ebjlady2 is trying to decide taken from "AVR replacement at 41yo.. Which way to go ?"

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Greg a

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ebjlady2 is trying to decide taken from "AVR replacement at 41yo.. Which way to go ?"

Hi...
Having my second valve replacement surgery on Feb. 8 at Duke..Also having an aortic anuerysm repaired. I had a St. Jude mehcanical valve in 1986 at age 37...I am now 62 and trying to decide on whether on having a mechanical valve or a tissue valve. I know all the pros and cons....but being on coumadin for 25 years has definitely got me thinking about the tissue valve. Last year I had 55 protimes at a protime clinic....so you can imagine how many I have done in 25 yers. I also understand the possibility of another surgery (tissue) in 10-15 years. So tough choice and only have another week to make a decision.


Welcome ebjlady.

Very happy you have found and joined us.
Please do start a new thread.
We all want to provide support and welcome but your post may not be seen in the midst of this thread.
Very sorry to read you are facing another surgery and understand how difficult your choice of valve.

I had two OHS in four years and can truthfully tell you my second was very much easier on me than my first.
Also, you may be very surprised at the advancements and changes since your last OHS.
Very Best Wishes.

A HEARTFELT WELCOME to our OHS family of brothers and sisters, there are some strong opinions here but the bottom line is that you must take all of those opinions and the debates with all the pros and cons anf THEN in conjunction with your health care team make a decision
 
ebjlady2, you may want to look at the study (or at least the Abstract) entitled "Hancock II Bioprosthesis for Aortic Valve Replacement: The Gold Standard of Bioprosthetic Valves Durability?" by Tirone E. David, MD, Susan Armstrong, MS, Manjula Maganti, MS, in Ann Thorac Surg 2010;90:775-781, abstract at ats.ctsnetjournals.org/cgi/content/abstract/90/3/775? .

In it, a top heart-surgery team shows remarkably good long-term results from the Hancock II "piggy" valve, especially in us over-60's. I think you'd have a reasonable chance of hitting your statistical life expectancy with the same valve, though there are never any guarantees in any of this. The only other tissue valve I know that has published durability results almost that long-term and almost that good, is the CE Perimount (mostly the older model, because I think the Magna is too new to have long-term results). The comparison between the two is discussed in great detail in the last few pages of the "Gold Standard" article -- which unfortunately is only available online for $$, maybe $30.

There are newer and "fancier" valves out there, and they MAY end up lasting even longer -- the ATF (?) valve made from a horse pericardium seems impressive to me, but quite new -- but for pure proven durability, the Hancock II does seem like the "Gold Standard". So if you really want to avoid ACT and ALSO have a good chance of avoiding the need for a re-op, it might be a good shot. Of course, there's also a reasonable chance that one of the two cath-implanted valves now being used in Europe and/or Japan and/or tested in the US will become a mainstream option by the time you need a re-do, if you ever do.
 
Good Luck with your choice--pick what you feel most comfortable with, and that will be the best for you. You're going to be a pro at getting through this!
Soon the worries about the aneurism will be history.
 
The 'other' option of course is a mechanical valve.

The On-X Valves have several technological improvements that are 'interesting'.
You can learn more about them at www.onxvalves.com and www.heartvalvechoice.com

The mechanical valve with the longest track record (30 years and counting) is the St. Jude Master's Series. See www.sjm.com for more information.

ATS and Carbomedics also manufacture mechanical valves and have websites describing their products.
 
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