who is known as something of an expert on radiation-damaged hearts) also advised me to have mechanical valves. He stressed that not only are the valves tricky due to radiation, but that the areas that the valves need to attach to are often thickened, scarred, etc., from the radiation damage. I know that in my case I had thickening of the heart walls (leading to moderate 'hypertrophic cardiomyopathy') and some damage to the coronary arteries as well as the two stenotic valves.

Dr. Lytle said he doesn't like to do 'reoperations' (which is what you'd need sometime if you got a mechanical valve) on radiation damaged-hearts. Considering both his advice and my relatively young age of 46 I opted for the mechanical valves.

As you probably already know, the downsides of mechanical valves are the need to take Warfarin daily and the sound of the valves. I was already facing a lifetime of daily medication (Synthroid, for a hyperactive thyroid, which you might have as well from the same radiation therapy), so I'm not expecting it to be a big deal.

As Bina said, there are quite a few here with radiation damage (and several of us with Hodgkin's Disease specifically), so I'm sure others will chime in.

 

[mac]

thanks

thanks

appreciate the input....25 days to surgery.

 

[flowergal]

Hi Mac,
I had radiation in the past to my chest and neck area over 35 years ago, I had a homograft placed in the aortic valve in 2000 and is still functioning well.
I have other complications secondary to the surgery. You can Pm me if you wish. Good luck.

Flowergal

 

[katie1234]

Hi there,
My mom had radiation for Hodgkins in the 1970s and got her aortic and mitral valves replaced in July 2007. We got several opinions and everyone said to go with mechanical for the reasons you and LuckyGuy stated stated. So she had decided to go with the On-X valves but when she came out of surgery, we were all surprised that she had two cow tissue valves instead of the mechanicals. The surgeon (Dr. Karl Krieger at NY Presbyterian) explained to us that given my mom's scarring and calcification, the tissue valves were a much better fit for her (he said this is not usually the case). Two years later, the valves are working really well. So she was definitely going to go with mechanical, but ended up with tissue and it's working out. That said, there is always the risk that in the future she will need another operation. Hope that is not too confusing and best of luck to you!

 

[Anne-Marie]

Hi Mac, I'm glad you found this wonderful forum. I learned so much from the people when I was facing surgery.

I had radiation for Hodgkin's back in '74. My heart surgeon recommended a mechanical valve because of my age, saying that it would last much longer, and I might be able to avoid having multiple surgeries to replace worn out tissue valves. I was never told that a second surgery would be more difficult on a radiated heart, so I'm glad I've got the mecanical valve! Mine is an On-X.

Again, welcome, you'll find there are many of us with radiation induced heart problems. Just run a search on radiation or hodgkin's!

Anne-Marie