Valve Decision - Mechanical or Tissue

[Lynlw]

OK, here's the news. Met with surgeon today and after he ran down to me the ups and downs of each (much of which I already knew from info from this site) we are leaning towards a tissue valve. The cat sure seems like he knows what he's doing. He is well experienced in this which made me very comfortable. We've got to move on this soon and my options are few.

I will go in on Monday for bloodwork and for CAT scan of the chest, which is like a card cath I received 14 years ago except it goes through the right arm instead of the groin. They will know more for sure after the tests but the guess here is surgery will be scheduled by late next week. I got a bunch of pamphlets to read from his assistant, and some do's and don'ts for before the Monday testing.

That's really all there is to report. Of course I will keep you all posted. Thank you so much for your input. I know it takes effort and is time consuming to write in this forum all just to help a stranger, but truly it is appreciated. God bless you all.

Johnny

I'm glad your appt went so well and you are comfortable with the surgeon. I am a little confused about the CAT scan. When Justin had his it was completely different than the caths he has had, it was more like an MRI and the only thing that went in his arm was the dye. I hope you get good results. Lyn

 

[just1gary]

Don't Forget The Surgeon

Don't Forget The Surgeon

Being this is my first posting I would like to add that you should also consider the surgeon you will be using and find out their preferences/experience level with the type of valve you want. You really can?t go wrong with either valve (depending on your situation) but if the surgeon you use has low experience with the valve you want than I would go fishing some more.

I really enjoyed BDMc comments and like him I didn?t have a choice, but what was more important to me, was that the surgeon I used. His experience and technique was the reason I went with him, Taro Yokoyama, otherwise I would have gone Cleveland.

Gary: 8/7/06 St. Jude Mitral Valve, St. Vincent Los Angeles. [/FONT]

 

[Karlynn]

Welcome Gary - when you get a chance, tell us some more about you and your experience!

 

[S2R1000]

Valve selection and location

Valve selection and location

I am 6 months out and selected an On-X mechanical valve with reduced INR from Christ Hospital in Cincinnati. My wife and I plus both parents (physicians) searched all over the USA and in Europe where my Uncle is a noted surgeon. We visited five hospitals and interviewed six surgeons. Basing our criteria on who does the most surgeries, nurse to patient ratio, age of ICU recovery recent Strep episodes etc...(dozens of issues).
We found Dr Thomas Ivey at Christ Hospital the most qualified working in state of the art best facilities. He opens you and closes you, that may not be the case in all places. Some notable locations actually teach on you. I guess that needs to be done but I preferred not on me.
I chose a mechanical valve for its reliability and long life. Remember that a organic bio valve lasting 10 years to replacement starts going bad way before they replace it in 10 years while that number may actually be much shorter if you are young and active, Im 37.
The On-X valve was designed as the third itteration of the Bileaflet valve made by Dr.Bokros and represents state of the art hemodynamic performance. So its not really new, just the third in a long series of improvements. Its very efficient so its likelyhood of developing a clot at the hindges is really reduced. It looks cool too, Im an engineer so I obviously looked into the construction of the valves including interviewing the actual factories (VP level and up) They were very willing to speak with me and open up about the type differentiation and features.
ITs newer so some dont recommend it but mostly because heart surgeons switch valves less often than wives.
Its a bit more difficult to install according to some leading surgeons in the field but I wasnt looking for an easy one done by someone with less than perfect skills.
Dr Ivey did a great job, Christ Hospital is a great place and I feel wonderful.
By the way it wasnt without glitches as my Aorta was huge and they were able to adjust the game plan to include a replacement in with the valve job, which is why you need an experienced well equiped team. Just in case.
Good luck to you and dont worry, you will be fine.

 

[Karlynn]

Welcome George! If I were to need to have my St. Jude replaced anytime soon (still going strong at 16 years w/out tissue encroachment) I would be extremely interested in the On-X for the reasons that you stated. Best wishes with your new valve and your new lease on life.

 

[geebee]

Welcome Gary and George.

Gary - I used to live very near to Rolling Hills Estates - beautiful area.

