Valve selection for older folks

[Marge]

I still haven't talked to my surgeon about what kind of valve to put in if he can't do a repair. I assume we'll go through that when I see him on Feb. 6 for the surgery on Feb. 12.

I've read up as much as I could on this valve selection thing, and read through a lot of the archives here. I'm still in a quandary as to what to tell him about what I want.

If I were a kid like so many of you here I wouldn't hesitate. Mechanical all the way. But -- I'm in my sixties. Oh, OK, the heck with it, I'll go ahead and ADMIT it -- I'm 66. The standard wisdom, apparently, is that people my age get tissue valves. The tissue valve theoretically will outlive you.

HOWEVER: people in my family live very long lives. All my grandparents lived into their 90's except for my Texas grandaddy who died at the early age of 86 (but, then, he led a hard life & was a heavy drinker). Both my parents died at 96. I surely don't expect to live that long -- given the valvular disease and the CHF. But I don't have any other medical problems, and my CHF seems to be under pretty good control -- when I said something about "years" of life expectancy the other day to my cardio he said that he thought I'd be around not for "years," but for "decades." (Course he may have been kidding.)

I'd hate to be having to think about another OHS in my 80's. (Of course, it's perfectly possible that techniques will have changed so much by that time that it wouldn't be nearly as strenuous as it is now.) OTOH, I'm sure that I could deal with anticoagulant therapy, but it would be nice not to have to.

 

[Birky]

valves

valves

First of all, you aren't that old. I had a St. Jude put in at 55. This should alleviate another surgery down the road. The Dr. said that they put tissue valves in the very young or people my age and older that they don't think will live more than 10 years or the life of the tissue valve. The coumadin is not such a big thing as some people make it out to be. I took it for 7 years or so prior to surgery but at that time, the Drs. here did no regulate very well. My reports are now sent to a Coumadin Clinic and they are wonderful. Has not changed my lifestyle much. Just have to be a little more careful with cuts. If I was 66, I would have gone with the mechanical. Really don't want another surgery in lates 70s or 80s. Imagine the recovery is a little difficult. The other aspect with the tissue valve is that maybe 10 years from now there will be a new way to operate and there will be some new things out there.

 

[ALCapshaw2]

My first choice (at age 58) was a Bovine Pericardial Valve but I ended up with a St. Jude Mechanical instead due to 'extenuating circumstances' once the sugeon got a look 'inside'. My valve is working just fine and I've only had one 'incident' with Coumadin where I was passing blood following an unexplained jump in INR (between 4.5 and 5.0). My INR before and after that incident has been stable.

I still like the Bovine Pericardial which has a very good chance of performing well for 15 to 20 years (or more) when inplanted in people over 60. It is the 'valve of choice' at the Cleveland Clinic.

'AL'

 

[Rich]

Marge,
That is a tough decision.
At the time my surgeon said I was too young for a tissue valve,
I was 58 at that time.
So I received a St. Jude mechanical and now I'm approaching 66.
I would not want to go through another surgery when I'm in my seventies or eighties, I think recovery would be a lot tougher.
I've had mine now for about seven and a half years, it's been great. The Coumadin is a bit of a pain sometime but really hasn't been a big deal. It hasn't stopped me from doing anything whatsoever, just need to be a little more careful these days.