Valve duration

[axs028400]

Hi, I am new to this forum and just have a few questions. Since 2000, I have had a dilated aortic root. Recently, I visited the cardiologist and it was really dilated (I had a feeling that it was since I had been really tired). Following rest and keeping my stress levels down, it is feeling better and I am going back to be re-echoed in about a month and a half. My problem is, I am a 26 year old active female and am going to begin medical school in the fall. If it is as stressful as they say, valve replacement may be my only option if the dilation does not stay under control. So my question is, are there any valves that would last me the rest of my life (and I want to be around for awhile!)? Also, what are the possible effects of valve replacement surgery on any future pregnancy, as I would like to have a kid when I'm done medical school. Finally, are there good surgeons in Dallas, or are there only a few in the nation that are experienced in performing this surgery. Sorry for the long post, but I really have a lot of questions.

 

[Karlynn]

Welcome to our forum!

Do you have your exact measurements that you can post. This place has a lot of very educated lay-people and your measurements on your dilation etc. would give us a better idea of just when you might be looking at surgery.

As far as valves- mechanical is obviously the one that will last you the longest, barring rare complications. Whether it will last a lifetime is unknown. If you are considering pregnancy, then I would recommend that you go with a tissue valve. It's not unheard of to have a child while on Coumadin, but it's very complicated and risky. The only problem with tissue is that you are young and tissue valves don't last nearly as long as the projected figures for a particular valve will show. Depending on when you have your surgery and how long after you plan to have a child, you may be looking at a second tissue replacement before a pregnancy.

 

[Phyllis]

Welcome to our forum. There are lots of people here to help you understand the difference between valves and being pregnant with valve disease. One place for you to start may be this thread: http://valvereplacement.com/forums/showthread.php?t=14564&highlight=pregnancy
If you put pregnancy into search, you will come up with many more threads and you should also check out the threads on valve selection.
There will be many more who come along to help. We wish you the best in your research and the decisions you will need to make.

 

[Phyllis]

You might also check out this thread on choosing a surgeon: http://valvereplacement.com/forums/showthread.php?t=6276&highlight=surgeons+dallas

You can check the best hospitals and doctors on this site:
http://www.usnews.com/usnews/nycu/health/hosptl/tophosp.htm

 

[axs028400]

Thanks for the quick responses....

Thanks for the quick responses....

I don't have an exact measurement, but I think I remember my cardiologist saying that I was in the 98.5th percentile and the 95th percentile or less was considered acceptable. I'll ask when I return. If pregnancy does require a tissue valve, I will probably consider adoption, but I'm not sure yet. I do know that it will be about 8-10 years before I would have a child. I would prefer to do this once if necessary and that's it. Last semester, my heart rate went up to about 90 beats/min when resting and it's normally in the 60s, and my BP is now around 128/82. I know that this isn't anything major, but it used to be about 110/60 (I exercised a lot). Fortunately, my HR is now down to about 70. Anyways, I appreciate all of the quick feedback. I'm really glad to have found this site!

 

[mmarshall]

i had my avr surgery last may so you can read my posts from back then or email me if you have any questions. i had my surgery done by dr. william ryan at presby of dallas and had the best experience one can have. there are some more of us that get on here from time to time that also had a great experience with dr. ryan. i visited three different surgeons in three different groups at 3 different hospitals...lol....so i did some research around here before my surgery. the worse part about the surgery is the pre-stress before hand.

 

[RCB]

How to help us help you

How to help us help you

Welcome to Vr.com,
You need to get a copy of your last echo(s). Many people here are good at explaining them to you. Also, you can plot your own progress. There is much good advice here, some already posted for you and some will be along to advise about Dallas surgeons.
You can think about a surrogate mother to carry your egg if you can't.
There are website to match you up.
Good luck and remember were here to help.

Hi, I am new to this forum and just have a few questions. Since 2000, I have had a dilated aortic root. Recently, I visited the cardiologist and it was really dilated (I had a feeling that it was since I had been really tired). Following rest and keeping my stress levels down, it is feeling better and I am going back to be re-echoed in about a month and a half. My problem is, I am a 26 year old active female and am going to begin medical school in the fall. If it is as stressful as they say, valve replacement may be my only option if the dilation does not stay under control. So my question is, are there any valves that would last me the rest of my life (and I want to be around for awhile!)? Also, what are the possible effects of valve replacement surgery on any future pregnancy, as I would like to have a kid when I'm done medical school. Finally, are there good surgeons in Dallas, or are there only a few in the nation that are experienced in performing this surgery. Sorry for the long post, but I really have a lot of questions.

