Early failure Medtronic mosaic porcine

[LLJ]

Well after a few years now I return to VR.org for the best source of info. Anyone seen the research on early failure in the aortic placement of the medtronic porcine mosaic valve? (Apparently not in the mitral placement) After only 5 years mine quite suddenly quit. No known infection after cultures. OK valavers-show me what you got-I AM NOT looking forward to yet another recuperation.

 

[Penny]

oh no! Sorry I don't have any advice or info for you.. I am sure you will get some good info or someone here will know where to look. Hang in there.

 

[ALCapshaw2]

Sorry to see you Back given the circumstances LLJ

It would be useful to know your age (or age at which you received your Porcine Valve).

I've seen reports of Porcine failures on VR rangeing from 1 year to 7 years.
Bovine Pericardial Tissue Valves tend to last longer, 20 years in patients over 60,
10 years from a couple of young women who chose Bovine Valves in order to bear children.

If you are still under age 60, your best chance of avoiding another surgery is with a Mechanical Valve.
If you've read my older posts on this forum, you know I am impressed with the advancements offered by the On-X valve.
See www.onxvalves.com and www.heartvalvechoice.com for more information.
My choice for a Plan B valve is the St. Jude Master's Series Valve (the one with the 30 year track record).
See www.sjm.com for more information.
Other options include ATS and Carbomedics.

 

[mainframe]

Bummer to hear of the earlier than expected valve failure. I don't have any statistical info on the porcine valve but just wanted to wish you luck which ever way you decide to go. My bovine valve failed rather quickly and I should have had my re-op sooner than I did. Please don't make that mistake.

 

[Mentu]

LLJ, I've looked for this sort information numerous times but little seems to be easily available. I did see discussion of this article which you might look for:

The changing spectrum of porcine bioprosthetic valve failure
Cardiovascular Pathology, Volume 16, Issue 1, January-February 2007, Pages 1-3

You can purchase it online for $5.00 the Patient button at

http://linkinghub.elsevier.com/retrieve/pii/S1054880706001542

Sorry I couldn't be more helpful.

Larry

 

[Philip B]

Tissue Valve Failure

Tissue Valve Failure

When discussing valve choices with my surgeon before surgery, a major downside he noted with tissue valves was how long these valves would last. Given my preference to continue pursuit of an active lifestyle, he told me I may get 5-10 years from a tissue valve. I didn't really press him on research stuff, but he felt tissue valves really don't last long in people who engage in regular, rigorous fitness-oriented activities.

Do you engage in regular fitness activities? If so, you might fit the low end of my surgeon's perspective on the longevity of tissue valves.

I did ask my surgeon why a tissue valve wouldn't last longer. He stated that is less about activity induced wear & tear on the valve and more about the body's defense systems attacking the valve tissue. He seemed to think higher metabolic rates tended to increase the intensity of the attacks.

Sorry to hear that you're facing a re-op more quickly than you'd like.

-Philip

 

[LLJ]

Thanks everyone! To answer questons: I am 51 and a triathlete with a special love of cycling. I am a founding member of the Valve-o-lines race team here. I am careful about keeping my heartrate down below 160. The cardiologist was floored at the speed at which my valve failed. It was "perfect" in Feb and now need a new one pronto. Really wrecks my summmer race schedule
The research pointing towards failure of the medtronic porcine mosaic valve in the aortic postion caught my eye. Appparently (and rightfully with the given small sample size in the study) medtronics vigorously denies this. Now,I am not sure I am cozy with medtronics any longer.
Thanks for the mechanical valve info as well as the tissue. I tried to avoid mechanical given my propensity for cycling and not always staying upright!!
One thing for sure-I don't think I will be wearing a tawdry shirt post surgery---any one have tawdry cycling jerseys?
Laura

 

[kfay]

I seem to remember a couple of other people on here who have had problems with this particular valve. I don't think anyone had a complete failure, but rather much earlier than expected deterioration of them, similar to what you are experiencing, but not as rapidly. Here is a thread from last year about this same valve http://www.valvereplacement.org/forums/showthread.php?31783-Medtronic-failure-rates

 

[Lynlw]

