Valve Questions

[tigerlily]

I've got about a week or less to make my final valve replacement decision. I may be asking questions that have been answered before but my time for research is growing short. My surgery is scheduled for March 7.

1. If I go tissue, should I worry that being very active will shorten the valve's life? I am 53 by the way.

2. I know mechanical valves are lasting for 30+ years. However, what are the chances that complications involving the valve might develop that would require another surgery anyway?

3. I have spoken with a co-worker of my husband who had mitral valve replacement with a mechanical last September. She is having a horrible time getting her INR regulated and has given up brocolli, greens, and salad etc. She says she has tried very hard to incorporate these foods in her diet but so far no success. This doesn't jive with what I've read in this forum. What do you think might be going on?

4. Is there a good site where I could go and read for myself the statistics for tissue valve longevity related to age of recipient?

That's it. I greatly appreciate that people here are supportive of a person's valve choice regardless of their own personal choice. I'm also glad that people aren't reluntant to share their personal views and experiences. As always, thanks so much for your help.

 

[geebee]

You are facing what will be one of the most difficult decisions in your life. You are lucky, however, that you get to make that decision. Many of us did not (at least I did not the first 2 times).

My understanding is an active lifestyle does not affect the tissue valve unless you are much younger. I could be wrong and I am sure you will hear from others regarding that question.

I am one of the people where having a mechanical valve did not avoid another surgery. However, it was not the valve's fault, it was my system's. I am a person who creates a lot of scar tissue and required additional surgeries because of it. So, yes, a mechanical does not guarantee a life free of more OHS. However, a tissue valve definitely will require another surgery.

I have never had problems with my INR and have been on the same dose of coumadin (with little tweaks here and there) for more than 25 years.

Some people do have trouble regulating their INR but they are the exception, just like I am the exception when it comes to mechanical and future surgeries. Altering what you eat to regulate your INR is indicative of a doctor who does not know how to inform patients of what to do. You do not have to change your eating habits, you just need to be somewhar consistent in what you eat. You do not want to avoid greens for months and then eat nothing but greens for a week. You should included a little of everything you usually eat in your weekly diet and everything should work out fine.

I do not have the site information on tissue valves but I know there are plenty. I am sure those will come along also.

Best of luck to you and I hope you are able to make a decision you are comfortable with. Just remember, once you make that decision, don't second guess yourself. Keep in mind that what you decide was the right choice when you made it.

Take care.

 

[MikeHeim]

I can only help with your first question. I was considering a tissue valve before my surgery and had the same question. I was 28 and led an extremely active lifestyle including marathon running, hiking, surfing, etc. After many hours of internet research, I was unable to find any link between an active lifestyle and tissue valve life. The calcification time seems mostly tied into each person's particular body chemistry. Unfortunately, nobody has found a way to determine how this chemistry will interract with the valve until it is in your body.

 

[tobagotwo]

I agree with Gina about INRs. Fluctuations can be more difficult for some people, but the main admonishment here is to "dose the diet, don't diet the dose." (Is that Ross's? It should be attributed to someone...)

The other thing is that the quality of the Coumadin clinic you're going to makes a big difference in your numbers. Some clinicians seem to knee-jerk with every change, and that throws people off more. In my view, the best answer is self-testing. Studies say that people are much better at minding their own store than having others monitor them.

A far as your friend, be aware that mitral and aortic valves have some differences. The mitral valve is often kept at a higher level of anticoagulation (higher INR level) than an aortic valve. The slower blood flow there increases the risk of clot formation. Apparently also because of the slower bloodflow there, tissue valves calcify more rapidly in the mitral position and don't last as long. Because of this, and because the mitral surgery is in a more electrically active area (meaning post-surgical afib is a higher risk), mitral valves are more often replaced with mechanical valves than are aortic valves.

Best wishes,

 

[Gemma]

3. I have spoken with a co-worker of my husband who had mitral valve replacement with a mechanical last September. She is having a horrible time getting her INR regulated and has given up brocolli, greens, and salad etc. She says she has tried very hard to incorporate these foods in her diet but so far no success. This doesn't jive with what I've read in this forum. What do you think might be going on?

Hi Tigerlily,

From what you've written, it sounds as if the woman you spoke to has been changing her diet to fit in with what she's been told she can do (ie eating greens) rather than sticking to what she's always been happy eating. Whether you're giving up greens because you're told you can't eat them, or as in her case, trying to eat more because you've been told you still can, either way it won't work out! If you choose a mechanical and therefore warfarin, just keep on eating what you've always done. That seems to be the best way to avoid problems. As someone said a while back, humans are pretty predictable and usually eat roughly the same each week.

As I understand it, you're at an age where a tissue valve should last a pretty long time. I think it tends to be people in their 20s and 30s who find the lifespan of a tissue valve is less than the published figures. Not sure about the likelihood of problems with a mechanical valve - they'd be things like scar tissue as Gina said, or clots, maybe the need for bypass surgery down the line, that kind of thing.