Life Expectancy after Valve Replacement

[tommyboy14]

Hello again,

I did not mean to be confusing. The only point I was trying to make, that the only logical conclusion from reading work on survival after AVR, is that it does not matter for life expectancy. That is what the statistics say. It is also, in my opinion, one of the key reasons why the Ross procedure has such good survival stats, because it is typically only offered to the healthiest/strongest patients.

This is what this article establishes, which is worth reading:
http://circ.ahajournals.org/content/123/1/31.full.pdf

Hope this helps

Clarity comes from reducing verbose language. One can bypass a lot of extraneous, superfluous data by merely focusing on substantiated risk factors. It's like the cardiac surgeon who outlined the mechanisms of heart disease. He isn't trying to fulfill the foregone conclusions of lobbyists in the food and medical industries with their 'peer reviewed' studies.

There is always someone ready to twist information to suit their own needs.

 

[PsyDanny]

Leading causes of death by age:

http://www.vox.com/2016/5/10/11608064/americans-cause-of-death

 

[PsyDanny]

I only clicked once, so have no idea why there are several duplicates.

 

[Heart Of The Sunrise]

The obvious answer to me is...much longer than if you do not have the surgery! My mother is 92......my family history says that now that I have had the surgery... that is a reasonable expectation.

 

[Nocturne]

Just found this study from earlier this year that examined long term AVR survival over twenty years by age category.

It seems to have more positive findings than previous studies I have read.

Average lifespan for AVR recipients is still shown to be lower than average, depending on age, but the relative survival rates don't look too abominable if you examine the charts near the end.

http://icfjournal.org/index.php/icfj/article/download/138/pdf-2

 

[pellicle]

Just found this study from earlier this year that examined long term AVR survival over twenty years by age category.

their conclusions section is what I've been saying to you all along:

Conclusions
Patients over 68 years discharged from hospital after aortic valve replacement had a similar 10-year survival as an age- and gendermatched population. In this age cohort surgery restored the patient’s normal life expectancy

 

[dick0236]

I'm sure glad I've outlived all of these studies on my mortality. I liked the way my surgeon put it to me in '67...."without surgery you'll be dead by forty"......"with surgery we just don't know, but we'll put in a valve that'll maybe last 50 years just in case". In less than a year I'll make the 50 years......then what? Oh well, it's getting late so I'll worry about that tomorrow.

 

[Nocturne]

Patients over 68 years of age, Pellicle. Yes, in THAT age cohort, AVR surgery restored normal life expectancy -- though there may be some selection bias at work there, as there is for the 74 and over cohort, because those deemed too frail to survive OHS do not receive it (this results in that cohort having post-AVR survival that is BETTER than that of the age matched cohort in the general population -- though TAVR will likely change this in the future, by bringing it down, which will curiously be a GOOD thing).

In the 15-59 age cohort, according to this study, survival at 10 years looks to be roughly 85-90% of normal, and trending downward.

 

[Nocturne]

Looking at it another way, the raw survival broke down such that for the 15-59 age group, about 80% of them were still alive 20 years after AVR. For the 60-69 age group, about half of them were still alive 16 years later. Those odds are significantly worse than the general population, but they don't mean you're doomed, either.

 

[pellicle]

face it mate ... you're going to die ... to be honest who cares when? Make the most of it ... don't sit around brooding about what are the possibilites

I really just do not get the point of this. You could die tomorrow in a crash ... or you could just get out and do exersize instead of reading reports on how short your life is going to be ... you could pack life into the time you have, rather than packing more and more morbidity into the time you have left.

What the hell is your priority? Enjoying life or sitting in a chair wondering if you're going to die because of being alive? I've got friends who suddenly developed MS at 30 ... do you think she sits around reading about how sick she's going to be?

No!! She goes out and does ****.

Tell me what this incessant focus on posting mortality stats achieves?

What is the question you're going to answer?

