Valve selection

[Neil R]

I found this website quite by accident! I am glad I did!

I am approaching valve replacement surgery next month, actually 2 weeks. (Jan 4th) I have been agonizing over which valve I want for about a month. What I have learned on this web site, that my doctor didn't mention, has been very helpful.

I have waivered back and forth, but now I am leaning for the biological (bovine) valve. I have learned that the mechanical valve can be qiute noisey. i am not a big person, just average size, and I think being able to hear that noise would drive me nuts!
I know most of the pros and cons of both, but would be interested in a discussion of actual experience to help me decide.

Thanks

 

[MarciaB]

Hi Neil! Welcome!

I think you will find from this site that everyone is different when it comes to how much noise their valve makes. I don't think it is noticably louder for those folks on the thin side. It is louder for those with good hearing, though! I have a brand new valve and I mostly hear it when I wake up at night. It doesn't keep me from going back to sleep (lots of other stuff going through my head), and I kind of like the sound. Our family has always been big on party tricks, now I have one! I think there are bigger issues to think about when considering valve choice, like how you feel about being on coumadin and the possibility of another replacement down the road. A second surgery is never the same as the first, and adding 15-20 years to your age at the time of second surgery is something to consider.

Good luck! I'm sure you will find a lot of valuable information and maybe some friends, too, on the site.

Marcia
MVR Dec. 9, 2003

 

[Nancy]

Hi Neil-

Welcome to the site. It's a great place. Loads of support and friendship from folks who've walked the walk.

My husband has 2 mechanical valves. He's very used to them, so doesn't pay any attention to them. I don't hear them much either.

I don't know your age, but having to have another possible surgery later on in life at an advanced age is something that you should be thinking about. It's pretty tough surgery, and the second one is a little more difficult. Plus before you would get approved for a second surgery, you will probably have many symptoms for quite a while, and that won't be pleasant.

Joe's been on Coumadin for 26 years. he doesn't consider it a problem. It's just another pill to take, one of many.

 

[bvdr]

Welcome Neil,

I think two people having the same model valve would most likely still have different experiences with their valve. I think mine (St.Jude's Mechanical) is very quiet and when I do hear it, I find it very soothing. My husband doesn't hear it. My cardio's nurse says she can hear it across the room....but she is very young.

You will most likely find we are all pretty content with the valves we have recieved. We recognize that it is a life saving surgery and the fact we even have been able to have choices is truly amazing.

I was on coumadin before surgery for atrial fib. I have adjusted to it and for me it isn't a big issue.

I hope all goes well with your surgery and that you too are pleased with your choice.

 

[ALCapshaw2]

Hello and Welcome aboard Neil,

My First Choice was for a Bovine Pericardial Valve but my surgeon felt a St. Jude Mechanical was a better choice after opening me up. I've learned to live with the Coumadin but there are times I still think I would have preferred the Bovine Valve. Only rarely do I hear my valve (such as if I take a deep breath and hold it in, or if I have a 'pounding' pulse).

AVR was my Second Heart Surgery, having previously had Bypass Surgery. The recovery was different from my first surgery, better in some respects but more difficult in others, especially regarding my lungs and fluid retention. It is my understanding that risks become significantly higher for a third surgery. Bottom Line: Getting 15 to 20 good years from a Bovine Valve still sounds pretty attractive to me.

What Hospital will you be going to for your AVR? I hear very good reports about Beaumont Hospital in Royal Oak.

'AL' (a former Michigander in my 50's)

 

[Kenny F]

Welcome aboard, Neil!

I had AVR 11/17/2003. I had decided to go with the bovine percardial, but leaving my surgeon room to move. I knew he wasn't too big on mech. As it turns out, he used a homograft because my aortic root was distended. That way the valve and root repair are all one piece.

It really matters what your surgeon thinks - you have to trust him with your life. The bovine has a great track record, good for 15-20 years and beyond. The homograft has a similar record. I found great appeal in getting better and not being on coumadin and not thinking much about it after I recovered. I am not on coumadin, just temporary Cardizem to slow my heart down.

The down side to homograft is supply. The bovine would be my first choice hands down. But there is no bad choice - the alternative sees to that.

