Valves-do I get to pick specifically?

[ruthienc1]

Hi all! Reading on this website is one of my favorite evening activities while I wait for my May surgery date to roll around.....and it's gotten me to wondering about valve selection. At this point I know the "when , where, and who" (May 15, Brigham & Women's, Dr. Cohn) and that I'll be getting a tissue valve, but nothing more. Should I know more? We'll be traveling from NC to Boston: I'll be admitted to the hospital 3 days early to test and see where I am as far as lung function goes. Is that likely to be when they inform me of the specific valve type they intend to use? Should I care- or just assume that the surgeon is the best one to make that determination?
Thanks for your input!
Ruth

 

[Karlynn]

Hi Ruth,
I think the choice is mostly "mechanical or tissue". Since you will be getting a tissue, I imagine the surgeon probably has specific valves that he prefers to use. However, if you've researched the different tissue valves and like one more than the others, by all means let your surgeon know. It's always good to discuss why a particular valve is being used with your surgeon.

Best wishes!

 

[Bina]

My surgeon knew I was leaning towards a mechanical and he agreed heartily.
I did ask my cardio which St.Jude I would get and he said which ever one fits best.

 

[ruthienc1]

I certainly know nothing about types of tissue valves- just have seen various ones mentioned on this site. I trust my surgeon implicitly, but wonder if there's anything I should know beforehand. I just don't want to be dumb and not have done my homework....if there is any!....Ruth

 

[Freddie]

As to your question of whether you get to pick specifically, the answer is no. If you want a specific valve, you get to pick a surgeon who agrees with your choice. A lot of surgeons will never discuss the make and model of the valve with you unless you ask. They generally will discuss mech vs. tissue with you; IMO they definitely should give you input into that.

My option was either repair or mechanical. My surgeon did show me and explain to me everything about the mechanical. But don't ask me now what he said...I was still in shock and dumbfounded about everything at the time.

 

[Phyllis]

Willing to bet it will be an Edwards valve- one of doctor Cohn's favorites, but you can call his office and ask. The Edwards Magna valve with the new anti-calcification treatment was new at the time Dick had his AVR and he called often to make sure they had it and were going to use it!

 

[ALCapshaw2]

Before discussing Valve Selection with your Surgeon, I strongly suggest that you educate yourself on at least the basics (Tissue vs. Mechanical) and then you may want to go into the differences between Bovine and Porcine Tissue Valves. When it comes to Mechanical Valves, I am biased in favor of the technological advances offered by the On-X Valves. The St. Jude Valves hold the record for durability at 30 years and counting.

For starters I recommend reading the "Sticky" at the Top of the Valve Selection Forum.

If you want to get more technical, see the websites for Edwards (Bovine Pericardial) and Medtronics Freestyle (Porcine) (there are also other tissue options).

For Mechanicals, see www.onxvalves.com, www.heartvalvechoice.com, www.sjm.com (St. Jude), and perhaps also the sites for Carbomedics and ATS Medical.

I also recommend making a First AND Second choice, just in case there is an issue with the first choice whereby it is not viable (which happened to ME and others).

'AL Capshaw'

 

[Susan BAV]

Hi Ruth - I think you're interested in personal experiences...? I consulted with three excellent and highly recommended surgeons. I knew I wanted a tissue valve and I discussed this preference in detail with the surgeon my husband and I chose. I also told him I was interested in a particular kind of tissue valve that I had read about here and asked him what he thought and he said he liked a different valve. That's what I have and I think it was a good call. I felt like I had educated myself [to the degree necessary for me] and at some point I needed to trust my experienced and expert surgeon. You could sure ask your surgeon which one he prefers and why, if it would make you more comfortable. Best wishes !

 

[Bryan B]

Ruth,

I looked at your profile and saw that you are 64 years old (sorry about letting that slip out ). At that age many surgeons start to lean towards a tissue valve because as you get older a tissue valve will last longer, it has something to do with slower metabolism and less calcium build up on the valve over time than in a younger patient. But as a patient you should feel free to ask your surgeon about all of the valve options available to you and also ask him why he thinks the particular tissue valve he has chosen is the best option for you. It is important to let your surgeon know that you have a vested interest in the successful outcome of your surgery and that you want the best available valve used to avoid another surgery.

Dr. Cohn has a great reputation, so I would just ask him what tissue valve he is planning on using in your case and why he thinks that is the right valve for you. It's good to have trust in your surgeon, but at the same time you need to be your own best advocate. My surgeon didn't mind me asking about all of the possible valve options available to me and he ultimately let me choose the option I felt was best for me. I guess I should mention that I specifically chose my surgeon because I wanted a Ross Procedure and he specializes in that procedure, but he also let me choose my backup valve in the event he decided the RP was not an option once he "got a peek inside".

I think the most important thing is for you and Dr. Cohn to be on the same page on what is the best valve for your particular case so that you have one less thing to worry about. Good luck with your upcoming surgery...you will be in the hands of a great surgeon.

 

[marilyn]

ruth

ruth

I did not have much knowledge about the different valves, but I wanted a tissue valve, because I did not want to take anticoagulants. The surgeon discussed both mechanical and tissue valves with me and told me that the mechanical valve would last a life time. I am very active, and I told him that I wanted the tissue valve, and he said he would give me what I wanted. It all came out fine.

 

[marilyn]

Bryan B

Bryan B

I started this and someway lost it. I hope this makes it through. I did not realize that the tissue valve got more calcium on it. That maybe why my surgeon was leaning toward the mechanical valve. He would not have known what mine was like until he opened me up. He told me he had to chisel it out, because it was so calcified.
I also have a very high metabolism. I am not worried about it, but I did find it
interesting. I always learn something on this site.