Why do Tissue Valves last longer in older patients?

[Mike1952]

Hi all,

I have read several times that tissue valves last longer in older patients (my cardiologist does not seem to know why other than statistically, it seems to be the case). Does anyone know why? Could it be that older folks tend to be more sedentary and don't stress the heart as much? I am 62 and had a bovine aortic valve replacement two years ago. I exercise quite strenuously but wonder if I might be over doing it. Thanks!

Mike

 

[dornole]

I assumed it was the strength of the immune response . . but know I realize I actually have no idea.

 

[Paleowoman]

Could it be that older folks tend to be more sedentary and don't stress the heart as much? I am 62 and had a bovine aortic valve replacement two years ago. I exercise quite strenuously but wonder if I might be over doing it.

I've always wondered why tissue valves last longer in older people too. I did a search and found an answer on another valve blog as to whether exercise has an effect: http://www.heart-valve-surgery.com/.../08/14/valve-replacement-durability-exercise/ A cardiac surgeon comments: The short answer is that we don’t have any reason to believe that exercise effects valve longevity.- Thank goodness ! I exercise pretty strenuously too and I'm sure that it's good for my heart and overall health, but it would be good to know the reason for why these valves deteriorate though.

 

[Paleowoman]

I've always wondered why tissue valves last longer in older people but not in younger ones. I did a search for an answer as to whether exercise had any negative effect on the valve and found an answer from a cardiac surgeon on another site: "The short answer is that we don't have any reason to believe that exercise effects valve longevity" http://www.heart-valve-surgery.com/.../08/14/valve-replacement-durability-exercise/ Thankgoodenss as I too do pretty strenuous exercise. It would be good though to know why valves deteriorate though.

 

[DebbyA]

I thought it was something to do with rate of cell replacement. It could be statistics are skewed by having older folks die before needing second replacement. Mine only lasted from age 60 to 66, so what is 'older'?

Anyway, exercise shouldn't shorten the life of your valve.

 

[pellicle]

I had read that the primary cause was the degeneration (denaturation is the technical word) of the collagen fibers causing the "leather leaflet" to become stiff (thus stenotic)

as to exactly why its longer in elderly than younger I think remains conjecture, but none the less is observed (even if we don't know why). Like all things statistical , without additional information, you may be an outlier and get longer life (or shorter) but there is a reason why people play safe hands in blackjack too rather than taking another card when they have 17

http://www.ncbi.nlm.nih.gov/pubmed/10357134 [h=3]Abstract[/h] Bioprosthetic heart valve (BPHV) degeneration, characterized by extracellular matrix deterioration, remodeling, and calcification, is an important clinical problem accounting for thousands of surgeries annually. Here we report for the first time, in a series of in vitro accelerated fatigue studies (5-500 million cycles) with glutaraldehyde fixed porcine aortic valve bioprostheses, that the mechanical function of cardiac valve cusps caused progressive damage to the molecular structure of type I collagen as assessed by Fourier transform IR spectroscopy (FTIR). The cyclic fatigue caused a progressive loss of helicity of the bioprosthetic cuspal collagen

 

[pellicle]

Hi Mike

I am 62 and had a bovine aortic valve replacement two years ago. I exercise quite strenuously but wonder if I might be over doing it. Thanks!

my view is that the other quite certain health benefits from good exersize will be more significant that the uncertain possibility that it may contribute to a more rapid degeneration of your valve.

If you have had your first OHS at 62, then I feel (myself having had 3 by 50) that you are well set to do well on your next (if you get to needing a next) OHS. So enjoy life, listen to the advice of your cardiac specialists (not I didn't say always obey) and be happy

best wishes.

 

[Paleowoman]

I've always wondered why tissue valves last longer in older people but not in younger ones. I did a search for an answer as to whether exercise had any negative effect on the valve and found an answer from a cardiac surgeon on another site: "The short answer is that we don't have any reason to believe that exercise effects valve longevity" http://www.heart-valve-surgery.com/heart-surgery-blog/2012/08/14/valve-replacement-durability-exercise/ Thankgoodenss as I too do pretty strenuous exercise. It would be good though to know why valves deteriorate though.

I posted this repy twice yesterday and twice it said it was "working" and then it disappeared. When I tried reposting it said I'd already posted it "during the last five minutes" !

 

[Paleowoman]

I have tried repying to this topic three times, twice yesterday when the topic first appeared and once now. I keep getting error messages. I wonder if it's because I put in a link ? I've decided to post this without the link:

I've always wondered why tissue valves last longer in older people but not in younger ones. I did a search for an answer as to whether exercise had any negative effect on the valve and found an answer from a cardiac surgeon on another site: "The short answer is that we don't have any reason to believe that exercise effects valve longevity" Thankgoodenss as I too do pretty strenuous exercise which I feel is beneficial for both my heart and general health overall. It would be good though to know why valves deteriorate (still happy I chose tissue).

 

[RobThatsMe]

Itried several times too, once it automatically took me to US News Best Hospitals site... Geezzzzz where did it come up with that?

 

[RobThatsMe]

I tried several times too, once it automatically took me to US News Best Hospitals site... Geezzzzz where did it come up with that?

 

[epstns]

I don't remember where this theory came from (I've been "studying" aortic stenosis for 12 or 13 years), but I was told that the shorter lifespan of tissue valves among younger patients was thought to be driven by the stronger immune system reaction in younger patients. This reaction was felt to attack the tissue used in the valve, shortening its life.

I'm also going to agree with pellicle -- we seem to have a lot of supporting correlation showing that the patients who are older at time of implant of tissue valves seem to experience longer prosthetic valve lifespans. But correlation is just that - when 'A' happens, we commonly observe 'B.' This does not mean that A causes B, it only means that we usually see them together.

I chose to "bet" on the correlation, having a tissue valve implanted at age 63. So far, so good. . .

 

[Mike1952]

Thanks for the input! I'm happy not to find a reason to quit exercising! My annual ultrasound is next week, it's great to have such a thorough checkup every year. Prior to getting a valve job, I really had no idea what was happening with my heart. Happy Thanksgiving, all!

 

[Mike1952]

Thanks for the input! I'm happy not to find a reason to quit exercising! My annual ultrasound is next week, it's great to have such a thorough checkup every year. Prior to getting a valve job, I really had no idea what was happening with my heart. Happy Thanksgiving, all!