 

[joey]

Shalom Neil, I was in the same predicament as you are now machanical or bilogical it drove me crazy. I dont think it realy matters as long as we can be given that extra years on our lives. Basicly both valves have their good and bad sides. I am 63 years old healthy ,was very fit before the AVR . It is now 6 weeks since I had the replacement. My surgeon suggested the machanical I reqested the bilogical. I did receive the bilogical and I am aware that 15 to 20 years down the road if I am still with the living I am going to have to replace the valve. I will request another bilogical valve. I think I will be too old to mess with coumadin however I must admit I am having very little problems with this medication. I think it all depends on ones medical history and health that can cause havoc with your recovery. The first four weeks was hell. To day I still do not sleep too well but I am back walking and exercising with light weights. I even managed to dance a few tango"s. I know that when I am older the recovery time will be longer the pain more servere I know that my good wife may not have the strength to help me and help I am going to need. I will worry about it when the time comes. Best of luck Neil. It's not that BAD so dont worry too much . I have a friend who too chose a bilogical but woke up after the op with a machanical. He is 72 five years later doing very well .

Joey

 

[Gail in Ca]

I didn't realize how noisey my mechanical valve would be until I got home and tried to sleep in my quiet home.
Yeah, it was very noisy and it took many months (years) before I am used to the click.
Now, it's more a part of me and I can go to sleep with no more problems.
Gail

 

[Neil R]

Valve Selection

Valve Selection

Thank you all for your support. It truly is helpful.

I am 7 days and counting to surgery! Right now I am leaning for the bovine valve, but as someone suggested, there is room for movement if the surgeon feels it necessary.

I am in Michigan and it will be done at Henry Ford Hospital. It is the number 1 in Michigan, particularly their cardiac unit and rated number 3 nationally.

Jed,
I can relate to what you are going through. I am somewhat older than you ( I am 59) and age is a factor in any decision you make. I have recently retired and have always been active. In fact, I umpire youth and High School baseball which results in an assortment of bumps and bruises. Cumodin (spelling ?) was a major consideration.

As my surgery date approaches I become more nervous and I admit it; frightened at the thought of it all.

Kenny,
I copied your list and I will give it to my wife to make sure I don't forget anything.

Thanks everyone!

 

[catwoman]

Neil:

I knew about porcine and bovine valves. My father-in-law had 2 procine mitral valves; a friend has a bovine.
My family has pretty good genes: My maternal grandmother was several months shy of 100 when she died; my father's mother lived to be 96; my parents are still with us at nearly 75 and 77; and both still have all their siblings.
The odds are that I will live at least another 20 years. Did I want to risk having to go through MVR again in 20 years? Nope. So, I agreed with my surgeon when he mentioned a St. Jude's valve.

The valve isn't noisy, but I joke about it. Told someone yesterday that I could be a walking Timex.

Coumadin? It's not bad. It's the ONLY Rx I take. The only adjustments I've made to my diet are cutting back on green things and hardly any alcohol. I could pig out on asparagus (grilled, it's heavenly) and other green stuff. I take about 37mg of Coumadin a week and do home testing.

At 6MO post-op, I'm doing fine.

 

[Neil R]

Catwomen.

Were you told by your Doctor to cut back on the green vegatables? Is it because of the coumodin?

My doctor believes that there is an 80% probability for a bovine valve to last 20 years and I hear of instances where it has lasted longer. Besides, who knows what new or improved surgical proceedures there will be 15 - 20 years from now.

 

[Birky]

valve

valve

I had a mitral valve replacement in Feb. of this year and have a St. Jude mechanical. I really wanted a repair but once the surgeon got it there, it was worse than he thought. At the time I was really disappointed that I had to get a mechanical but I feel so good it really isn't much of an issue these days. I take approximately 30 mg a week on Coumadin. I would like to home test but need to get more info on this. I hear the valve at times but no always. Mainly when I lay a certain way in bed or are taking a soak in the tub. My granddaughter swears that she hears it all the time.

 

[bvdr]

Neil,

Henry Ford is an excellent hospital with a great reputation. I'm confident you will get wonderful care there.

