Valve Question

[BGold]

JeffM
Do you know what kind of body chemestry produces calcium?

 

[Roberta]

JeffM
Do you know what kind of body chemestry produces calcium?

When I asked my surgeon this question, he said there is no definitive answer. He did say that the younger one is (i.e. under 50) the greater the risk of quicker calcification, possibly due to a younger metabolism.
I recall there being discussions on this topic and from what I can recall, researchers have not yet identified the cause for calcification of valves. Perhaps, someone else can chime in to provide more accurate information.

 

[socalhome]

I would agree that a great discussion with your cardiologist and surgeon about all the potential outcomes with either valve selection is warranted. Certainly with age and co-morbidities the likelihood of additional medications is always a possibility.

But, I would hope it best that recommendations about valves be limited to personal experiences and personal decisions. Perhaps posting any journal references as support for one type of valve without the a panel of expert academic research cardiologists and surgeons (who will also undoubtably have various opinions) is not best serving the group.

Having a background that was able to tap into these experts and interpret the journals, we found that there is not a "clear" choice. Certainly if there was, we wouldn't be asked to choose

 

[pellicle]

Hi

JeffM
Do you know what kind of body chemestry produces calcium?

it has been a while since my biochem degree and things have changed as we understand more. Calcium must be taken in, and isn't made by the body (it is an element), but I guess you were meaning who its put in 'the wrong places'.

I understood that it is thought to be based on the same metabolism which causes bones to generate (which is in itself not completely understood). There was some discussion that it is related to adsorption of calcium being transported in the blood (note: not absorption: http://en.wikipedia.org/wiki/Adsorption). Often stuff is 'generalised' over in metabolic biochemistry unless some pathway needs to be explored or the glossing over makes theory no longer fit (enough) observed facts. Certainly kidney disease is linked to calcification issues.

A quick skim revealed this interesting article:

http://www.ncbi.nlm.nih.gov/pubmed/21044018

Although vascular calcification was commonly regarded as a passive process of mineral adsorption or precipitation, it tends to be an active process associated with the expression of growth factors, matrix proteins, and other bone-related proteins.

Also, something to search on is Mineral metabolism: Spironolactone and calcification

which probably provokes more questions than it provides answers.

Certainly Calcium is moved about in the blood, but what other factors cause it to be plated onto artery walls, valve surfaces and even grow bony spurs on places while allowing for de-calcification of bones is as yet uncertain (as far as I know).

reading this makes me wonder if that helped at all ;-)

 

[Jkm7]

Hi



I never make any comments without either a reference to some facts or studies or with out the qualifications that "I don't know for sure" and / or "it is my impression".

the reference I have is from this company:
http://www.onxlti.com/heart-valves/...echanical-and-tissue-heart-valve-performance/



However they cite another references for their assertion. So (as they have a vested interest) I chased up that ref,
it is here: http://www.ncbi.nlm.nih.gov/pubmed/15225017


(emphasis mine)
Those references (6,7,11-17,29) (which you can verify by reading that above paper) are provided here for your convenience.



If you do continue this by reading those please post if the Steven Phillips was incorrect in his assertion of what the literature held . I did not follow up past his literature review. This seemed enough and given the journal (The Journal of Heart Valve Disease) is more credible than some TV show host claiming X Y or Z.



I feel there was an amount of sarcasm in your reply and based on other conversations we have had I feel that you don't like me or my views. That is of course your prerogative, but I take unkindly to harassment on a forum. I had hoped this forum would be more educated. Perhaps I'm wrong.

If I may ask you to in future to be a little less accusative in tone I would appreciate it. I am not a moron and anyone who has read any of my comments (and you have certainly commented enough to imply you have read them) would know that I don' like mis-information, try my best to make only factual and scientifically verifiable assertions.

If I wanted to fight I'd go pick up discussions on Apple or Android phones.

Facts are not football teams. You don't barrack for them.

You state you are accustomed to forums where attacks are common.
They are not here and certainly not appropriate here. Please keep your attacks over there and
Kindly stop it here.
This has always been a supportive, informative, comfortable and welcoming site. There has been none of this sort of ugliness and it isn't called for.
This site is not about any one person and so many of us have gotten so much information, comfort, support and relief here there is no room for personal attacks. We have enough stress in our lives.

I, however, am not a doormat.
The written word, without facial expression and body language, can be misunderstood. I am not a sarcastic person and there was no sarcasm intended in my question. You have read more than was written.
I ask you in public, in the most polite way I can find to please send any personal messages you may have for me in a private PM. Do not ruin this site with these sort of attacks on me or anyone.

Thank you if you can consider that. This site has been very important to me and to many other for many years....... No one has the right to ruin that atmosphere. IMO


Beats me why I bothered to respond. I probably should not have.

