I'm surprised to read that a surgeon would state that a 52 year old patient would require two or three additional surgeries if they went with a tissue valve.
which valve???????
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Gail in Ca
Well-known member
I'm not surprised at all. My surgeon, Dr. Miller, stated the same to me at age 54 just 4 yrs ago. He knows the averages, and felt I would probably need 2 more surgeries if I got tissue. I also come from longevity, Mom is 95, her mom was 97, Grandpa lived to be 96.
I don't think my surgeon considered my family's longevity when he told me to expect another replacement at some point in time. Since many surgeons now routinely recommend a tissue valve for people in their mid-60's, it doesn't seem logical that they would tell a patient in their fifties to expect two or more three replacements.
pellicle
Professional Dingbat, Guru and Merkintologist
It could be simply "under promise and over deliver"
pellicle
Professional Dingbat, Guru and Merkintologist
Hi
I'm living on my third OHS. When I had my second OHS it was a replacement with a homograph. No one was clear about how long it might last. It might last my lifetime I was told at one point.
My valve was becoming incompetent to an extent in 2011, but nothing to require surgery. It was however the aortic aneurysm which necessitated the 2011 (third) surgery.
I mention this to get you to broaden you scope of the possibilities. We all wish to plan for ideal futures, but the reality is we don't even know what will happen or be found when we are on the table. I can assure you that certainties are not certain, only probable.
For some reason I (after my 2nd OHS) developed the idea that warfarin was something of a doom drug that would see me unable to really love and end up a frail man before my time. I have found since my starting it that my conceptions were quite unfounded.
I have some views that the medical profession is largely ignorant about it and that their habit of discussing worse case turns people to think ey are discussing the routine.
Should you have a fall on the Anupurna track, you will likely find that were you on warfarin that the local hospital are actually well geared for handling you. Warfarin is well understood in ER and unlike many modern alternatives clears quickly from your system. Vitamin K can be given to speed this up. Its quite simple to restore your natural clotting.
I understand the hesitancy to have something "unnatural" in your body. How would you feel about a knee replacement for example? That is a more complex part than a valve.
When examining the data about valves also enquire about calcification of tissue valves. There are a number of people here who have had their valves calcify and need replacement. Some say that a more active person is likely to calcify a valve earlier, others suggest there is no relationship, and that it remains unknown why they calcify. I recently read a thread here where the person got less than three years on their tissue valve.
To my limited knowledge this never happens and the main cause for reoperation of mechanical valves is pannus growth. The newer valves have that issue in mind in their design. My surgeon suggests that keeping the INR too low has an influence on this... who knows.
I wish you all the best with your decision
PS something I came across recently
http://www.heartvalvepatients.org/hvp/showthread.php?t=782
I'm living on my third OHS. When I had my second OHS it was a replacement with a homograph. No one was clear about how long it might last. It might last my lifetime I was told at one point.
My valve was becoming incompetent to an extent in 2011, but nothing to require surgery. It was however the aortic aneurysm which necessitated the 2011 (third) surgery.
I mention this to get you to broaden you scope of the possibilities. We all wish to plan for ideal futures, but the reality is we don't even know what will happen or be found when we are on the table. I can assure you that certainties are not certain, only probable.
For some reason I (after my 2nd OHS) developed the idea that warfarin was something of a doom drug that would see me unable to really love and end up a frail man before my time. I have found since my starting it that my conceptions were quite unfounded.
I have some views that the medical profession is largely ignorant about it and that their habit of discussing worse case turns people to think ey are discussing the routine.
Should you have a fall on the Anupurna track, you will likely find that were you on warfarin that the local hospital are actually well geared for handling you. Warfarin is well understood in ER and unlike many modern alternatives clears quickly from your system. Vitamin K can be given to speed this up. Its quite simple to restore your natural clotting.
I understand the hesitancy to have something "unnatural" in your body. How would you feel about a knee replacement for example? That is a more complex part than a valve.
When examining the data about valves also enquire about calcification of tissue valves. There are a number of people here who have had their valves calcify and need replacement. Some say that a more active person is likely to calcify a valve earlier, others suggest there is no relationship, and that it remains unknown why they calcify. I recently read a thread here where the person got less than three years on their tissue valve.
To my limited knowledge this never happens and the main cause for reoperation of mechanical valves is pannus growth. The newer valves have that issue in mind in their design. My surgeon suggests that keeping the INR too low has an influence on this... who knows.
I wish you all the best with your decision
PS something I came across recently
http://www.heartvalvepatients.org/hvp/showthread.php?t=782
Per "I'm surprised to read that a surgeon would state that a 52 year old patient would require two or three additional surgeries if they went with a tissue valve." I was 54 and told the same thing by my surgeon. If the valve lasts 15 years, that's two operations by 82 yo.
