What Kind Of Valve

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Ah Dennis I see you are still dreaming fondly of Luba. If she knew that you still retained such kind thoughts about her she would smile back at you. When I have my next admission I will specifically ask for her. Bob just wanted to let you know I have used the surgeons, Joyce, Eales and Kroshus. Been with them so long the surgeon who did my three prior hearts has retired. His name was Dr Orn Arnar. He was from Iceland and has the most amazing hands. I always look at their hands.
 
Hi Bulldog-Bob -

I've been struggling with this post since I read your first one... For tissue valves some of your options include bovine and porcine and maybe in your case canine:p!

Welcome to this site! Keep posting and asking your questions; there are a lot of people here with a lot of experience they are willing to share with you!
 
Hey Bulldog,
I did forget to mention in my previous post that I have a tissue valve and love it. I can take any over-the-counter medication with a concern for conflict. I can have a glass of red wine and I only take a beta-blocker and aspirin on a daily basis. I don't have to monitor my levels. I have high anxiety so the lack of coumadin was a good choice for me.
 

Hello Dennis S. This Is Bob The Bulldog. Could You Tell Me How Old You Are And How Long Ago You Had It Done At Abbott. And What Kind Of A Valve And Why You Chose It. Also How Do You Like The South We Are Thinking About San Diego If Everything Goes Good. Honestly How Much Did You Worry Before And How Much Do You Worry Now? Thanks A Million. Bulldog

P.s. Nine Of My Relatives Including My Dad And Three Uncles All Died Of Heart Trouble Before 62.
 
Answers:

Answers:

Dear Bulldog-I have sworn off advising people on what valve to chose unless they specifically asked me, and you are the first to ask! I am happy to answer your questions.

I was 58 years old when I had my aortic valve and aortic stem replaced at Abbott on August 5th, 2005. I cose the St. Jude's mechanical valve because my surgeon strongly recommended it, and I felt I would have a very good chance of never needing another surgery. My wife was very happy with a choice that mimimized the chance of another surgery. I have no regrets. and expect that, as the years roll by and I experience the inevitable weaknesses of old age, I will be especially happy that a second surgery is not a likely part of my future.

In my particular caes, insurance was also an issue. At the time of my surgery, I had a very good, and very expensive health insurance policy that covered all but $100.00 of my bill. I retired at age 55 to move on to other things. If I fully expected a second surgery, I would probably have keept that policy, despite the $1,000.00 per month premium for my wife & I. But I don't expect a second surgery, and we have switched to a very good policy that costs half as much.

I was surprised at how little I worried before the surgery. I think that is a reflection on my relegious faith, and my faith in Dr. Kshettry. I gave myself a good long time to recover, and have really not worried after the first few months.

People on this forum probably get a chuckle out of your asking me how I ike New Mexico. I love it, feel like it has brought out the past in me. Especially if you have hi-speed, you can tell how much I like New Mexico by checking out my pictures at:

http://www.flickr.com/photos/dennis_and_barb/

Once you get past the Puerto Rico pictures, you will see a lot of pictures of New Mexico, most of them from our deck.
 
Welcome Bulldog

Welcome Bulldog

Bulldog, I am 10 days post op., and went with a Bovine valve. I can truly say, this was not my first choice, but the surgeon and I had great discussions over options, and thanks to this site, I was ready and able to take whatever valve the surgeon felt was best for me, once I was open. Someone here once said there is no bad choice, except doing nothing.
 
Thank You Note

Thank You Note


Thanks Dennis I Appreciate Everything And I Most Certainly Appreciate This Forum.

Bulldog
 
rckrzy1 said:
Just had an interesting talk with my surgeon today, as I told him my cardiologist was dead set against anything but mechanical. BUT my surgeon
has replaced 5 of those "life time" mechanical valves so far this year.

Did your surgeon say WHY he replaced the mechanical valves?

'AL Capshaw'
 
ALCapshaw2 said:
Did your surgeon say WHY he replaced the mechanical valves?

'AL Capshaw'

I agree. These kind of statements don't do much for giving anyone a clear picture of what each kind of valve entails.

There are many factors that could have caused a mechanical valve to need to be replaced and some of them would also cause a tissue valve to be replaced before it's time, or a repair or a Ross to fail as well.

I'm 15 years post op. If I had to have my mechanical valve replaced tomorrow I would consider it to have been a success. Having had my VR at the age of 32, I'd be well in to my second valve by now had I gone with a tissue valve. Linda, Twinmaker, has had hers 25 years. Both of our valves do not have the technology that the mechanical valves have now, and they still serve us well.
 
