What areas should i research more?

[Mister_James]

Don't get into the weeds. The most important thing is a cardiologist you click with. A doctor who understands what is important to you to help you navigate post surgery world.
Things you cannot control, let them be. If your surgeon is an OnX or St Jude, let them pick the valve. Let them work with what they are familiar with.
Worry about getting better.

 

[jamie14512]

Since you have aortic regurgitation, has anyone suggested that your valve could be spared?

Could you have valve sparing surgery? This is called a David or a Yacoub operation, but you get to keep your own aortic valve. It is also often referred to as aortic valve repair surgery.

Finally, I see that you are in England. There is now a new option called the Ozaki operation where they make a valve from your heart pericardium. The longevity in older people is very good, but it is unknown how long this will last in a young person. Dr. Cesare Quarto at the Royal Brompton in the UK does this surgery. I am not recommending this, you need to do your own research as you say, but for completeness I wanted to make you aware of this option.

Good luck with your surgery.
Tommy boy.

Hi Tommy,

Thank you for your suggestions, i've looked into both. From what i've read valve sparing surgery will only delay me having to have a OHS at some point to replace the valve anyways, which i'd rather jsut have one OHS.

The Ozaki procedure is exciting however i feel like there is not enough data on it and i don't know if it will last as long as i'd like, if it only last 20 years then i'm more inclined to just be done with a mechanical valve.

Thanks

 

[jamie14512]

Don't get into the weeds. The most important thing is a cardiologist you click with. A doctor who understands what is important to you to help you navigate post surgery world.
Things you cannot control, let them be. If your surgeon is an OnX or St Jude, let them pick the valve. Let them work with what they are familiar with.
Worry about getting better.

Thanks James,

You're right, theres not much choice i really have anyway to be honest, in the NHS i don't think i get much choice over valve and things like that.

 

[tommyboy14]

Hi Tommy,

Thank you for your suggestions, i've looked into both. From what i've read valve sparing surgery will only delay me having to have a OHS at some point to replace the valve anyways, which i'd rather jsut have one OHS.

The Ozaki procedure is exciting however i feel like there is not enough data on it and i don't know if it will last as long as i'd like, if it only last 20 years then i'm more inclined to just be done with a mechanical valve.

Thanks

I myself have a mech valve now, but if your valve can be spared, you should prob ask yourself if you are giving up a perfectly good valve? In some people all that happens is that the aneurysm pulls a perfectly good valve apart. Then once you fix the aneurysm, the valve is fine.

Have you been tested for Marfans? In the UK, there is now also the PEARS option if the main issue is a dilated aortic root. They image your root and wrap with a novel mesh. They dont need to put you on the heart lung machine, since all that is happening is that they support your root externally. Apparently this works quite well in selected patients:

https://www.hcahealthcare.co.uk/our-services/treatments/personalised-external-aortic-root-support

 

[pellicle]

You're right, theres not much choice i really have anyway

that's true of everything, worse, when presented with more choice all it does is make it harder to choose.

This surgery practice has at least 50 years behind it and it has been iteratively altered and improved. Many practices have fallen away from main stream and you have to ask "why". My answer is "because it made more sense" ... you could drive a grass fuelled steam powered car, but we don't (and when first getting into it you may ask "why is that"). Some would say "Big Petroleum" ... I'd say 'natural selection'

TBH it comes down to

• repair if you're a candidate
• mech if you are under a certain age
• bioprosthesis if you are medically unable to tolerate ACT

everything else is fringe and has a small subset of followers (much like a cult if you ask me).

Stick to the main stream and you'll be fine.

 

[jeffreycaulfield]

Hey @jamie14512 ,

Thanks for sharing this. I'm 35 and also finalising my surgery. BAV that started with predominantly regurgitation but now have stenosis also. Never had surgery before.

I'm comparing Ross to Mechanical. It would be great to know what option you went with and why?

Cheers, Jeff