Do you think by the analysis you'll be able to be sure you'll live X years? Its a farce ... you have ZERO idea how long you'll live unless you put a gun to your head and kiil yourself ... then you'll be able to determine the time and date.

Just live life and enjoy what you have. Who knows you may get a brain tumour and die unexpectedly like my wife did.

 

[Agian]

Statistically, take a large group with any illness and you'll find a reduction in longevity; be it asthma, diabetes, etc etc etc

Stats and rats.

 

[Nocturne]

Pellicle, I knew I'd be attacked for it (and have you once again insinuate that I'm not doing anything positive for my health in the face of overwhelming evidence to the contrary), but I posted that link because it made me feel better, and I thought it might do the same for others.

You and I are at different stages, and besides that I do not think we process the same way at all. Let's just leave it at that.

I know this is unpleasant information to talk about, but let me put it in perspective -- the last generation of my large family KNEW about the familial prevalence of heart disease in the two generations before them. For starters, my grandfather and HIS father died of heart attacks in their 50s. Luckily for the last generation, none of them have had heart attacks yet (they are in their 60s to late 70s). But they never spoke about the familial trend towards heart trouble because (in the words of the ones I have spoken about it with since) it was "unpleasant information to dwell on". I was told a funny story about how my grandfather died young because he had all of his teeth pulled at once in order to save money on false teeth. That actually did happen, but what he died of was heart disease, and at a very young age, just like his father before him, just like various relatives in generations I cannot remember.

If just one of them had pulled me aside when I was young, and told me the whole truth, scary and unpleasant as it was...

But THAT isn't worth dwelling on. Still, I see clearly what comes of NOT talking about things because they are unpleasant to talk about.

Knowing your odds can give you the opportunity and incentive to work to improve them. I realize that many people here are coming from a totally different perspective because they knew about their BAV from an early age.

 

[Nocturne]

Statistically, take a large group with any illness and you'll find a reduction in longevity; be it asthma, diabetes, etc etc etc

Stats and rats.

Probably true -- but how much reduction? A day? A month? Two decades? There is a difference.

 

[Agian]

Probably true -- but how much reduction? A day? A month? Two decades? There is a difference.

You're hard to have a dialogue with. We know the cause of mortality post-AVR. People don't just die all of a sudden because the statistics predict a certain life expectancy: Valve failure, clots, bleeds, endo, the risks associated with the operation itself (1% mortality) and above all comorbidities. Pool it all together and of course you're going to get stats that impact life expectancy. Think about the impact on the stats of people who have died because of three-monthly INR checks. There are even people with mechanical valves who stopped taking 'tablets' years ago. People still lose legs because of poorly-managed diabetes. How many people out there with aortic stenosis smoke? Heaps.

 

[Paleowoman]

I know this is unpleasant information to talk about, but let me put it in perspective -- the last generation of my large family KNEW about the familial prevalence of heart disease in the two generations before them. For starters, my grandfather and HIS father died of heart attacks in their 50s. Luckily for the last generation, none of them have had heart attacks yet (they are in their 60s to late 70s)..

Hi Nocturne,

What may interest you here is that heart disease peaked some time ago and then lessened. Both my dh’'s grandparents died in their 50's of heart attack, and his father had his first heart attack when he was in his 50's but survived, with several heart attacks inbetween, until he was 80. That’'s not to say that heart disease has completely disappeared, no it hasn’'t, but it’'s much less than it was. Here’'s an article by a UK doctor who shows the data of the decline in heart disease in the US: http://www.drdavidgrimes.com/2016/01...ic-report.html Please read it. Here’s just one interesting paragraph:

“…"....autopsy findings in US soldiers killed in wars. In the young men who died in the Korean war (1951–1953), pathological evidence of CHD was found in 77%. This had fallen to 45% in those who died in the Vietnam war (1968–1978), and to 8.5% in those who died in the Iraq and Afghanistan wars (2000–2011). There is clearly a major decrease of the pathological basis of CHD, corresponding to the decrease of deaths in the general population."