Both Los Angeles and Cincinnati have great hospitals. I looked into Cleveland for my last OHS but my insurance wouldn't allow me to go there. I had my surgery at Jewish Hospital although most people in the area choose Christ. My surgeon was in charge of the OHS unit at Jewish at the time so Jewish made more sense to me. Not sure what I would do if I ever needed a fourth surgery.

Hope all continues to go well with you both.

 

[S2R1000]

Dont worry about a fourth unless you need to worry. Take good care of yourself and enjoy what you have.

 

[S2R1000]

Hello Everyone.
Thank you for the welcome. I am glad to be here and blogging. I would be more than happy to help anyone with the information I collected to help them make their own choice. Feel free to email me.
Things are going well and I am really happy with my choice. The main reasons for choosing the valve were the driving force behind choosing the location. It was a predetermining factor. I mean that choosing the valve helped me choose locations. One of teh worlds best AVR surgeons said to me "I guess we ought to start stocking more of those On-X valves". If you see the surgeon and hospital first, they are already predisposed for a certain procedure and valve, so you need to be balanced and careful in teh analysis. They have more experience in one form (valve / procedure) than another and they overlap in application so its natural for them to have a preference.
Some people just want the salesman to tell them which car to buy, others come in ready to roll, while some have no idea how they were sold. It depends on the individuals desire to be involved in teh decision and the level of responsibility they take for their own outcome. Either way there are many who are willing to step in and support you at any level of the decision making process.
There is an FDA trial for reduced INR and even no warfarin for the On-X valve. In africa it turns out a bunch of noncompliant patients have suffered no apparaent ill effects to not taking anticoagulants. It will be a while before I would ever take the risk even if they do say its OK (risk reward?). Good to know thought that reduced INR is OK and heavan forbid that brocoli sandwhich gets to me, Ill still be OK. I beleive they told me that the valve is statistically tested for over 300 years of service life.
On-X seemed to be the best choice for me. Im glad to be around and Im incredibly grateful for how fantastic this country is with healthcare. My choice, my responsibility, my life, my way.
I delivered my second son four months after surgery.

 

[uchong]

ON-X Valve

ON-X Valve

I am 63 and had the on-x in July 07 and have the hope of no coumadin. no pig skin for me i know a friend who had it and in 5 years they had to do it again because it wore out.

Bill

 

[BDMc]

Great Posts!

Great Posts!

Just wanted to say I think this guy has provided two of the best posts I've seen on the subject! Sorry for shouting, but sometimes it really seems appropriate. Thanks for the information! Knowledge is power. All the best, Brian

Hello Everyone.
Thank you for the welcome. I am glad to be here and blogging. I would be more than happy to help anyone with the information I collected to help them make their own choice. Feel free to email me.
Things are going well and I am really happy with my choice. The main reasons for choosing the valve were the driving force behind choosing the location. It was a predetermining factor. I mean that choosing the valve helped me choose locations. One of teh worlds best AVR surgeons said to me "I guess we ought to start stocking more of those On-X valves". If you see the surgeon and hospital first, they are already predisposed for a certain procedure and valve, so you need to be balanced and careful in teh analysis. They have more experience in one form (valve / procedure) than another and they overlap in application so its natural for them to have a preference.
Some people just want the salesman to tell them which car to buy, others come in ready to roll, while some have no idea how they were sold. It depends on the individuals desire to be involved in teh decision and the level of responsibility they take for their own outcome. Either way there are many who are willing to step in and support you at any level of the decision making process.
There is an FDA trial for reduced INR and even no warfarin for the On-X valve. In africa it turns out a bunch of noncompliant patients have suffered no apparaent ill effects to not taking anticoagulants. It will be a while before I would ever take the risk even if they do say its OK (risk reward?). Good to know thought that reduced INR is OK and heavan forbid that brocoli sandwhich gets to me, Ill still be OK. I beleive they told me that the valve is statistically tested for over 300 years of service life.
On-X seemed to be the best choice for me. Im glad to be around and Im incredibly grateful for how fantastic this country is with healthcare. My choice, my responsibility, my life, my way.
I delivered my second son four months after surgery.