I'm sorry to hear of another Mosiac failing early. there have been a few member here who have had this happen. I know several had there explanted valves sent for testing because there surgeon saw problems with the valve, (bumps or something on the valve ) and reports were filed to the FDA. There stories are similar to the report in the papers (in Kims link) ect, and I know some centers are not using the mosiac, because of the things that have come up, until they have better answers of what the problem is. The hospital that first reported the probles patients were in their 70s, so their age was not an issue for their valves failing so quickly.
I know Tobog, had problems here is his descripription if it helps http://www.valvereplacement.org/forums/showthread.php?32635-The-Old-Valve&highlight=mosaic+bob
Different doctors do have different opinions, but the ones I've spoke to over the years, say they amount of excercise a person gets should NOT make a tissue valve wear out any faster than someone not as active, The hospitals I've talked to are the larger Congenital heart defect /adults with CHD hospitals so have alot of experience with young adults (20s-30s0 and children, who do tend to go thru tissue valves conduits faster. So do alot of research into it.
IF you are interested in another tissue valve, the one many larger centers give to their younger patients is the CE Bovine perimount, Bob got a Biocor which is SJM mixed (pig/cow) and is pretty new in the US, but has a track record in Europe like the CE perimounts.

 

[ARGreenMN]

One addition to Al's info above about mechanical valves. St. Jude now makes one called the Regent (I think it's basically the newer generation of the master series, which is close to the On-X in terms of performance). That's the one my surgeon preferred so I went with his recommendation. And he's got me on a 1.8-2.2 INR range for that one (which I've been able to stay in for the most part so far). With that low of an INR, I haven't noticed hardly any (if any) difference in how long it takes to stop bleeding. Here's a link to that valve:

http://www.sjmprofessional.com/Products/US/Heart-Valve-Replacement/St-Jude-Medical-Regent.aspx

Re: bike riding, I'm still new to this (only 7 wks post-op) but my understanding is you really don't need to limit your activity much with mechanical valves (at least these days). I'm under the impression the external bleeding from a fall wouldn't be that big of a deal (seems to be backed up by the times I've bled since being on Coumadin). Although the internal bleeding from a concussion might be more of a concern? I'm planning to go back to some competitive sports once past recovery, and I know there are a bunch of people here in the forum that do some things like that - even some (I think) who ride motorcycles (which I'm also considering some day). Was the Active Lifestyles forum part of this site last time you were here? If not, might be worth a look - think I remember several bikers in there that are on Coumadin.

 

[Lynlw]

I was gogling to see if there was more info about early failure of Mosaics, since i was last looking atit. and this isn't a new article BUT it looks from the comments,(from doctors and medical staff) it maybe happening more often than expected
_before you follow my link, you might want to google "Surgeons report "alarmingly early stenosis" with porcine heart valve; manufacturer assures safety, efficacy" theheart.org because when I try to use my link, it says I have to be a member http://www.theheart.org/article/986119.do

 

[Philip B]

Upright Cycling?

Upright Cycling?

Upright cycling... what's that?

Cycling is my exercise of choice. Sure, failure to stay in an upright position results in bruising and road rash that looks a little worse when one is on coumadin, but falling is going to result in bruises and road rash for folks who aren't on coumadin as well.

I've got a chewed-up elbow, bruised hip, and scrapes on a leg from my first encounter with the Sonoran Desert after failing to stay upright on my mtn bike last week. Minor stuff like this heals.

Road cycling would pose few problems with the staying upright thing if motor vehicles would just leave me alone. If you get bounced off a car (been there done that) odds are pretty good that you'll have injuries regardless of what type of valve you have and what medications you use.

Perhaps you simply got a defective porcine implant. This said, my surgeon didn't have much faith in the longevity of tissue, but that was just his opinion. I don't think he minded getting paid for re-doing valve implants; he just didn't like putting his his patients through the stress and strain of re-ops. Again, just his perspective.

-Philip

 

[LLJ]

Phillip:If I could figure out the avatar and phot things here I would download you a pix of my left leg road rash and "a baby head" sized lump on my thigh after a particularly exciting encounter at 22 mph downhill in the rain onto a steel grate bridge...Yeeee-ha!
Andy: Yup-the active lifestyles was here 5 years ago-that's how we developed the Valve0-lines racing team and cardiac Athletes marathon relay team. You should check it out!! Harrisburg Marathon this year is gonna be AMAZING!!!!
just got back a couple weeks ago from 4 great days of road cycling in Massachutes, what a blast!!! I try to get our on my mountain bike once a week as well
Did a tri last Sunday and was awoken Monday night by the sound of my heart "squeaking" Yes--my cardiologist was amazed as well.
I hate the idea of a mechanical valve because frankly I eat more leafy greens than any one I know-really..it is gonna suck
Lyn, Kfay and Mentu-thanks for the links I will check them out.
Laura

 

[ARGreenMN]

Haha, I may have to get into cycling just to join that relay team. Sounds like fun! Squeaking heart??? What was that all about??? Oh, that's right you got a pig valve, lol. Ok, enough pig jokes. When you say it's gonna suck, you mean if you have to go mechanical because of the leafy greens? My understanding (again, kinda new to this game) is as long as you're consistent, you can eat as many greens as you want - just have to adjust your Coumadin accordingly. I'm gonna try to do the same w/ Slimast once I get a home tester - it's got a lot of Vit. K in it too. Anywho, good luck with whatever you decide, and I'll have to look up that marathon relay team!