 

[JeffM]

Ah, tissue versus mechanical. Always a passionate issue. You make what you think are a few harmless comments and it's quite interesting to check back a couple days later and see the direction the conversation has taken. I admire the intellect and energy for research of some of the folks in this forum. I also appreciate the different reasons why each of us might want to make the choices that we might make. I simply shared mine for what they were and laid them out as honestly as I could. Glad I took 2 days to log back on because I couldn't have responded to BGOLD's body chemistry question as well as the responses I read! Thanks.

For what it's worth, if this current (extra large btw) porcine valve needs to be replaced earlier than expected, I'll have to make the choice again. At that time, I'll consider all my options as well as my lifestyle. No way I could tell you today the choice I would make then.

 

[njean]

This was our hardest decision. My husband 50, healthy no meds prior and compliant personality struggled with which type of valve. Both mechanical and bio were better than his own, but neither are perfect and both come with risks which led to many discussions with various physicians, surgeons, reading many journals for months. As our cardiologist has said, if it was an easy answer, there wouldn't be so many publications regarding choice guidelines. Know that any valve is better than your own, and hope for smooth recovery and lengthy duration before you have to make any choice again!

Well said!

 

[njean]

Glad to know you arrived at your decision. As long as you feel confident and comfortable with your choice, then go that route and don't look or second guess yourself.

Wishing you the best!

 

[Pat J]

I went with a mechanical valve and I'm 57 as I am terrified of surgery and doctors. My surgeon (Johns Hopkins) agreed with me, but said every other surgeon he works with would not as they are in the second phase of trials to replace aortic valves through a catheter. He said in 10 years valve replacement will be a same day procedure. He ALSO said that in 5 years there will be a much better replacement for comadin on the market. I told him I'm not a gambler and would prefer to never see him again.

 

[pellicle]

You state you are accustomed to forums where attacks are common.
They are not here and certainly not appropriate here. Please keep your attacks over there and
Kindly stop it here.

Actually I am saying YOU are attacking me and I don't like it. I have felt harassed (and I have expressed this). Please discusses things rationally. It is what I have been doing.

Beats me why I bothered to respond. I probably should not have.

Interesting. You threw it in my face then when I provide data to suggest where I got my views from you do not acknowledge that, then blame me?

The written word, without facial expression and body language, can be misunderstood. I am not a sarcastic person and there was no sarcasm intended in my question. You have read more than was written.

Correct, and I apologise if I have made an error in interpretation. Since you seem to know this so well, why didn't you consider using words such as may be more neurtral. Such things as:

..in my understanding

.. that is not what I thought, do you have any references to support your position?

Can you not see that your "I've never heard a percentage anywhere near that and would really like to read your reliable reference."

could be quickly interpreted as smug?

Please note THIS IS NOT A PERSONAL ATTACK it is simply asking.

Do not ruin this site with these sort of attacks on me or anyone.

can you please identify how providing you with answers to which you validly asked me to provide can be described as an attack on you?

I identified where I was feeling attacked by you, I think if you are genuine and there has been a genuine misunderstanding, then you could identify what I have written that caused you to feel I was attacking you?

You may not grasp this but I too am going through a lot. Seems all I get for my attempts to assist here is rejection and dismissal.

Your view suggests that I do not deserve any place where I can participate.

 

[clay_from_nj]

I do see that a lot of people choose tissue valves because of the noise of mechanicals. Funny, mine must be VERY unusual. I have to really work at trying to hear any sound from my valve. Once, standing in a quiet room, I thought I heard a clock ticking in the background and realized it was my valve. If I had to hear that all the time, it wouldn't be much of a problem. (For reference, my valve is a Medtronic OpenPivot supra-annular 24mm aortic. I am a 47 year old male, about 5' 8", 170 pounds, 32 inch waist, 40 inch chest.)

I think the real difference boils down to anti-coagulation vs re-operation. This in turn depends on your personal situation. How are you with taking drugs? How many OHS's have you already had? What other medical conditions of yours might be relevant to either medication or surgery? What kind of lifestyle do you lead? MANY other relevant questions. Just don't depend on unknown future advancements, like super-duper, side-effect free anti-coag drugs or quick-and-easy, in-and-out-in-a-day catheter valve replacements (which I doubt will ever be as good as a nice, solid, tissue or mechanical valve carefully hand-installed in a properly-prepared site).

If technology in this field goes as it does in others, we will get something we never expected, like valves constructed in situ by nano-bots or replacements grown from our own DNA, or maybe even a whole replacement heart. Then we'll all be arguing the relative merits of the super-silent turbine pump vs. the vat-grown clone vs. the in-place stem cell regeneration. I'm now concentrating on making my patched-up heart last long enough to try out one of those future technologies.

 

[enkaynj]

I was 51 when I got my tissue valve; went for it as the surgeon recommended it over mechanical valves because tissue technology has evolved and continues to evolve. Good Luck making the right decision for you.