What type valve?

[Cozycat]

Hi
I am 62 and got an aortic valve replacement with a tissue valve from a cow 2 years ago and am doing wonderfully. I'm not as tired, my hair and nails are stronger and growing healthier, I have color in my cheeks and lips and feel wonderful.
Wishing you the best!
Viki

Thanks for all the input everyone. I read alot of the thread begun by Alerion and I never dreamed I would want to know this much about my heart...but I'm finding that the more you know the clearer it becomes--after first seeming like a muddy mess. Don't have an appointment with the surgeon yet but agree that alot of the decision will be made between us -- imagine he will have alot more to say than was said after the cath. I want to do some more research on the bovine tissue valve before my appointment...your comments and discussions have gotten my thoughts going in this direction. Those of you with more experience can probably get thru all this info much faster than we noobies, but I'm understanding more each time I come back to you great helpers. Ask and you shall receive...and I thank God for each and every one of you who appears on these pages. Back later with more questions.

Cozycat

 

[ALCapshaw2]

It sounds like you are making good progress in understanding this new world you have been cast into.

FWIW, the Bovine Pericardial Tissue Valve was my first choice (at an even younger age) but my Surgeon ended up putting in a St. Jude Master's Series Mechanical Valve due to Radiation Damage from a long time ago.

Bottom Line: It is wise to make a Plan A *and* a Plan B,
'just in case' there is some reason Plan A doesn't work out.

(Given your age and *assumed* good health otherwise, my choices would be Bovine Pericardial Tissue Valve as Plan A, On-X Mechanical as Plan B, St. Jude Master's Series as Plan C. If your parents lived beyond their mid 80's, I would give consideration to putting the On-X valve as Plan A to avoid a possible re-operation later in life).

Disclaimer: I am not a Medical Professional and this should not be construed as Medical Advice.

 

[DebbyA]

Hi
I am 62 and got an aortic valve replacement with a tissue valve from a cow 2 years ago and am doing wonderfully. I'm not as tired, my hair and nails are stronger and growing healthier, I have color in my cheeks and lips and feel wonderful.
Wishing you the best!
Viki

I'm 61 and got a porcine valve, and my cowlick came back!

I'm glad you found us--it sounds like you're getting the information you need! Stay in touch,

Debby

 

[TomD]

Valve decision

Valve decision

I had my surgery last Feb at Stanford. I spent a lot of time researching the valves and concluded that the potential for failure of a tissue valve, and then the need for ANOTHER OPERATION while in my eighties, was way to high so I went with mechanical. After going through the process I am so glad that I don't have the potential for another operation hanging over my head. What we can endure in our mid sixties is way more difficult 15-20 years later with the potential of huge complications. Taking Coumidine is no big deal either. Get your insurance to pay for a home tester and it's no big deal.

 

[Karlynn]

Unless I had a family history of people living into their 90's, I'd definitely go tissue at 67. Welcome and best wishes!

 

[dlangton]

Oink

Oink

I vote for porcine tissue. Pigs are friendlier.

 

[Cozycat]

Unless I had a family history of people living into their 90's, I'd definitely go tissue at 67. Welcome and best wishes!

Don't know about my biological father's history--never, ever saw him. But on my mother's side, living into late 80's is common. That does throw another dimension into my thinking because I, too, don't think heart surgery in my 80s would be exactly what I want to do....on the other hand by then the use of the mini surgery may be more common and it would'nt be such a big deal. Had lung surgery in 2002 to remove a nodule from my lungs using minimally invasive surgery and it was so smooth (and it was Valley Fever and not lung cancer, much to my delight . One thing about this site, it really makes you think!

Cozycat

 

[Cozycat]

I vote for porcine tissue. Pigs are friendlier.

I don't know....I met some pretty nice cows when I lived back in Illinois. Maybe with a bovine valve you get the big brown soulful eyes also.

Cozycat

 

[Alerion]

Hey Cozycat!
Man, I can so relate to your predicament. All of us who have yet to go through the surgery are conflicted to some extant as to what's the best choice. I am 48 and have been told I'm too young for a tissue valve. I've also been told that's nonsense.

You'll read a lot here and elsewhere that points out the fact that the decision is ultimately your own personal hurdle - not particularly helpful at first but true.

My own experience tells me that like me, you will need to go through the process of researching until you reach the point that you're saturated. After that, you become somewhat detached and can dispassionately evaluate your choice and come to terms with it more easily. I'm almost there.

I had a talk with a surgeon today and he showed a preference for the St Jude mechanical valve for my situation. Another doc might have a totally different yet no more or less valid, opinion.

I just decided to get a guy who does a LOT of my kind of operation, check to see that his hospital doesn't kill people routinely, and make a choice on a valve based on the life I want after the surgery. If I get 15 years out of it without the complications and risks of Anti-coagulant therapy, I think I'll be ok.

Might I need another surgery? If I'm not hit by a bus or licked to death by my idiot dog, I probably will. Yeah that will stink. But hell, I'll only be 63, not 83. That leaves me with an option for another tissue valve or trying the latest mechanical valve.

So I'm pbly 80% decided on a tissue valve, but of course, I could change my mind at anytime for some compelling reason I've not yet encountered. It's that close a call.

Best of luck to you. You've come to the right place.

 

[neil]

alerion totally agree mate good post.

