expected longevity of 25-yearo

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Pizza-fan

Hi, valvers!
I'm a 25 yearo, waiting for valve replacement in Athens in May 28 (not sure yet). They want to place in me a mechanical valve (St. Jude or On-X).
May be as everybody here, I searched for some data of life expectancy. What I found was a study from 1999, where they give 27,5 years average expected live for male 25 years old valve patient with mechanical valve. How should I understand it? Does my lifespan is so limited, only becouse of my artificial valve? My heart is still working fine and I am not ill and have no other diseases.

Best wishes.

Victor
 
Hi Victor,

I had my aortic valve replaced in November 1991 at the age of 22. I have had no valve-related issues since then. Last week I had an aneurysm repaired that my doctors believe is a leftover effect of the old, leaky valve.

That said, when they opened me up for my AAA repair, the surgeons said the valve looks as good as new and did not need replacing. They keep telling me that the valve should outlive me. Not sure where you are getting those longevity figures but maybe those figures are related to coumadin/bleeding/infection disorders that are related to valves?

Everything I have heard and read pretty much states that valves are to last forever mechanically and structurally, but if you get infected or if you throw a clot, maybe that would alter your lifespan?

Not sure.
 
Welcome Victor, I'm happy you found us. I'm not sure where you are finding your information. Regardless of what kind of valve they end up using, no one is going to tell you that you have any sort of life expectancy significantly shorter than people who do not have valve replacements. If you are an other-wise healthy 25 year old, you can expect to live a nice long life. What you may be seeing is a number associated with how long a mechanical is expected to last in you (and if that is the case I don't necessarily agree with that number). Even if the valve does last 27 years, this doesn't mean that when it ceases to work well, your life is over. You will just be preparing for another replacement. PLEASE rest assured that you are not being told you have 27 years left to live!!!!!:eek: :eek: :eek: :D

The reason a mechanical is generally the preferred type of valve for a young adult is because it is expected to last a long time and keep you out of the operating room. We have a member here who had his valve replaced with one of the first models of mechanical valves, and he has had it 40 years. We have members who have had their mechanical valves 25 - 30 years. I have 15 on mine. The newest mechanical valves have very promising expectations. The On-X is a very promising newer mechanical. Some people do end up having to have their mechanical valves replaced, but the reason for this is growth of tissue, clots or infection around the valve and not the valve itself failing.

I feel so badly that you may have been thinking you were looking at a shortened life. You'll get your valve replacement and lead a very full, active life.

Please feel free to ask any and all questions.
 
Back when I had my valve replaced, I found a number closer to 150-200 years for the life expectancy of my valve. They had tested the mechanical valve outside a human body, and expect it to function for at least that long. That was good enough for me. The rest of my body will fall apart first.
 
I once corresponded with an engineer who worked for St Judes and got him to describe the testing procedures. They obviously can't run it at 60 beats per minute or it would take 30 years to test. So what they do is run it at a very high rate, several thousand cycles per minute, to simulate 30 years of use. They test dozens at a time to get a good statistical sample.

Their quality criteria is no mechanical failures in 30 "years". After that they may go another 30 or 50 "years" before the mean time between failures becomes significant. So yes, there is some small statistical probability that one valve from a production run will fail in about 30 years. That's pretty small in comparison to the probability that you would die in surgery or die in a car crash or even die getting struck by lightening.
 
Pizza-fan said:
Hi, valvers!
I'm a 25 yearo, waiting for valve replacement in Athens in May 28 (not sure yet). They want to place in me a mechanical valve (St. Jude or On-X).
May be as everybody here, I searched for some data of life expectancy. What I found was a study from 1999, where they give 27,5 years average expected live for male 25 years old valve patient with mechanical valve. How should I understand it? Does my lifespan is so limited, only becouse of my artificial valve? My heart is still working fine and I am not ill and have no other diseases.

Best wishes.