 

[JeffM]

Hi Laura,

I feel for you. We have similar situations: I'm a fairly hardcore road cyclist and lifetime athlete who is almost 55. I opted for a medtronics 3rd generation porcine valve. My valve, now almost 2 yeasrs old has been doing great from the start, but I know I'm a relatively young tissue valve recipient and that the stats are not favorable for valve longevity in people our age. I actually allow my heart rate to max (now only about 174) because I asked my cardiologist whether that was OK and was told not to worry about it. I know I'll need another AVR and I'm hoping it'll be later rather than sooner. But your story is a reminder that I need to watch it closely. Did you pick up on some performance problems that led you to want to check out your heart? Sorry you're having to deal with this again so soon.

Jeff

 

[LLJ]

Jeff: No I had no performance issues (unless you call chronic slowness on the run an issue )
Never a problem riding--as a matter of fact the 160 was sort of a self imposed top number based on my Lactic threshold number of 155bpm. I haven't seen any research that says exercise has an effect on valve life;however as pointed out here-there is not big pool of athletic 40-60 y/o who are more than 5-10 years post valve replacement
I had a completely normal non leaking valve via echo in Feb. and as of Tuesday mine was suddenly moderate to severe regurg...Had a great race Sunday prior and enjoyed a very regular training protocol(complete with HR monitor)
Like my doc said"Failure rate is 4%,but when it's you it's 100%"
whopeeeeeeeeeee
Laura

 

[LLJ]

No Andy it's running not cycling!!! Look us up on this site or cardiacathletes.com. And keep those jokes coming--it's what keeps things tolerable. What's Slimast???

 

[ALCapshaw2]

Luara,

You didn't buy into the MYTH that you can't eat any Leafy Greens (or any other Vitamin K containing veggies) did you?

The Key is to be CONSISTENT, i.e. eat some Green Every Day, and adjust your Coumadin / Warfarin Dose accordingly.

Studies have actually PROVEN that maintaining a consistent level of Vitamin K intake results in a More Constant INR than (trying) to maintain NO vitamin K intake.

Think of entering a Dark Room and then turning on a light.
That is akin to taking NO vitamin K and then inadvertently consuming some.

Now think of entering a room with a 50 Watt Light turned on and switching it to 100 W.
Not so big a DIFFERENCE.
That is akin to consuming a consistent level of Vitamin K intake and inadvertently taking in more than your usual dose.
NO BIG DEAL.

'AL Capshaw'

 

[Luana]

I hate the idea of a mechanical valve because frankly I eat more leafy greens than any one I know-really..it is gonna suck
Laura

Hi Laura,
We might be able to have a contest as to who eats more greens. I like every vegetable, really, there's not one I don't like. I freely eat my veggies and salads and my INR is very stable. The key is, as I've learned here, dose to the diet, not diet to the dose. There's no reason for you to give up any of your greens.

 

[Philip B]

Pics

Pics

Yeah Laura, we could trade pics if we could figure out the photo thing. You should see mine after I got tagged by a hit & run driver about a year ago... I don't think I've ever been bruised like that before... broken bones, and a traumatic brain injury... somehow, I lost the month of July (if someone finds it out there please let me know). My wife was picking gravel out of my back for six months. Despite the injuries and my coumadin use, I recovered well enough to do a major event ride in the mountains of Colorado in August.

I suspect you really took some major wear & tear if you dropped into grate. When I was younger I never really thought of cycling as a contact sport. Now that I'm older and it takes longer for injuries to heal, I've changed my perspective a little bit. It's hard for me not to tense up every time I hear a car coming up behind me. I've crashed so many times on my mtn bike that I ride too tentatively.

Hopefully, your next time around will get you a valve that will last longer. Too bad there aren't any guarantees for how long replacement valves will last.

Life's short... ride hard... and pedal fast!

-Philip