The wait is the hardest part. The longest night of my life (at least it seems that way) was the night before surgery. I was half sitting up in the hospital bed and watched the second hand go around on the clock. I had some heartburn and rang for the nurse to see if I could get something for it before the clock hit 12 midnight and I would be cut off from food and fluids until after surgery. Next thing you know the resident on duty came in and I had to convince him it wasn't my heart....only heartburn. I still got an ekg and finally some Maalox and I watched the clock some more but this time without heartburn. I figured I would be asleep the next day anyway so it didn't matter if I got sleep then or not.

The next morning went rapidly and now I can't believe the whole thing was 4 months ago! Hang in there. The hands on the clock are still moving even when it doesn't seem like they are.

 

[catwoman]

Neil:

No, my doctor didn't tell me to cut back on green stuff.

Main thing with Coumadin is consistency, consistency, consistency on vitamin K intake -- amount and frequency.

Pre-op, I often had 3 platefuls of salad for dinner in the summer. Then no salad the next night. If asparagus was cheap, I'd buy some and eat most of it for dinner (my husband is not an asparagus fan). I could eat an avocado by myself. Obviously, my diet was very heavy in vitamin K.

Now I eat one salad a day, instead of one at both lunch and dinner. If I have broccoli or asparagus, I skip the salad. Dining out involves more conscious decisions instead of impulsive ones. Which is good for the waistline.

 

[Granbonny]

Hi Neil

Hi Neil

I had my AV replaced when I was age 61..due to an aneurysm..found on a thursday and surgery on Monday. when they brought my surgeon to see me after my cath...he told my family. I will put in a mechanical valve..do not want her at her age to go thru another operation. So glad. coumadin is no problem for me and barely ever hear my ticking.. My family (hubby) and daughter and son helped me out for almost a year. NEVER, would I want them to know, I was going to have the operation again in 10-15 years. They have their own lives to live....and Hubby will be older too. Who, would help me out? And, yes, you will need help..first few months..and later. Just knowing I have someone to fall back on..when I have those not so good days.....I have an age 11 year old Grandson..who I keep up with pretty darn good. Attend all his sports. In basketball now. I'm his biggest Cheerleader...however, come Spring and baseball begins..believe me. will be more careful..Those little boys can really hit those foul balls up into stands. Missed my head twice last year. Any valve you choose will be a good one...but remember the recovery period is SLOW.....One day good..the next you may feel bad. Strange, this Open-heart surgery recovery....Bonnie

 

[Birky]

valve

valve

I forgot to say on my 1st post is that the surgeon felt that anyone that was going to live longer than 10 years should get the mechanical. He did not want me to have to go through the surgery a 2nd time. I was 55 at the time of the surgery. Any one that you may get will be the right one.

 

[Nancy]

Hi Neil R-

Is your surgery scheduled for Jan. 5, Monday? I saw in one of your first posts that it was scheduled for Jan. 4, which is a Sun.

So let me know because I added it to the calendar for the 4th, and I thought it might not be right.

I'll correct it if Monday Jan. 5 is right.

 

[Neil R]

Nancy,

I'm sorry, I don't know if I typed the wrong date or what.

My surgery is scheduled for Jan, 5, 2004.

Very soon!!!

I'll be off line for a week or so. I hope to be back in touch in about 8 or 9 days.

Thank you for putting it on the calender for me.

 

[ddarsch]

Two time porcine valve

Two time porcine valve

Neil:

By the time you get this, you will be on your road to recovery. Just to let you know, I had a second MV replacement on September 9th 2003 and had a porcine put in. The first surgery was on November 21st, 1991.

The decision as to the type of valve is a very important, yet very personal decision. I feel that whatever decision a person makes is the correct one for them - - - if it was an easy decision, it would not be hard to make.

Stay strong, and recover quick

 

[joey]

Hi Neil, It is now just over two months since I had my AVR . I'm 64 years old and received a bilogical valve to tell you the trueth I do not even know which kind of bilogical valve I received . Should be off Coumadin sometime next month. Can't complain about coumadin it's not that bad however I am looking forward to get back to drinking wine with my meals and enjoying my green salad twice a day.
There is no doubt to go through a second op will not be easy. I do not even think about it , will worry about it when the time comes. My friend who is now 71 has just had her second double hip replacement she is not having it easy but she will survive, the same goes with the second valve replacement . The main thing is to get well soon , try and put everything behind you and get on with your life.

Regards
Joey