Just chiming in to say that I agree with Karlynn. And according to the St. Jude website, the specifics of the St. Jude mechanical valve has changed very, very little since they developed that particular valve. Why mess with a good thing?:) LINDA
 
rckrzy1 said:
I can't remember the technical word he used, but it has to do with tissue growing over.

And the ONLY point I'm making in the great debate is NOTHING is FOR SURE.
Which is what many people might have you believe .

I was wondering about tissue growth as that CAN BE a problem with the Standard St. Jude Valve (such as the one in MY Aortic Valve Position).

For the On-X skeptics, the On-X Valves have a BARRIER incorporated in their design to prevent (or at least inhibit) Tissue Growth that would impede proper valve movement. This is one of several design improvements in these third generation valves that appeals to my engineering mind.

'AL Capshaw' (On-X is my FIRST Choice for my upcoming MVR)
 
I rest my case.

I rest my case.

rckrzy1 said:
Just had an interesting talk with my surgeon today, as I told him my cardiologist was dead set against anything but mechanical. BUT my surgeon
has replaced 5 of those "life time" mechanical valves so far this year.


In an earlier post I noted the following: "In my opinion helping someone else decide what valve to choose is very difficult for people to do. As I have said on other occaisions, human beings who have been required to make an important choice on the basis of limited information can experience a strong motivation to validate that choice by seeing others make the same choice they did."

I submit this is a perfect example of what I was talking about. And I see little value-when someone is facing imminent surgery-in making sure they know that "nothing is for sure".
 
Hi Bulldog

Welcome to a great site.....the people are the very best here!

I'm Evelyn whose husband, Tyce, had AVR in 6/02. He was 59 at the time of the surgery and we both chose the St. Jude's mechanical because a second surgery was something Tyce wanted NO part of if at all possible.

He has been on Coumadin/warfarin since, with basically no problems....up until Coaguchek recalled their strips we were home testers which I would heartily recommend, but now test weekly at our local cardio's clinic.

I'm sure you'll have MANY more questions, but just wanted to welcome you and let you know that there's MAJOR life after OHS.

Again, WELCOME>
Evelyn

PS....Have a friend in Rogers, MN.....close to you?
 
Dennis S said:
In an earlier post I noted the following: "In my opinion helping someone else decide what valve to choose is very difficult for people to do. As I have said on other occaisions, human beings who have been required to make an important choice on the basis of limited information can experience a strong motivation to validate that choice by seeing others make the same choice they did."

I submit this is a perfect example of what I was talking about. And I see little value-when someone is facing imminent surgery-in making sure they know that "nothing is for sure".

(edit - see the original post that the above was in response to...)

The man, BulldogBob, is asking, "What Kind of Valve?" Evidently, from that question, he is asking for fairly open feedback.

Call it validation if you choose; but couldn't it instead be instances of people who have found something that is evidently working for them, something they are happy with, which they are recommending to another, as in, "Consider this?" There are plenty of people here who tell us the bad experiences they have had with this or that valve also, no doubt as a well-meant warning. Would it be best if they hold their tongues so as not to discourage people going into heart valve replacement surgery?

And, the fact -- and the way -- that Adam's surgeon's comment was in reply to what Adam told him his cardio said, namely, "Go mechanical," is rather thought provoking, is it not?

My husband builds diesel engines and fuel pumps. He knows which gaskets work and which don't. And he knows why they tend to fail also. Good builders have insight that regular monkey wrenches and gas station attendants don't have, due to education, and that all important thing called experience, among other things. (Any surgeon or cardio who may read that might cringe at the comparison; I use it as an illustration.)

From what I've read on this forum, those who have asked their surgeons what they would personally choose, mostly got replies of tissue valves.

By the way, can somebody explain a little more about that potential "tissue growth" to me with the mechanicals? Is it similar to those valvular strands that Arlyss' husband had?
 
Hi Bulldog,

I just joined VR a couple of days ago and I can't tell you how great it is to get info from people who have had OHS. I have two St Jude Mechanical valves (aortic and mitral) and one bovine valve (tricuspid). My surgery was at Mass General Hosp in Boston 12/23/04. The valve choice is definitely personal. The coumadin is a pain sometimes, (trying to remember to take it) but if that's what it takes to feel great then I can deal with it. You will make the right choice!!!!!
 