 

[Soilman]

Johnnycake,

I had my bicuspid aortic valve replaced back in Aug. at age 43. I lead a fairly "rough and tumble" lifestyle and was a little worried about choosing a mechanical valve because of the coumadin issues. I finally decided on an On-X mechanical because I didn' t want a "do over" in 10 years. I've had no regrets. The coumadin has been no big issue at all. The little cuts and scratches I used to ignore...well, I pretty much still do. My INR is being kept between 2.0 and 2.5. The coumadin...it's just another pill I take.

Good luck

 

[Susan BAV]

Johnnycake's situation sounds as though it's a fairly urgent matter; anyone know if/when he had surgery?

 

[johnnycake23]

Hi there. I saw the last posting and thought I'd give a quick update. I had my surgery on November 19 an Northwestern Hospital in Chicago. Obviously I made it through, but it was a tough go. After discussing with surgeon I decided to do a tissue valve. I was supposed to be in ICU for two days........and I was actually in for five, due to complications. It turns out my body did not like being on heart/lung machine, and my lungs got lazy, to the point where one collapsed. I was on heavy oxygen for a while - picture being in a wind tunnel with a constant breeze in your face. The biggest pain was brain freeze (no kidding). It's almost four weeks now.

Anyway, I will continue the post in the Post Surgery section. But let me say here thanks for everyone's input. It is very comforting to know others have gone/are going through this.

 

[Phyllis]

Thanks so much for the update and we will look forward to hearing more from you in the post surgery thread. So sorry you had such a rough time and hope that all is uneventful and easy from now on.

 

[Susan BAV]

Thanks so much for the update and we will look forward to hearing more from you in the post surgery thread. So sorry you had such a rough time and hope that all is uneventful and easy from now on.

I will just "ditto" what Phyllis said here. Very glad you're doing better now. Take care and post again.

 

[Ross]

Obviously I made it through, but it was a tough go.

Care to elaborate on your experience a bit deeper? You can PM it to me if you'd rather not post it, but it would be better for all if all could be included. You don't have too, just asking.

 

[S2R1000]

mmmmmm BraIN fREEZe

mmmmmm BraIN fREEZe

Any open heart you can walk away from is successful. My three days turned into a week too. I wasnt great on opiates and I decided to turn into part plant acidic blood and post operative CO2 or something. Nothing like taking it home on OTC tylenol and advil. Ouch.... They say the pain subsides sooner but I think its like something other people who dont feel it say you know.
I bet you will never look at chugging icecream the same way again.
Good to hear you are out and about.

 

[tjadams]

I am 28 years old. Two weeks ago I chose tissue. Now if things go well I will need a replacement before I am 55. I personally believe that the trials they are doing today with robotic assisted non chest cracking surgeries will be the norm in 5-10 years. I also believe that in 15 years they will have a more permanent solution for valve replacement being either a mechanical valve that does not need blood thinners, or a tissue valve grown from your own cells. In either case, My guess is that in 20 years we can all get our substandard valves replaced in a 4 hour day surgery and be out within 48 hours.

Now is this guaranteed? Of course not. I feel it is very likely.

If nothing else the pain killers can only get better :O

 

[marie]

I am 28 years old. Two weeks ago I chose tissue. Now if things go well I will need a replacement before I am 55. I personally believe that the trials they are doing today with robotic assisted non chest cracking surgeries will be the norm in 5-10 years. I also believe that in 15 years they will have a more permanent solution for valve replacement being either a mechanical valve that does not need blood thinners, or a tissue valve grown from your own cells. In either case, My guess is that in 20 years we can all get our substandard valves replaced in a 4 hour day surgery and be out within 48 hours.

Now is this guaranteed? Of course not. I feel it is very likely.

If nothing else the pain killers can only get better :O

What type of tissue valve did you choose if you care to share
Earline

 

[Karlynn]

I am 28 years old. Two weeks ago I chose tissue. Now if things go well I will need a replacement before I am 55.

What valve did you get? Did your surgeon really give you that long a projection for how long a tissue valve will last in a 28 year old? 27 years is a "reaching" projection for a 65 year-old. Don't get me wrong - I wish you 27 years with your tissue valve, but I don't want other young adults thinking that they have the same tissue valve longevity as older adults.

Best wishes.