 

[Nocturne]

You're hard to have a dialogue with. We know the cause of mortality post-AVR. People don't just die all of a sudden because the statistics predict a certain life expectancy: Valve failure, clots, bleeds, endo, the risks associated with the operation itself (1% mortality) and above all comorbidities. Pool it all together and of course you're going to get stats that impact life expectancy. Think about the impact on the stats of people who have died because of three-monthly INR checks. There are even people with mechanical valves who stopped taking 'tablets' years ago. People still lose legs because of poorly-managed diabetes. How many people out there with aortic stenosis smoke? Heaps.

And what percentage of those people being irresponsible were reassured by their docs that they'd have a post-AVR life expectancy of "almost normal", or that they'd have normal lifespans "barring future complications", or some other pleasant wordplay? Maybe if that had some unpleasant facts put before them, they'd have been more inclined to be careful. Maybe they'd have quit smoking, hit the gym, been more careful about their pills.

What you are saying, maybe to yourself more than to me, is "I'm safe because I'm responsible about my health, so no need to talk about that unpleasant stuff." That sort of self reassurance smacks of my family's logic -- "we're safe because of statins/bypass/bettergenesfrommom'sside, so no need to talk about that unpleasant stuff."

Of course some of the mortality post AVR comes from dumb people doing dumb things that we can all feel safer knowing we won't do. But that's not all of it, and while focusing on it might shield our minds from unpleasantness, it doesn't really help people who are trying to make an accurate assessment of how to best live their lives to obscure the danger they are in because pointing it out is unpleasant.

 

[Agian]

No, we're safer because we take responsibility. Sometimes **** just happens. I could have a stroke right now because of something completely unrelated to my heart.
You're right when you say that knowing your risks can avert a disaster. Knowledge is power.

 

[pellicle]

Mate

Pellicle, I knew I'd be attacked for it (and have you once again insinuate that I'm not doing anything positive for my health in the face of overwhelming evidence to the contrary), butperspective because they knew about their BAV from an early age.

Once again you misunderstand, it seems almost deliberate

I ask what is the benefit of your posts? What does it bring to the table?

I do not insinuate you are doing nothing for your health. I state plainly that no matter what you do, focus on enoying your life, focus on getting happiness from your life.

Stop focusing on death, on attempting to know how long you may live because that is unknowable.

Your interpretations of attack are mistaken, I am trying to more vociferously restate what Dick said to you months ago when he said "I was once like you..."

There is no balance in your posts that focus only on the topic of how long you are statistically likely to live.

I have tried to show you that it's perception
I have tried to show you that it's unimportant
I have tried to show you that there are too many variables

But you have consistently rejected that, you have never acknowledged a single point and repeatedly reply with more focus on mortality stats

My goal is to shift your stare from that to the fact that you are wasting your life on this bullshit staring into the abyss

I don't care what you are or aren't doing, but I'm willing to bet if you came and lived with me and for a while you would see changes.

What I am saying is this : change your life to save your life

I suspect however you are more interested in putting more energy into reading about causes of death and mortality than just living and being happy that you are

All of your posts presume that there is a fixed outcome. There is not.

 

[cldlhd]

You seem to be attempting to control what you can to improve your health and gain some knowledge on the subject and other than that there's not much you can do. You can't change your genetics unless you grab Marty McFly and fire up the Delorean.

 

[pellicle]

You're hard to have a dialogue with. We know the cause of mortality post-AVR. People don't just die all of a sudden because the statistics predict a certain life expectancy: Valve failure, clots, bleeds, endo, the risks associated with the operation itself (1% mortality) and above all comorbidities. Pool it all together and of course you're going to get stats that impact life expectancy. Think about the impact on the stats of people who have died because of three-monthly INR checks. There are even people with mechanical valves who stopped taking 'tablets' years ago. People still lose legs because of poorly-managed diabetes. How many people out there with aortic stenosis smoke? Heaps.

+1

All points