Why do younger patients need new valves sooner?

[Janea]

Hi all-
A surgeon told me that someone my age (31) could expect a tissue valve to need replacing within 10 years. My surgeon disagreed and said that was true for teens in puberty, but not for matured adults. He said there was an 85% to 90% chance my valve would last me at least ten years and maybe 15 or more. I desperately want to believe him and not the other surgeon. From the threads I have read, I seem to get the impression that being active wears on your valve more. Is that true? I would be thrilled to talk to someone who has had a tissue valve for 15+ years.
Thanks so much!
--Janea

 

[OldManEmu]

Janea it is not the level of physical activity that wears the tissue valve out, so don't worry about vigorous exercise wearing the valve out. The valve accumulates calcification over time, the rate of calcification is faster in younger patients, and this appears to be related to metabolic rate which is higher in younger patients.

 

[mmarshall]

janea,
you will probably not find anyone that had a tissue valve installed around our age that has lasted over 15 years. i was 31 when i had my avr done last year. the latest and greatest tissue valves with the anti-calcifacation stuff has only been on the market for the last 12-13 years. while the results of these valves have been very promising during that time, no one can tell you that these tissue valves have a 100% guarantee that it will last 15 years or longer...not your cardio or surgeon...if they do...find another cardio or surgeon at the same time...with these new valves...they can not exactly guarantee that it will only last 10 years or less either. there is the possiblity of it only lasting that long but there is also the possibility that a mechanical will only last that long too.

 

[geebee]

janea,
..... but there is also the possibility that a mechanical will only last that long too.

I do not know of any mechanical valve currently on the market that will only last 10 years. There may be an issue with someone's system that might require a reop but it is not because the valve failed. In my case, I built up an excessive amount of scar tissue that required removal but my mechanical valve was left in place.

 

[Guest]

Hmm....

My first pig's valve lasted 10 years (1977-1987). BUT, it was only replaced because I was out-growing it.

My second pig's valve lasted just about 16 years (March 1987 - January 2003). It was replaced because of calcification, among other issues.

My third pig's valve ... don't know yet how long it will last ... and hopefully won't find out anytime soon .



Cort, "Mr MC" / "Mr Road Trip", 32swm/pig valve/pacemaker
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[ALCapshaw2]

Untreated PIG valves (mostly from the 80's?) have the LOWEST durability, in the range of 8 to 12 years. Newer specialized PIG valves "should" last longer.

Studies show that the Bovine Pericardial Valves have a 90% durability approaching 20 years when placed in OLDER patients (age 60 or above). Like ALL tissue valves, they deteriorate more rapidly in younger patients.

MANY surgeons recommend that younger patients such as yourself get a MECHANICAL Valve which should last longer than you can hope to live. Of course you will need anticoagulation (Coumadin) for the rest of your life to prevent clot formation.

The (standard) St. Jude Mechanical Valve is the Gold Standard and has been around for decades with an excellent durability record.

Third Generation Mechanical Valves (such as the St. Jude Regent, or On-X, or Sorin - only available in Europe, and one other ...ATS?) offer the HOPE of reduced anticoagulation requirements when long term testing data becomes available. These valves are designed to have less turbulence and other design benefits that result in a lower liklihood of clot formation. See their websites for more details or do a SEARCH on VR.com for those valve names.

Valve Selection is a BIG ISSUE for most patients facing Valve Replacement. ALL Valves have their positive and negative aspects. Most patients who have a choice end up choosing the valve whose negative aspects they believe they can best live with. Browse through the Valve Selection Forum and you will find LOTS of (sometimes heated) discussion on the pluses and minuses of each valve. That should keep you busy for a while

'AL Capshaw'

 

[Andyrdj]

This might help

This might help

Janea, i refer you to this ongoing debate here for some statistics. I'm in the process of trying to check their validity. It's damned hard finding stats on younger patients as they're always in the minority in tissue valve studies.

http://www.valvereplacement.com/forums/showthread.php?t=15720

 

[mmarshall]

geebee..sorry for not being specific. that is what i was referring to...the mechanical valve having the possibility of not lasting over 10 years due to other issues. i think a lot of people that are coming in asking questions about a certain valve are wanting to hear that it will last as long as possible...are doing so with the hope that they will not have to face the surgery again.

i did not go against my surgeon's suggestion. i went in for a ross procedure and my surgeon recommended my tissue valve as a backup...and that is what i ended up with. but every case is different...i was looking at another surgery in my lifetime no matter what valve i went with so i took the route of what valve will get me back to the normal lifestyle i had before surgery.

it is usually a heated debate when it comes to valve choice but in my opinion the best choice is to go with what valve you are comfortable with...and listen to your cardio and surgeon....in my case...before surgery i got the opinion of 3 different surgeons. so do your research and make the choice that you are most comfortable with.

 

[geebee]

geebee..sorry for not being specific. that is what i was referring to...the mechanical valve having the possibility of not lasting over 10 years due to other issues. i think a lot of people that are coming in asking questions about a certain valve are wanting to hear that it will last as long as possible...are doing so with the hope that they will not have to face the surgery again.

i did not go against my surgeon's suggestion. i went in for a ross procedure and my surgeon recommended my tissue valve as a backup...and that is what i ended up with. but every case is different...i was looking at another surgery in my lifetime no matter what valve i went with so i took the route of what valve will get me back to the normal lifestyle i had before surgery.

it is usually a heated debate when it comes to valve choice but in my opinion the best choice is to go with what valve you are comfortable with...and listen to your cardio and surgeon....in my case...before surgery i got the opinion of 3 different surgeons. so do your research and make the choice that you are most comfortable with.

No reason to be sorry - I just wanted to mention that the mechanical valves themselves do not usually fail. You are so correct, valve choice is so very personal and everyone has to make a list (and check it twice ) to determine what will be best for them. I think every member on here is comfortable with the choice they made (how awful would it be not to be happy with something implanted in your heart?) and only wants new folks to have all the correct information. That is the only reason I made my post.
Thanks for understanding.