When to get a reop with a tissue valve?

[bbuck]

I've been reading the pros and cons of tissue versus mechanical, and have pretty much decided on the tissue, unless the doc gives me good reason otherwise anyhow. But I do have a question. How do they determine when the tissue valve needs to be replaced? Do they somehow monitor it? Or do you have to have some sort of medical even for them to say " hey, we better do something here"?
I'm of the opinion that at 46, by the time I have to have another one (barring anything unforseen that is) I will more than likely be able to have one via cath.

 

[kfay]

I got a tissue valve at 45. My cardio told me they will know when it needs replaced before I have any idea. My valve is now almost 4 years old, so I go once a year for the full workup which includes an echo, x-ray, a 24-holter monitor (for rhythm issues), an overnight pulse-ox, and a stress test. In the echo, they measure the gradients of the valve and check it for regurg as well. When that gradient gets to a certain number, it will be time to replace the valve.

Also, at 46, I think you may be looking at 2 more replacements. The first valve will probably last a shorter period of time due to your age. The second one a little longer hopefully, etc...


Kim

 

[Lionheart]

bbuck,
A tissue valve will gradually calcify just like your natural (bi-cuspid) valve. So after the operation, your cardiologist will monitor you and the new tissue valve with echocardiograms that monitor the performance of the new valve. You will need echos about every 1-2 years. Over time (hopefully many years) it is expected that the valve function will gradually get worse and eventually the numbers from the echo will show that the valve is not performing as it should and it will need to be replaced.
John

 

[Jkm7]

I have tissue mitral valve and have an annual echo and see my cardio regularly. Having had my native valve fail and need replacement, I expect I'll probably recognize familiar symptoms when/if my tissue valve ultimately needs replacement. Echo certainly tracks what condition it is in and thankfully, thus far at four years, it is doing just fine.

 

[Lynlw]

Justin's got his Tissue valve in 05. but had other repairs replacemnts in differnt parts since he was a baby. Pretty much deciding when that valve needs replaced is the same as when they decide you need your native valve replaced. As others said, follow up with ECHOs, MRIs and watching how things are going. I agree with you that the chances are pretty high by the time a tissue valve you get now at the age of 46 needs replaced it could be replaced by cath and not OHS are pretty good by the looks of how things are going now.
Good luck witth everything

 

[bbuck]

Thanks everyone
Guess I didnt think about they'd figure it out about the same way they figured this one aint workin so well. Tho it did take about 3 years of complaining of shortness of breath and me asking to get an echo cardiogram done at the VA for them to get to it.
So I see I am in for going to the cardiologist at least once a year, thats not too bad I guess. It is about 260 miles from home so I'm glad to hear its not weekly, lol. Should I expect to go back a little sooner tho after the surgery is done? Like at a month or 6 months or something?

 

[esvaja]

Hey yooper, Oh that's right your from the banana belt. I lived in the copper country for a while & hope to get back some day. Still stay @ a friends camp every summer on the Lake. Do you go to the VA in Ann Arbor? Wouldn't Green Bay have a VA hospital? As far as followup, they'll probably see you in 3 months after. I had my AVR done in Cleveland, & all my followup will be here in A2, my choice.
Is Dr Deeb doing your surgery?
esvaja

 

[Jkm7]

Thanks everyone
Guess I didnt think about they'd figure it out about the same way they figured this one aint workin so well. Tho it did take about 3 years of complaining of shortness of breath and me asking to get an echo cardiogram done at the VA for them to get to it.
So I see I am in for going to the cardiologist at least once a year, thats not too bad I guess. It is about 260 miles from home so I'm glad to hear its not weekly, lol. Should I expect to go back a little sooner tho after the surgery is done? Like at a month or 6 months or something?

Once you actually have a prosthetic valve, anytime you mention to a cardio or PCP anything that sounds like symptoms, you won't be jumping through hoops like you had to this go round. They will listen and take you seriously. Mention short of breath to any decent doctor who knows you have a prosthetic valve and if they don't take you seriously you need another doctor. IMO

As to cardio visits after surgery, most of us see our surgeon at least once post op and assuming they release you, which happens to most of us, you then are referred to the care of your cardio and PCP. My cardio kept a very close eye on me and I saw him more than most but the usual is one or two visits post op and then if all looks good, probably once a year with annual echo. That definitely varies and each individual case dictates needs/reasons for more or less frequent appointments.

 

[Mentu]

I asked my surgeon this same question. Essentially, if your tissue valve becomes stenotic, it will display the same symptoms of a natural valve. It will first develop a significant murmur, the valve area will decrease and pressures will rise. Those of us with third generation valves can be hopeful that ours will last longer than earlier versions but since no one still understands why calcification happens there are no guarantees. As I've mentioned to several other people, tissue valves are not the only valves that can have problems although it less common for problems to develop with mechanical valves. For me, aortic stenosis is a family problem. My Grandfather and one of his sons died with it. Another son, my Uncle Bob, was the first to have a valve replacement which went very well. At about 10 years, however, his St Jude mechanical valve began to function less well as tissue grew over it. It had to be removed and was replaced with a porcine valve since tissue valves function better where tissue growth is an issue.