If your surgery is not for 6 months, you certainly should not have to make up your mind in a week. Per my surgeon, he said they stock the parts (for emergency operations as well as scheduled) and he told me I could change my mind up until the last day. However, if I wanted a specific type of valve, they may not stock them and this required a ~2 week notice.
If your surgery is not for 6 months, you certainly should not have to make up your mind in a week. Per my surgeon, he said they stock the parts (for emergency operations as well as scheduled) and he told me I could change my mind up until the last day. However, if I wanted a specific type of valve, they may not stock them and this required a ~2 week notice.
maisiejane
Well-known member
Well that's it, decision made I am going with my gut and what feels right for me in so many ways.
I don't know why he gave the timescale of 1 week for me to decide, but I have lost many hours sleep over this debate, I have researched and listened to many wise and experienced people but as so many of you have very kindly said the final decision has to be made by me,
Thank you all, your advice is priceless, I will let you know of any updates xxxxx
I don't know why he gave the timescale of 1 week for me to decide, but I have lost many hours sleep over this debate, I have researched and listened to many wise and experienced people but as so many of you have very kindly said the final decision has to be made by me,
Thank you all, your advice is priceless, I will let you know of any updates xxxxx
maisiejane
Well-known member
Opps sorry, Tissue valve xxx
pellicle
Professional Dingbat, Guru and Merkintologist
just thought i would put my opinion in the hat, remember everbody on here will give a slightly biased view for there valve me included lol, dont make YOUR choice on the thoughts of others,if your gut reaction is tissue or mech well thats what you go for,we could stay on here for weeks on end telling you whats best, but its you who counts nobody else, good luck and am sure you will do just fine
I chose a mechanical valve after all of my research. My heart beat so loud before my AVR surgery that the faint ticking, that I only hear sometimes, is a non issue. I figure if I hear it, I am alive. I am 10 weeks post op and feeling great. Went camping for the first time this weekend and had more energy than I have had in 10 years in the waiting room. Coumadin dosage is still being worked out. After it is stabilized, I will do home testing. I have not changed my diet. I have a salad and a few glasses of wine. My inr has been good for the last two weeks so maybe we have found the sweet spot with my dosage.
No one can choose for you. Do your research and go for it. No right or wrong answer. After you make your decision. just know you educated yourself and chose what is best for you.
Good luck with your decision. Either way, we will all be here after you are on the other side of the mountain.
No one can choose for you. Do your research and go for it. No right or wrong answer. After you make your decision. just know you educated yourself and chose what is best for you.
Good luck with your decision. Either way, we will all be here after you are on the other side of the mountain.
Heather Anne
Well-known member
Ditto to everything kmcdougc said. I, like you, wrestled with the decision, going back and forth several times, but I eventually went with my gut/first response. I don't have the valve yet (tomorrow!!!), so I don't have the benefit of hindsight like others in this thread, but I will say that once I made the decision I felt a huge weight drop from my shoulders, and I haven't wavered in that decision in the two months since I made it. Knowing that the choice is not clear-cut, and that there are pluses and minuses on both sides, actually helps me, because that means that what it does come down to is personal comfort and preference, and that is something I am prepared to own. I think most others that I've encountered on these boards feel the same way, whatever their choice may be/have been.
Good luck to you!
Good luck to you!
maisiejane
Well-known member
Good luck with your surgery Heatheranne, I will be thinking of you x
clawie1
Well-known member
The Thief
Well-known member
i will be getting my OHS on November 25th, and going with mechanical valve: On-X. Nervous about blood thinners, but not scared. I will continue to rock climb, cycle, backpack, etc. I'm 30. This is an obvious choice for me.
my journey: http://robovalve.wordpress.com/
my journey: http://robovalve.wordpress.com/
I was told the same thing and was only a few years older.
I would think a surgeon would state the probability in terms of years for a tissue valve's longevity, because a patient will decide each and every time what valve they want. The decision really isn't being made for possible multiple replacements, only the probability of one, since the choice exists for a mechanical valve to be implanted if the first one fails early.
Do we know anyone who has had a mechanical valve that failed? I don't recall reading of any.
As for tissue valve longevity, there really is no set number of years for people under 65. Ok, maybe 8-10 is an average, but what about those that have a valve fail after only 2 or 3 years? I know I've read of that here. I know there have been those whose first VR was great with no problems and the second surgery practically brought them to death's door.
pellicle
Professional Dingbat, Guru and Merkintologist
The literature mentions only one as far as I know.
http://m.circ.ahajournals.org/content/111/18/e280.full
Anyway I'm not sure that's what Duffey was meaning.
This is not to say that reoperation is not required from things such as panus ingrowth. I wonder if this effects tissue valves?
Thanks for the reference.
