need my valve replaced and want to know chances of..

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17yeartricuspid

New member
Joined
Apr 19, 2014
Messages
4
Location
Manchester, UK
I need OHS to replace a tricuspid valve I have had since birth as now it has severe regurgitation.. need the operation in 1-2 years.
I am 17 years old, 6ft1, 13 and a half stone and athleticly built and quite fit...
it is a very stupid question but one I would like to know
what are the chances I could pass away during/after the surgery?

I know you will say don't worry and I am not, I just want to know what the statistics are :p
thanks
x
 
I need OHS to replace a tricuspid valve I have had since birth as now it has severe regurgitation.. need the operation in 1-2 years.
I am 17 years old, 6ft1, 13 and a half stone and athleticly built and quite fit...
it is a very stupid question but one I would like to know
what are the chances I could pass away during/after the surgery?

I know you will say don't worry and I am not, I just want to know what the statistics are :p
thanks
x
well first of all being an American I have no idea what 16 stone is but from your description it sounds like you're in good shape. I haven't had surgery yet either but as it's an eventuality I've been interested in the same question. The information I've come across basically lists a few factors 1) age of the patient 2) physical condition of patient 3) quality and experience of the surgeon 4) quality of the place your having it done and 5) complexity of procedure. It seems you have the first 2 on your side as for three and four I don't have the necessary information to comment .
 
I know you will say don't worry and I am not, I just want to know what the statistics are :p

ok ...

According to Guidelines on the management of valvular heart
disease
published European Heart Journal doi:10.1093/eurheartj/ehs109

Operative mortality after surgery for valvular heart disease
Aortic valve replacement
European Association for Cardiothoracic Surgery (2010) 2.9% (sample size 40 662)
Society of Thoracic Surgeons (2010) 3.7% (sample size 25 515)

Which includes elderly, infirm, diabetics and any other 'comorbididty' you can think of

So given your health condition, I reckon you'll be waking up again.
 
PS

stats are stats, and among the worst offenders for mishandling stats are medical people. (see this journal article)

However to open the can and see what worms are inside: This article
http://www.ncbi.nlm.nih.gov/pubmed/16515904
seems to be well cited
Determinants of operative mortality in valvular heart surgery.
Rankin JS1, Hammill BG, Ferguson TB Jr, Glower DD, O'Brien SM, DeLong ER, Peterson ED, Edwards FH.
Abstract
OBJECTIVE:

In some respects, outcome reporting in valvular surgery has been hampered by focusing on specific populations, reluctance to publish high-risk subgroups, and possibly skewed or inadequate samples. The goal of this study was to evaluate risk factors for operative mortality comprehensively across the entire spectrum of cardiac valvular procedures over the past decade.
METHODS:
All 409,904 valve procedures in the Society of Thoracic Surgeons database performed between 1994 and 2003 were assessed, and Society of Thoracic Surgeons preoperative and operative variables were related to operative mortality by using a multivariable logistic regression model. Data were greater than 95% complete, and the relative importance of relevant risk factors was determined by ranking odds ratios. The analysis had a high predictive power, with a C statistic of 0.735.

RESULTS:
In the model, 19 variables independently influenced operative mortality (all P < .01). The most significant was nonelective (acute) presentation (odds ratios, 2.11), followed by advanced age (odds ratios, 1.88), reoperation (odds ratios, 1.61), endocarditis (odds ratios, 1.59), and coronary disease (odds ratios, 1.58). Generally, valve replacement was associated with higher mortality than repair (odds ratios, 1.52). Overall, female gender was very important (odds ratios, 1.37), and earlier year of operation increased risk (odds ratios, 1.34), implying improving outcomes over time. Although any single comorbidity, on average, was only moderately contributory (odds ratios, 1.19), specific comorbidities, such as renal failure, or multiple comorbidities in a given patient could be very significant. Aortic root reconstruction carried the highest risk (odds ratios, 2.78), followed by tricuspid valve surgery (odds ratios, 2.26), multiple valve procedures (odds ratios, 2.06), and then isolated mitral (odds ratios, 1.47), pulmonic (odds ratios, 1.29), and aortic (reference procedure) operations. Reduced ejection fraction and severity of valve lesion were relatively less important (odds ratios, 1.34 and 0.83, respectively).