 

[tobagotwo]

It's very difficult to have to hear a diagnosis that leads to open heart surgery, particularly at your age. It sounds like your circumstances haven't really sunk in yet. We in this forum truly understand how hard it is to deal with, and I want to welcome you to our company.

As for your question, a mechanical valve will give you the longest service, without doubt. However, no valve can promise you a lifetime at your tender age. Any of the top brand mechanical valves can easily outlast you structurally, but your heart may give cause for it to be replaced (or have another OHS), by another valve having an issue, tissue growth or interfering with the valve, a blood clot, or development of myxomatous (weakened) tissue.

Without intending to be a wet blanket, I have to suggest that this may not be an isolated incident in your life that you won't ever have to think about or deal with again. If you're considering Med school, this would be an excellent place for your medical curiosity to start. Knowing as much as you can about your condition is your best defense in the long run.

As you are still quite young to have a dilating aortic root, you should be aware that you might have some other, related connective tissue problems. It might make sense to ask your cardiologist about testing you for early signs of aortic aneurism. You've not mentioned a bicuspid aortic valve, which would not be unusual with an enlarging root, nor mitral valve prolapse, another possibility. Sometimes a bicuspid valve is not very obvious, even on an echo.

If you have more issues than the aortic root (and you may not), it might be wise to understand what they are first, rather than agree to a surgery which could just leave you open to another surgery when the next thing pops up. I only bring this up because an expanding root can be a marker for connective tissue problems, as can a bicuspid aortic valve.

Please understand, I'm not trying to frighten you, or to make you worry about things that may not be problems at all. I'm just suggesting that you should be aware and assertive in understanding exactly what your condition is, as that is the best way I know of to avoid unnecessary future surgeries.

Best wishes,

 

[Tom F.]

At your age and considering your desire to have a child I would encourage you to look into having the Ross Procedure done. There are many posts here, and a great deal of information on the internet regarding the Ross. You might want to look into it.

 

[axs028400]

Wow! Thanks for all of the responses

Wow! Thanks for all of the responses

If I do have to look at this surgery in the future, I will definitely consider Dr. Ryan, and I know Presby Dallas really well (I currently work there as a physician scribe, a pre-med job, part time). I will look into a Ross procedure and get a copy of all of my past echos the next time I see the cardiologist on March 20th. It is a very frustrating place to be, b/c I will feel better for a year or two, and then all of sudden start feeling horrible again. I understand that they would probably like to put off surgery if possible, but I am just so active and not being able to exercise and feeling tired all of the time stinks. I did have mitral valve prolapse about 2 years ago, but this time on my echo there was none. I have never been told that I have bicuspid valve but will ask again when I go in. Thanks again for all of the advice!

 

[mmarshall]

if you are looking into the ross procedure...definitely have a visit with dr. ryan....he has done over 200 procedures (recommend finding someone that has done at leat 150 rp). the plan for me going in was to have the ross pro. done and he recommended a tissue valve as a backup. given my situation that was the best thing to do. the ross did not work out due to the enlargement of my heart but it has been going down since surgery and may be possilbe to do it the second time around. actually...looking back...i'm kinda glad i had to get the tissue valve since given my age...i am looking at 2 surgeries in my lifetime....and i'd rather worry about one valve for the next 10-15..hopefully 20 years. i did not have any signs of fatigue or short of breath and worked out all of the time. i just went in for a long over due check up since my bav was detected when i was a week old...then was told that i needed ohs in the next 6 to 8 weeks. so yea...i know where you are coming from when you get a bomb like ohs dropped on you (especially when you feel just fine). we all have gone through that feeling here...and being stuck in limbo of being told ohs is in the future....that's just torture to one's mind.

 

[roxdrop]

Hi!
It looks like you've already received many thorough responses, but I just wanted to put in my two cents since we seem to be somewhat similar.

I am 24, female, active, starting medical school in the fall and don't have much of a choice about going in for a valve replacement next month. My main concerns related to life after surgery have been that I will be able to handle the rigors of medical school, and that whenever I am ready, I will still be able to have children.

My cardiologist and I decided it would be best for me to get a tissue valve to prevent pregnancy complications from Coumadin, even though this means I will need a new valve in 10-15 years (although the surgeon tells me 20 years). I am actually looking forward to getting the surgery/recovery out of the way so I can go to medical school with my health intact and deal with the second surgery later on down the road. If I did have a choice about surgery, I would still have it ASAP- especially if there were any chance of needing it during med school/residency. That would be even more miserable! As would heading to school with my questionable health status/fatigue/etc. My general advice is to go ahead with surgery without delay if your doctor and surgeon decide you are a candidate.

Good luck!

 

[chilihead]

Check out Dr. Ryan. He will talk straight to you and is a great surgeon. Good luck.