What if they can't repair my valve?

[LAK]

When they do my surgery to repair my mitral valve what will they do if they get in there and can't fix it? Will I have to have it replaced or what? They may tell me this when I go for my pre op tests on Tuesday but I was wondering if anyone else had went into surgery for a repair and then had to have a replacement. I mean I would hope they would at least let me have a choice in what type of replacement valve the put it but I couldn't if I was done in surgery. I need some advise.

Liz

 

[Freddie]

Well Liz, your question may very well be answered on Tuesday during your pre-op tests.

My surgeon simply told me if he could repair it he would, if not, he would replace it with a mechanical due to my age and felt that I wouldn't want to have this surgery again.

I wasn't aware of this forum at the time and just went with what my surgeon said.....after all, he knew what he was talking about and I had no else to trust when it came to this matter.

Good Luck come Tuesday

 

[Nancy]

Well, they certainly aren't going to go in there and if they can't do a repair, just close you up again. They will then do a replacement for you, since something has to be done.

 

[Jkm7]

My surgeon hoped he'd be able to repair my mitral valve but it was not possible.
During my pre-surgery consultation with him, we discussed possible repair and probable replacement. He was very clear as to my choice for bovine (tissue) valve prior to the surgery and when he knew he could not make a repair that satisfied him, he went ahead and implanted my choice of valve.
You must be certain during your visit with your surgeon (s)he is very clear about your "Plan B" in the event repair is not possible.

 

[Bean Counter]

Mine was beyond repair, but I think that you should have that discussion with the surgeon prior to surgery. The hardest part is what kind of valve you want. If they know that, then you should be good.

Good Luck!

 

[Philip B]

Backup Plan

Backup Plan

They'll have a backup plan that includes a replacement valve at the ready. It might be worth having a discussion with your surgeon about choices you may have if replacement is necessary. You'll be out so the surgical team won't be able to ask you about what kind of replacement valve you'd like.

-Philip

 

[Adrienne]

Mine told me the same as Freddie's did, i.e. if he couldn't repair it, he would give me a mechanical valve. I had already read a bit about the pros and cons of mechanical vs. tissue, so I just went along with him. Luckily he could repair it. I find that in Canadian hospitals, they don't seem to ask whether you want a tissue (unless maybe you are vary advanced in age) because it costs too much on the health system to do another surgery.

 

[Cris N]

I think they all say they'll try to repair unless they know it's impossible. Unfortunately, most seem to wind up as replacements. You should have the conversation with your surgeon so you can discuss your options - particularly if you have a preference for which valve they should use if necessary.

 

[Marcia58]

Liz,

My surgeon said he'd try to repair, AND HE DID! He indicated that he wasn't expecting me to need another OHS.

We did discuss a "Plan B" though, just in case.

Marcia

 

[LAK]

When I talked with my surgeon on 6/7/2010 I asked him what he thought the odds were that he could fix my valve. He said 85% to 90% chance he could fix it, but he never said anything about replacing it. I will ask them about that on Tuesday. I guess I have something else to have to think about now...what type of valve to choose. Thanks for the info.

Liz

 

[Greg a]

Well, they certainly aren't going to go in there and if they can't do a repair, just close you up again. They will then do a replacement for you, since something has to be done.

EXACTLY !!!!!! And so the importance of knowing and talking about your "plan B" with your surgeon

 

[ejc61]

Hello LAK,
They will have a Plan B if it can't be repaired way before the surgery. You and the surgeon will have than conversation and also the discussion about mechanical or natural valve. For the record, I chose mechanical although I'm still not sure what is best. Make sure you bring it up, although I can't imagine the conversation not taking place. Btw, I was told 90% that it could be repaired and and it was repaired.

 

[ALCapshaw2]

When they do my surgery to repair my mitral valve what will they do if they get in there and can't fix it? Will I have to have it replaced or what? They may tell me this when I go for my pre op tests on Tuesday but I was wondering if anyone else had went into surgery for a repair and then had to have a replacement. I mean I would hope they would at least let me have a choice in what type of replacement valve the put it but I couldn't if I was done in surgery. I need some advise.

Liz

The situation you describe is EXACTLY why it is important to have discussed and agreed on a PLAN B with your Surgeon beforehand!