CONCLUSIONS:
These data illustrate the significance of acute presentation in determining operative risk, and earlier surgical intervention under elective conditions might be emphasized for all types of significant valve lesions. Because aortic root reconstruction doubles mortality compared with simple aortic valve procedures, root replacement should be reserved for specific root pathology. Finally, issues related to reoperation, endocarditis, valve repair, gender, and the various procedures deserve more detailed examination.

and:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2694240/

DISCUSSION/CONCLUSIONS:
In octogenarian patients, the need for a procedure associated with surgical myocardial revascularization produces an absolute increase in hospital mortality risk of 45%. The variables that contributed to hospital mortality were preoperative endocarditis, preoperative cardiogenic shock, the use of extracorporeal circulation, the length of time of extracorporeal circulation, postoperative creatinine level, and postoperative need for prolonged respiratory support.

so (referring to the underlined above) as I said in my first post, age has a lot to do with it. Time on "pump" (extracorporeal circulation as I understand it) is the next big factor.

... just because when it comes to information : too much is always enough ;-)
 
hi and welcome aboard, sometimes to much info makes your head spin and can make things worse, for me when i asked my cardio the same question he said less than one per cent looked me up and down and said, you will do just fine, sorted lol
 
ok ...

According to Guidelines on the management of valvular heart
disease
published European Heart Journal doi:10.1093/eurheartj/ehs109

Operative mortality after surgery for valvular heart disease
Aortic valve replacement
European Association for Cardiothoracic Surgery (2010) 2.9% (sample size 40 662)
Society of Thoracic Surgeons (2010) 3.7% (sample size 25 515)

Which includes elderly, infirm, diabetics and any other 'comorbididty' you can think of

So given your health condition, I reckon you'll be waking up again.
The whole "time on the pump" factor is another vote for replacement over repair, I assume repair is a longer procedure.
As for aortic root work doubling the mortality rate compared to simple valve work that's not the kind of reading I usually prefer with my morning coffee. ....
 
Hi all I am a 49 year old female and had severe bicuspid valve stenosis just had AVR 6 weeks ago and the surgeon said there was about a 1% chance of the surgery being fatal. I didn't even give it a second thought. After 6 weeks I feel pretty good, I have to remind myself not to do any lifting. The surgeon replaced my valve by a small 3" horizontal incision above my right breast.
 
For my first surgery at age 43 I was told 2.0% and for my second surgery at age 50 I was told 3.5%. Those numbers were related only to surviving the initial surgery.

My first surgery was a bit more complicated because I had a Ross Procedure and the second one was a redo and also involved repairing my ascending aorta, so both numbers are probably slightly higher than for an isolated valve replacement. Either way it's pretty low. For an otherwise healthy 17 year old I would think it would be even lower than whatever the statistical average is.
 
I know you will say don't worry and I am not, I just want to know what the statistics are :p
x

WebMD has a site where you see the stats on local hospitals for various procedures ("The Hospital Advisor tool from WebMD Health Manager"). Unfortunately, it doesn't look like a public site. I get to it via my insurance (BlueCrossBlueShield), but if I try to directly open the link, it wants a log in.
 
I understand your concern and that is a normal concern, we have all faced that. I think your chances of survival not just through surgery, but through a normal life span are extreemly excellent. As long as you take care of yourself and do the right things, you will live to be as old as anyone without a heart problem. I can tell you through my research of the hospital I had my valve replaced at, they hadn't lost anybody as a result of the surgery. It has become routine and you shouldn't worry about it.
 
If you go to a top-notch surgeon and hospital, it should be about 1%. And just because their estimate is "1-2 years" don't get too caught up in that. Your heart might cope better than they expect. Best of luck to you. :)
 
I agree with what others have said. The odds of dying during or after surgery are very, very low. I always figured I was in more danger as my heart was struggling to keep up in the weeks before my surgery. Keep monitoring your situation and when the doctors say it's time for surgery, move forward without hesitation and without fear. When all are in agreement (cardiologist, surgeon, etc.) that it's time for surgery, you will know that the estimated risk of doing nothing outweighs the risk of the surgery. At age 17, I think you should be more worried about the risks of driving a car (my son is 15 years old and just learning to drive).
 
Clay makes a great point. They dont recommend that we have this operation because everything is OK with our health.

Dont get me wrong, its not a walk in the park. Its a envasive procedure but its low risk. My surgeon told me that in terms of life expectancy, once I've had my valve replacement it will be like I never had a valve issue. The risks are generally related to age and other health conditions a patient might have.

At 17 you have very little to worry about, and you'll bounce back before you know it.
I had OHS at 21 and was off camping and fishing before others who had operations were discharged from hospital.
 
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