We have no certainty about our future. The thing to consider is that which ever valve you choose will restore your health and let you lead a normal life. Heart surgery does make us more aware of how precious and wonderful our life is. Issues such as valve longevity are part of the package but they are not the important part. Having a future, again, is the important part.

Larry

 

[bbuck]

Hey yooper, Oh that's right your from the banana belt. I lived in the copper country for a while & hope to get back some day. Still stay @ a friends camp every summer on the Lake. Do you go to the VA in Ann Arbor? Wouldn't Green Bay have a VA hospital? As far as followup, they'll probably see you in 3 months after. I had my AVR done in Cleveland, & all my followup will be here in A2, my choice.
Is Dr Deeb doing your surgery?
esvaja

Yea, gotta love the bannana belt, ha,, there is a VA hospital in Iron Mountain that I go to, I do have a local doctor in town too that I am switching to as I've recently had some problems with the VA hospital.
I am not going thru the VA for the actual AVR, we have more or less settled on Northwest Memorial Hospital in Chicago, We have contacted Dr. McGee's office and have to send them all of my info from the VA. But we have not had the consult with them yet, I'm expecting that here in Feb. We'll be meeting with him.

 

[bbuck]

I asked my surgeon this same question. Essentially, if your tissue valve becomes stenotic, it will display the same symptoms of a natural valve. It will first develop a significant murmur, the valve area will decrease and pressures will rise. Those of us with third generation valves can be hopeful that ours will last longer than earlier versions but since no one still understands why calcification happens there are no guarantees. As I've mentioned to several other people, tissue valves are not the only valves that can have problems although it less common for problems to develop with mechanical valves. For me, aortic stenosis is a family problem. My Grandfather and one of his sons died with it. Another son, my Uncle Bob, was the first to have a valve replacement which went very well. At about 10 years, however, his St Jude mechanical valve began to function less well as tissue grew over it. It had to be removed and was replaced with a porcine valve since tissue valves function better where tissue growth is an issue.

We have no certainty about our future. The thing to consider is that which ever valve you choose will restore your health and let you lead a normal life. Heart surgery does make us more aware of how precious and wonderful our life is. Issues such as valve longevity are part of the package but they are not the important part. Having a future, again, is the important part.

Larry

Hi Larry, and thanks for your reply
I see you have the sternal talons, we have been looking at that as well, is there any reason you wouldnt go that route again? or was it not up to you anyhow? Any problems with that that you have dealt with?
Thanks again

Bill

 

[Phil]

Hi,

I had AVR at aged 44 years (human tissue) and are awaiting a second valve replacement this year. In answer to your question when do you know - your body tells you - I'm so tired, breathless when going upstairs, have heavy legs, etc. This has also been backed up by ECHO tests which show I'm on the cusp of moderate/severe. I turn 54 this year, so have gotten almost 10 years out of the tissue valve. I'm very much looking forward to the surgery as I feel ordinary most of the time and I'm keen to get it done, so I can get on with my life.

All the best.

Phil.

 

[JimL]

I had my mech put in at age 46 ten years ago, and I'm good for 150 years or so, I feel great, no such worries. Your choice, and your life, and we love the UP!

 

[Jkm7]

I asked my surgeon this same question. Essentially, if your tissue valve becomes stenotic, it will display the same symptoms of a natural valve. It will first develop a significant murmur, the valve area will decrease and pressures will rise. Those of us with third generation valves can be hopeful that ours will last longer than earlier versions but since no one still understands why calcification happens there are no guarantees. As I've mentioned to several other people, tissue valves are not the only valves that can have problems although it less common for problems to develop with mechanical valves. For me, aortic stenosis is a family problem. My Grandfather and one of his sons died with it. Another son, my Uncle Bob, was the first to have a valve replacement which went very well. At about 10 years, however, his St Jude mechanical valve began to function less well as tissue grew over it. It had to be removed and was replaced with a porcine valve since tissue valves function better where tissue growth is an issue.

We have no certainty about our future. The thing to consider is that which ever valve you choose will restore your health and let you lead a normal life. Heart surgery does make us more aware of how precious and wonderful our life is. Issues such as valve longevity are part of the package but they are not the important part. Having a future, again, is the important part.

Larry

That speaks for stenotic valves.
I needed valve replacement because of regurgitation.

 

[JeffM]

Same here. Mine was purely regurgitant. It begs the question: Do those of us who don't show a tendency toward stenosis stand to get better longevity from our tissue valves? Stay tuned.