My Surgeon suggested Mosaic Valve????

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S

swatig

Hi Everyone,

Thanks for all the support and love you have shown.

The news is that I went to meet a Cardiosurgeon today. I Had 45 minutes conversation with him, he said in my case he would be going for a Tissue valve called Mosiac, its a third generation valve with higher life span. I tried to get some information regarding mosaic but couldnt find anything great.
I asked him if I can undergo minimal invasive procedure and his answer was yes but he also told me that since I am 26 I will have to undergo another surgery and then I wont have an option of minimal invasive procedure so it doesnt matter if I get it done this time or not. He also said that recovery would be better and sooner in case of regular procedure.

Another thing he told me was that he wouldnt suggest me the Ross procedure because it might only create complications and would like simple valve replacement since rest of the heart seems to be doing fine.

I Have another appointment with Dr. Verrier on 3rd May. Will keep everyone updated.

Can anyone tell me anything about Mosaic Valve or point me to any data base?

Thanks for all your support once again, You guys are great!

Regards
Swati
 
mosaic valve

mosaic valve

I'm sure you can understand that anyone who has been in your position and proceeded to make the difficult valve-choice decision and then gone through the procedure is heavily invested in the particular solution he or she has chosen, so there is a strong tendency to be an enthusiastic proponent of such an important personal choice. This is not to say that anyone is necessarily "wrong" in their views but maybe nobody is strictly "right" either, since this is a situation where you must look at the available options and try to educate yourself as much as possible and then make a personal choice that you feel comfortable with. It is not an easy decision for anyone. In your case, since you are young, many people would likely recommend a carbon or stainless steel valve instead of the tissue option your surgeon is recommending, since those non-tissue valves last forever and no reoperation would be required down the road.

I was 30 years older than you when I got the medtronic mosaic ultra valve installed in my aorta last December, almost 5 months ago now. My recovery has proceeded well (not without some minor issues, which is fairly normal) and I am comfortable and happy with my decision, though I know I might have to get another operation in 20 years or so (longer if I'm lucky). In your case, I might have been persuaded to choose differently, depending on surgeon's advice.

Others on this list will promote the virtues of the Ross procedure, though I didn't consider it myself since someone told me that it posed greater risks simply because it is more complicated so more things can go wrong. It is also a question of how you feel about the advice you are receiving from your surgeon or cardio specialist. If you trust the person who is providing it, that counts a lot. My surgeon told me that he himself would get the mosaic valve and it is the one he recommends to most people, and he was very experienced at putting it into people and he works in a surgical unit that does a great many of these operations.

I asked him about the On-X valve but he said it was still too early, that not enough data is available about the On-X yet, and the fact that he knew so much about the mosaic was determinative for me as well. Others on this list have chosen the On-X and you might want to know about their experience too, but my main point here is that you want a surgeon who is an expert at what he is going to be doing to you, obviously. Nobody wants to be a guniea pig. (No pun on pig tissue intended)

One thing bothers me: I am a little dubious about your surgeon saying that the recovery is easier for a standard sternotomy than for a minimally invasive approach. That makes no sense and I would question him about that. It might be a misunderstanding on your part about what he said? One of the members of my surgical team told me (before I talked to the surgeon himself) that tissue valves typically last only about five years, and on the basis of that one remark I almost ditched this surgeon because I knew that was not the case, but the surgeon himself was more knowledgeable so I stuck it through all the way and am now very glad that I did.

I wish you the best of luck and will follow your progress with interest.

David L.

Bicuspid heart valve replaced with medtronic mosaic ultra tissue valve at Bellevue Hospital, NYC, on 12.12.06 with root repair and one bypass. Surgery performed by Drs Charles Schwartz and Juan Grau.
 
Hi David,

Thanks a lot for the quick reply. I really appreciate it.

My surgeon suggested me tissue valve because I told him that I want to have kids. Even before my appointment with the surgeon I did a lot of research which made me feel very confident about my decision of getting a tissue valve. But I dint feel great after meeting the cardiosurgeon my cardiologist had refered. As you said even I found some of his answers vague and not very satisfying. He said that If I was his wife he would go for mosaic but wasnt able to give a lot of information about Mosaic valve except the fact that he thought that they last longer. Also his answers on minimal invasive surgery were not very satisfying. I am planning to meet other surgeons too. Lets see how they turn out.

Thanks a lot once again,
Swati
 
I have read and heard that the minimally invasive is more painful initially than a full sternotomy, but the healing period is shorter for the chest area (not necessarily the heart). This might be what the surgeon was referring to.
 
By minimally invasive, does he mean a smaller incision (maybe 4-5 inches) or through the side? I would think he just means a smaller incision, as that's what the referred to for mine. It doesn't extend the typical, and more common, (at least several years ago) full sternotomy. My incision would be maybe 3.5 inches total, but my surgeon ran out of room, and had to cut more. He said that my anatomy was slightly higher than he thought.

As far as the mosaic, and your surgeon not really giving you any specifics, I would be bothered by it. If he is so sure this is the valve to go with, he should have plenty of reasons why, and even documentation/studies that have convinced him of that reason.

I would suggest do your research on the type of incision, valve, etc before meeting with surgeons. Then, when you meet with them, you are better prepared to ask the right question. If your not getting the answers to the questions you answer, and you feel uncomfortable with that, then move on.

My surgeon made himself available via phone, on a few different occasions to address very specific questions I had. He had operated on many BAV patients, but I wouldn't call him a BAV specialist. I had specific questions about my ascending aortic aneurysm and how he was going to address it during surgery. I was satisfied with his response, and his willingness to talk to me personally rather then through his office staff.

Its important that you feel this way about the surgeon and valve you choose.
Good luck,
 
The Mosaic is one of the Big Three - the premium tissue valves. The Medtronics Mosaic is an actual pig valve that has been carefully preserved and treated to reduce calcification. The Medtronic Freestyle is another preserved, anti-calcification-treated porcine valve with aortic root, which is stentless. The third is the Edwards Perimount Magna, a bovine valve manufactured from cow pericardium (the tough tissue that surrounds the heart). It is also carefully preserved and treated to resist calcification.

All three are great. The one with the longest track record is the Edwards bovine valve. There may be another on the way, a new entry from St. Jude, called the SJM Epic. However, it's still on trials for acceptance in the United States.

Do you have a bicuspid aortic valve, or is there some other problem? Depending on your issues, I wouldn't be so fast to throw away the Ross Procedure card. If you have early-onset bicuspid valve problems, there might be some concern about the stability of the pulmonary valve. If it's something else, the Ross Procedure might be a viable contender.

Best wishes,
 

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