Victor
Absolutely NOT! That is about as long as they've done the study and at the end of it, that is there conclusion. We've got members here going on nearly 50 years and still ticking!
 
not for the valve

not for the valve

No, the subject of the study was the patient's life expectancy, according to his age and gender (not anything more), a randomized average outcome for the past 40 years. There was written an average expected longevity of:

- for 25 years old = 27,5 years
- for 35 = 22,0 years
- for 45 = 17 years
...

I know, that I won't die exactly after 27 years and 6 months :D
It was interesting for me, what are the main reasons about these outcomes in the past 40 years.

I have also read, that by young people, who have valve disease, there may be an association with other heart diseases. Hmm... I don't have any relations with any heart issues! :confused:

Hope it's kind of good predictor. :rolleyes:

Best wishes!

Victor
 
event-free?

event-free?

What is the difference between "life expectancy" and "event-free life expectancy"?:confused:
 
Event-free, I'm guessing, is referring to no clots or major bleeds. For a mechanical valve, depending on what report you look at, you have a 1-3% chance of having an "event" per year. This is NOT a cummulative effect issue, so your chances don't increase with each year. I've had my valve 15 years with no events to date.

I still am not getting the thought process behind the study you are referring to. It seems like a pretty bogus study (and darned depressing!), no matter how it is viewed.

Your life expectancy without surgery is pretty dim. Even though your heart is in otherwise good shape, it will not continue to be as the valve deteriorates and it will eventually take your life.
 
Hi Pizza-fan,

I read over the study that you posted. The objecitve of the study was to develop a statistical (and thus unbiased) model of patient outcomes based on the type of AVR undergone. They simulated different age groups because, as we know, operational outcome, valve durability, and event-free living all have correlations (be they positive or negative) with the age of the patient undergoing AVR. Overall, I applaud their attempt to create this model. However, very few conclusions can be drawn from this model for a number of reasons:

1. One would certainly expect an AVR patient to have a lower life-span than an otherwise healthy individual. OHS and then having a non-native aortic valve both carry increased risks of mortality. The researchers found that average life expectancy for valve recipients was shorter but this could only be partially explained by valve-related issues. Apparently, valve patients have a higher risk of other non-related valve health problems than the general population. Unfortunately, the authors gave no explanation for why this might be the case.
They had to collect data to calibrate their simulation model, however, they give very little information on what patients were used and which were not. We all know that many, if not most, aortic valve patients do not just have isolated aortic valve disease. Some have aortic valve disease because of rheumatic fever, others because of radiation from cancer therapy, others because of a wide-ranging syndrome like Marfan's, not too mention a myriad of other reasons. Other AVR patients have issues with multiple valves. Being in any of these aforementioned categories would lower one's life expectancy compared to someone like yourself who has isolated aortic valve disease. If one was to remove all of those patients who had concomitant health problems from the model it is quite obvious that the life expectancy for aortic valve replacement patients would be only slightly less than an average healthy individual of the same age. Until the patients are grouped according to other risk factors the study remains mostly useless to both patients and health care providers. In fact, it could be misleading to many patients who read it and do not see the clear caveats issued by the authors. They know that there study should not be taken at face value as many patients who read it would end up taking it.

2. The outcomes used to calibrate the simulation were based on surgical techniques and non-invasive cardiac medicine techniques that have been significantly improved upon in the past ten years. Operative and re-operative mortality and morbidity rates continue to decrease every year. Non-invasive techniques continue to improve every year: new medicines come out and doctors learn how to more correctly treat the patient using these new medicines and existing ones every year. Any valve study which takes patient data from the 90s and even the 80s, which this one does, must be viewed with more omptimism then it puts forth due to these significant increases in helath care outcomes for AVR patients in the past 10-20 years.