FWIW, my surgeon agreed to implant a Bovine Pericardial Tissue Valve. We did not discuss a Plan B.

Well, after he 'got in there', he concluded that a Tissue Valve was NOT a wise choice in MY Case because of 'complications' from scar tissue. He implanted a St. Jude Master's Series Mechanical Valve instead.

In hindsight, that is exactly what I would have selected for My Plan B at that time (years ago), had we had that conversation.

Many Surgeons simply ask you whether you would want a Mechanical or Tissue Valve and then offer/give you the particular Valve of THEIR Choice (i.e. one they use and are familiar with). That is why it is important to Know the Options and find a surgeon who has knowledge and experience with Your Valve of Choice if you have a particular preference. OR, just take what they offer.

You may want to know that many Hospitals (including some of the Majors) only select / offer a limited selection of Mechanical and Tissue Valves, often based on Competitive Bid. In other words, selection of a Hospital and/or particular Surgeon may also be tantamount to Valve Selection or limitation in Valve Choices (in my non-professional opinion).

In any case, be SURE to discuss your Valve Options and Choices with your Surgeon "just in case" your first choice is not viable 'once he gets in there'.

'AL C'

 

[Luckyguy17]

Liz,

I needed work on 2 valves.

It was thought pre op that Mitral valve could be repaired, if not mitral Plan B was to replace with a mechanical, St-Jude I believe, Plan A was enacted at OHS as the Mitral was reparable.

For aortic though, to address severe stenosis and BAV, repair was not an option, surgeon suggested replacement, a bio bovine preference was chosen, but a plan B was enacted for differnent bio porcine valve.

All good though for me
Gil

 

[jendyk]

I'm 63 years old and happy that I have a guaranteed 17 more years with my bovine valve replacement. If I manage to stay healthy, there have been cases that the valve has served well for 30 years and still going strong. I really did not want to have to take warfarin for the rest of my life. I am optimistic that research will provide the extra years if my valve should start to fail at 17 years. Meanwhile, I'm enjoying being able to do stuff again.

 

[ALCapshaw2]

I'm 63 years old and happy that I have a guaranteed 17 more years with my bovine valve replacement. If I manage to stay healthy, there have been cases that the valve has served well for 30 years and still going strong. I really did not want to have to take warfarin for the rest of my life. I am optimistic that research will provide the extra years if my valve should start to fail at 17 years. Meanwhile, I'm enjoying being able to do stuff again.

Bovine Tissue Valve Guaranteed for 20 Years? By who? I would say you have a good chance of getting 20 years but there are NO 100% Guarantees.

30 Years? I've never heard of a Bovine Valve going 30 years. It was my understanding that they have only been available for a little over 20 years now. Anybody know exactly when the Bovine Pericardial Tissue Valves were first introduced?

 

[Jkm7]

I have bovine replacement and definitely was not guaranteed any length of time it would last. If it lasts 20 years, YIPPEEEE but I was told they "hope" for 15-20 years and also allowed for the pleasant chance of even longer.

Nope,,,,,,,,,,,, no guarantees when it comes to heart valves including mechanicals.

 

[TXGal]

Hi Liz, very good question.
I was 17 during my first heart surgery (ASD repair) and 20 when I had my last 2 surgeries which were a week apart (valve repair/valve replacement). My cardiologist at the time had told me that I would need a replacement and I headed back to Houston for my "replacement". During my consultation with my surgeon he had told me he would replace my valve.
Day of surgery, I was in pre-op (already on sleepy meds mind you) and my surgeon walked up to me and strongly encouraged me to think about "repair".. He wanted to try to repair my valve because I was 20 with no children yet. He expressed that if I were on Coumadin, I would not be able to have children, etc... So, I was thrilled at this possibility.. he did repair my valve, but after 1 week of 3 chest tubes & laying in bed and numerous tests, I had to go back in for surgery(so more scar tissue around my heart) and they replaced my mitral valve with a mechanical St. Jude Valve (now 10 years later, doing fine).

I'm not sure how old you are, if children is an issue, etc. Your valve, might not be nearly as damaged as was mine.. and a repair could be all that you need! If you don't need to have a valve replacement or be on coumadin, that would be best of course.. but, definitely have a Plan B with your surgeon! This is a great place to come to ask questions.. Best of luck to you!