Upon Further Review:

Upon Further Review:

One part of my post assigned a motive to Adam?s post. That was wrong, and I apologize. I know better than to do that, and I am sorry, and embarrassed.
 
The things I would consider important are these:

At 58, if you have one of the top three tissue valves, it will very likely last you from 15-22 years. (The 7-10 years data is an old dodge used by carbon salespeople. It's true - but it's true for the tissue valves that were made thirty years ago.)

You will most likely not have to use Coumadin, and your life may be medically simple throughout the valve's useful life, as it relates to your valve. For some, this is a quality of life issue.

However, you will need a replacement when you're 76 or so. That will most likely mean another OHS. There is some chance that stent-based valves (implanted through the arteries in a procedure similar to cardiac catheterization) may have become reliable by then, but never count on unhatched technology.


If you decide on a carbon (mechanical) valve, you will need to use Coumadin, and your life will be a little more complicated. Some dental and testing procedures will require negotiations, there will be blood testing, and drug interactions and operations will be more complex to deal with.

However, you most likely will never have to have the valve replaced.

The Art Den Lady's surgeon must have been speaking to her personal heart anatomy when he said that he didn't feel the On-X was a good choice for her. Of the carbons available, it is the most advanced and fully thought out, in my opinion. It's the only one in trials for reduced Coumadin, or possibly even aspirin anticoagulation therapy. Its unique carbon was developed by the same genius who developed the carbon for the St. Jude valve. He felt it can be good to tamper with a good thing, and I agree. Are the other major carbon valves also excellent? Yes. You can trust your life to any of them, and on this forum there is someone who has.


Some more info -

Carbon:
On-X: http://www.onxvalves.com/ValveInformation.asp
St. Jude: http://www.sjm.com/devices/devicetype.aspx?location=us&type=18
ATS: http://www.atsmedical.com/Physicians.aspx?id=1144

Tissue:
Edwards Bovine: http://www.edwards.com/Products/HeartValves/PericardialCategory.htm
Medtronic Mosaic porcine: http://www.medtronic.com/cardsurgery/products/mosaic_index.html
Medtronic Freestyle porcine (stentless - root can be used or not as required): http://www.medtronic.com/cardsurgery/products/free_index.html

Best wishes,
 
Gosh, I guess in a way I'm glad that I had my replacement 25 years ago. The only choice I was given was: do you want one of the older mechanical valves that will definitely need to be replaced in the future OR do you want to try a new one that we believe might never have to be replaced...and by the way...the new one hasn't been approved yet by the FDA. I looked at the surgeon and said, "which one would you put in your wife?" He said, the new one (St. Jude mechanical). I trusted what he said to me and commenced to signing all the papers promising I wouldn't sue the government of the USA. Remember, we didn't have the internet back then. I had my nursing books from college but of course they didn't have anything about the St. Jude...only the older valves. I could have gone to a medical school library, but didn't. Even with the other ups and downs with my heart disease, I know for myself, I made the right decision. Of course, hindsight is 20/20. This is just from my personal situation but thought it might be helpful. LINDA
 
VERY INTERESTING STORY Linda !

It supports what I had been told by the RN / Education MGR at On-X about how St. Jude came to be the 'Gold Standard' of Mechanical Valves.

Mechanical FAILURES were showing up in the older (ball and cage type) valves, both in structural failure of the cage and cracked balls (that promoted clot formaton). Someone posted a picture of a severely cracked ball on VR.com some time ago (years?).

St. Jude had just introduced their 'new bi-leaflet valve' but as you noted, it was NOT yet approved by the FDA. Many Surgeons found themselves "between a rock and a hard place" but recognized to potential of the new design and began using it (with the appropriate disclaimers and waivers you cited).

And the rest, as they say, "IS HISTORY".

By the way, the CARBON leaflets for ALL the Major Mechanical Valves for the last 30 years eminated from designs by the SAME individual, Jack Bokros, Ph.D., who developed Pyrolytic Carbon for applications in the Nuclear Industry but recognized the potential benefit to heart valves after reading an article about them in the 1960's. It appears that every time he has a new idea for improving valves, he joins or forms a New Company (St. Jude, CarboMedics, ATS Medical, and now On-X).*

"And now you know the REST of the story!"

*as reported in the On-X Patient Information Guide
"Heart Valve Replacement Surgery - Increasing Your Awareness"

'AL Capshaw'
 
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