Of course, the best would be if they can repair your mitral valve, instead of replacing it.
I don't actually disagree with Sam on many levels, and I really don't want to be a wet blanket. I wanted - and have - a tissue aortic valve myself. And I certainly agree that in most circumstances, there is no right or wrong choice.
There are so many things that can be involved in the decision, especially with the mitral valve. And in deference to Sam's post, maybe I pushed a point too hard. I see forty as being much younger than 55. In fact it may easily and reasonably be considered one full surgery younger. But it is just my opinion. I don't have a lock on the truth. I will, however, guarantee the opinion is worth every penny it costs ($0), or all your money back.
The CEPM has the longest track record of any of the tissue valves, and is the most likely of any of them to make it to 25 years, based on historical durability (in my humble estimation) - again, in the aortic position. We'll see. I don't really think it'll do 25 in the mitral position, but I do opine that it will likely give fifteen+ years of years of service there, maybe even twenty. On average.
And that's the other problem with being 40. You're not the "average" valve consumer, who is past retirement age. Your system is much more rigorous than an older person's about Things That Don't Belong. Younger people with more aggressive healing systems calcify tissue valves much more rapidly than older folks. A "15-year" valve often goes only 8-10 years in a 30+ patient, 10-12 in a 40+ patient. How long will a "20-year" valve go in a 40-year-old? My guess would be an average of 15-18 years. The problem is that anticalcification treatments are new. It is still reasonable to assume the valves will last less time in a younger person, but we don't know how much less. And won't for some years to come.
Even when looking at the studies provided in an earlier post, there are study dates as old as 1991, on valves manufactured in the 1970s. It is hard to say how accurately those could reflect on current tissue valve technology.
And, unless they reliably work out the logistics of percutaneous implanting of the mitral valve (and improve the collapsible valves), you're back to surgery. Even robotic surgery involves cutting the heart. The smaller hole will be in the chest, not the heart. If catheter-placed valves become a regular method, aortic valves will probably be done regularly before mitral valves.
In the end, we merge our gut feel with what we've absorbed, make a decision, and move ahead. As long as the person is going through with the needed surgery, I fully agree that once the decision has been made, it is the best decision for that person, whatever it may be.
Best wishes,
I don't actually disagree with Sam on many levels, and I really don't want to be a wet blanket. I wanted - and have - a tissue aortic valve myself. And I certainly agree that in most circumstances, there is no right or wrong choice.
There are so many things that can be involved in the decision, especially with the mitral valve. And in deference to Sam's post, maybe I pushed a point too hard. I see forty as being much younger than 55. In fact it may easily and reasonably be considered one full surgery younger. But it is just my opinion. I don't have a lock on the truth. I will, however, guarantee the opinion is worth every penny it costs ($0), or all your money back.
The CEPM has the longest track record of any of the tissue valves, and is the most likely of any of them to make it to 25 years, based on historical durability (in my humble estimation) - again, in the aortic position. We'll see. I don't really think it'll do 25 in the mitral position, but I do opine that it will likely give fifteen+ years of years of service there, maybe even twenty. On average.
And that's the other problem with being 40. You're not the "average" valve consumer, who is past retirement age. Your system is much more rigorous than an older person's about Things That Don't Belong. Younger people with more aggressive healing systems calcify tissue valves much more rapidly than older folks. A "15-year" valve often goes only 8-10 years in a 30+ patient, 10-12 in a 40+ patient. How long will a "20-year" valve go in a 40-year-old? My guess would be an average of 15-18 years. The problem is that anticalcification treatments are new. It is still reasonable to assume the valves will last less time in a younger person, but we don't know how much less. And won't for some years to come.
Even when looking at the studies provided in an earlier post, there are study dates as old as 1991, on valves manufactured in the 1970s. It is hard to say how accurately those could reflect on current tissue valve technology.
And, unless they reliably work out the logistics of percutaneous implanting of the mitral valve (and improve the collapsible valves), you're back to surgery. Even robotic surgery involves cutting the heart. The smaller hole will be in the chest, not the heart. If catheter-placed valves become a regular method, aortic valves will probably be done regularly before mitral valves.
In the end, we merge our gut feel with what we've absorbed, make a decision, and move ahead. As long as the person is going through with the needed surgery, I fully agree that once the decision has been made, it is the best decision for that person, whatever it may be.
Best wishes,