 

[Cozycat]

Neil, was the choice of a porcine valve your own, the doctor's or both of you? I see you are a bit younger than I and so will most certainly need another valve in your lifetime. Was that a consideration or of not much consequence? How was your recovery? The actual surgery doesn't concern me much (but, life and death always is of some concern) but so many people have commented about the painful sternum after the surgery that I do wonder about that and for how long it goes on. Have not seen a surgeon yet but have gotten lots of papers in the mail from my HMO so imagine I will have a appointment soon. Like Alerion, I'm still on the fence about tissue vs mechanical but imagine the surgeon will have something to say about the choices. I'd really like to get this done and over with but know it will happen as it should.

Coztcat

 

[Cozycat]

Alerion, thanks for your message. Talk about a life altering decision, guess you might say this is definitely one. On the other hand, guess we must be thankful that there are choices we can make, most of which will let us continue on with life in better condition.

I belong to a Medicare Choice HMO so may not have all the availability of choice that some people have, but I can do with that. Luckily my HMO has a big cardiac center down in LA and does these procedures on a regular basis so experience is on my side. I'm having enough trouble deciding on the valve choices, let alone trying to chose a doctor and hospital! My big concern is having to have another operation before I leave this earth.....but, by then the surgeries could be much easier or they may have a way to lengthen the useful life of the tissue valves. On the other hand, I'm sure the sound of the mechanical valve and having to take the anti-coagulant along with monitoring it would not be that bad. One of my grandsons has been Type 1 diabetic since he was almost 3 and that is serious monitoring...but he spends almost every weekend with us and you just get used to doing it so that's not an issue.

I'm sure some "bolt out of the blue" will hit me one of these days and I'll know which way to go, as I feel that the path is always revealed to us if we are aware enough to follow it.

Thanks for all the info and it sure helps to know that there are other people trying to puzzle out these perplexing decisions. Hey, everybody, we need to produce a t-shirt that says "I just had a valve job". That way we could recognize each other.

Cozycat

 

[Eva]

....

I'm sure some "bolt out of the blue" will hit me one of these days and I'll know which way to go, as I feel that the path is always revealed to us if we are aware enough to follow it.
Cozycat

You are absolutely right. I was convinced of what I wanted for a few months, and in my case after lots and lots of prayers, suddenly it hit me that I made the wrong choice (which was tissue for me) and I called the surgeon's office three days before surgery to inform them I changed my mind asking if it was too late. Her answer was: "it is not too late, we have some patients who changed their mind on the morning of the surgery". Turst your guts, it will come to you!

 

[vprnet]

Cozycat, welcome.

On blood flow, the newer mechanical valves are outperforming stented tissue valves and the mechanical ON-X is one of the top performers for small diameter valves that many woman require.

Have a look at the hemodynamics chart (blood flow) comparision on this weblink and discuss it with your doctor. The lower the number the better the blood flow.

http://www.onxlti.com/onxlti-hvm-hemodynamics.html

It's a tough call even at 67 if there is a risk of reop in your 80's. Please understand that I'm biased as an ON-X recipient but I am hopeful that the FDA trial for lowered warfarin therapy for this valve pans out by 2012 which means INR levels of 1.5 - 2.0 rather rather than 2.0 - 3.0. That is a significant reduction. 1.0 - 1.1 is the INR of a normal individaul not on warfarin therapy.

http://www.onxlti.com/onxlti-hv-proact.html

Four weeks with this valve and the ticking sound is all but faded into my chest. It's amazing how the faint ticking has just disappeared as the weeks progressed.

Best wishes

BAVR with 27mm ON-X NYP Weill Cornell Dec 19, 2008.


PS. I am not a medical professional or a doctor. My comments in this forum are my own opinion and are not intended to be given as medical or professional advise or a recommendation of any valve choice. Decisions that affect your health and wellbeing are ultimately yours and your doctors. vprnet

 

[neil]

cozycat i had 4 month to think about which valve,i weighed up all the pros and cons of both and my personnal choice was tissue,i asked my cardio and my surgeon which there would choose,and one said tissue and one mech lol.whichever you choose its gonna be a whole lot better than the one you got now, before the op i had never been in hospital for any op,so was very nervous,but personally found i had very little pain,infact every day i was expecting the pain to kick in,but it didnt, just tender and sore really,and remember us men are not that brave ha ha,i know all things being equal i will need another op in 10 ? 12? yrs time,but thats then,who knows how far medicine will have come,if not the op doesnt freak me out anymore, plus i like to live for today not 10yrs in the future,remember one thing its a personnal choice,so go for it,.............neil

 

[bookjp]

Hi and Welcome. Happy you found us but sorry for the reason.

I'm younger than you and opted for tissue valve last February. There is no wrong choice. Whichever you choose, don't look back or second guess yourself.

Mechanical, as I am sure you know, requires lifelong anti-coagulation. Many (most) here who are on coumadin/warfarin handle it well and their lives are full.

Tissue valves sometimes require a brief (2-3 months) usage of the drug but unless you have a-fib, you probably would be coumadin free after that brief time.

My surgeon felt it probably in someone 60 or over, a bovine valve is probably good for something in the range of 18-20+ years. He felt very strongly by that time, If I should need another, they won't be doing the replacements with such traumatic surgery. There have already been some percutaneous replacements....same method as you just had for your cath.

Good luck in making your choice. When you meet with your surgeon, you'll discuss your choices.

Jkm7 I'm with you on this.I'm 56 if I can get 20-25 years on the bovine tissue valve I would be completely happy.I don't want to be on coumadin the rest of my life.I just don't like taking pills if I can help it.Also like to get together with friends for poker game or football games and like to have 5 or 6 beers now and then.That would be my choice but I will have to take the surgeons opinion into account also.Good Luck!!