All in all, of course your life expecatncy is reduced after AVR compared to a healthy individual of the same age. Anyone who says otherwise is deliberately hiding from the truth. Your life expectancy is significantly reduced if you have concomitant health problems (whether or not they were the causation) associated with your aortic valve disease. However, individuals who are otherwise healthly like yourself should expect, on average, to have a life-span approaching (but not reaching) that of a healthy individual of the same age.

Brad
 
Perhaps a MVR is different, or my cardio is just telling me what he thinks I want to hear, but his belief is that my life expectancy is not altered due to my MVR.
 
Hi Gina,

Your cardio may be right. At this point in time, your life-expectancy may be similar (although I doubt quite as high) as non-MVR patients. However, the study under discussion measured life expectancy from immediately before the first AVR onwards. If I remember correctly you have had two rather risky open heart surgeries since your first MVR. If I remember what you wrote correctly, in one case you were given a 50/50 chance of surviving. Thus, if one were to calculate your average life expectancy from the day before your first MVR onwards I doubt anyone could argue it would have been as high as an healthy individual of the same age. Now that you have survived many significant risks associated with your valve disease and you have no other major health problems your life expectancy may be very close to the average for someone in the general population of your age. So I don't think your cardio and this study were in opposition, they were jsut coming at it from different angles.

Brad
 
healthy living

healthy living

Yes! That's what I wanted to say. My cardio told me: "You may feel even more safety, couse you are observed often for any health conditions".
 
Adam,

I agree. No one, including the authors of that study, are in any way whatsoever insinuating that one should not have aortic valve replacement surgery. Even with the overly pessimistic life-expectancies given in the study they are significantly higher than one's life expectancy if they do not undergo AVR. This is a fact that is not disputed.

Brad
 
To Bradley

To Bradley

Bradley, I see that you are very educated in understanding medical documents. But I want to ask you something. "Life expectancy" means, that one should expect life, full of risks, which by itself add reduction in many lifes. And assumed, this statistics give average prognosis. But I sow too, that here are some valvers, who were operated in the 60's and still lead normal life (one of them is 71 yearo :) now).

So, may I understand that "life expectancy" doesn't mean death sentence, just expectation?

Thank you!
 
Victor, I think the message we are trying to leave you with is that you have a very promising outlook for a very happy, long life. Your time might be shortened a little, but who can really say what that is. If I live to 75, will someone say - Poor thing, she only made it to 75 because of her valve replacement. Or will someone say - Wow, look, she made it to 75 because of her valve replacement. I would choose the latter and not the former. One thing I'm pretty certain of, if I hadn't had my valve replaced 15 years ago, I would not be here at the ripe old age of 48. Best wishes!
 
Hi Pizza-fan,

Just as pathfinder, karylnn and the others have said life expectancy most certainly doesn't mean a death sentence -- it is just the average.

I'm completely making this up, but let's pretend life-expectancy for a healthy 25 year old is 76 years. For a 25 year old individual about to undergo aortic valve replacement the life expctancy is 69 years. In this made-up scenario, there is a 7 year difference in the average "life-expectancy."
That doesn't mean that if you had AVR at 25 once you hit 69 you will die. Not at all. 69 is just the average. Some very, very small amount of people die on the operating table, then some people die at 35 in a car crash, some at 59 because of liver failure, etc, etc. Some live to be 80 or 90, some even longer.

The same can be said for those not undergoing valve replacement. Some are going to die before they hit thirty because of a car accident, some will die in their 40s because of a heart attack. Some don't die until they are 95. One's life expectancy is an average made up from all of these people.

If you rode a motorcycle w/out a helmet your life expectancy would be reduced because of the number of fatal motorcycle crashes. Every individual has their own unique risks in life. For us, one risk is valve replacement. It is not a death sentence, we are people, not statistics, and how long we each live will be an outcome of completely unique events. Medical statistics are invaluable tools for both patients and caregivers, but they most always be understood and evaluated in the proper context.

All in all, if you live a healthy lifestyle you can expect to live a long, full life on par with anyone who wasn't an aortic valve recipient.

Brad
 
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