My first thought on reading this was "What company paid for this article?" Because it offers no numbers for comparison. It speaks of the great financial and physical costs of choosing mechanical but says nothing about the financial and physical costs of chosing tissue valves. It discusses no drawbacks associated with tissue valves. What is the baseline risk that mechanical valves have a great than 50% risk of achieving? If it's 1%, then mechanical valves would have a 1.5% risk. I should also mention that tissue valves carry the same risk of clot/stroke as properly anticoagulated mechanical valves. The "over 10 years" is misleading as well because the 1-3% risk numbers is per year and not cummulative. It is clear that this article was written to achieve a specific purpose.
I looked up Advamed. "AdvaMed is the world's largest trade association representing medical device manufacturers, makers of medical equipment, medical software and supplies" (from the site). Both Metronics and Edwards are large members of this organization - 2 of the top manufacturos of tissue valves. So I can now understand why the drawbacks and costs, physical and financial, of tissue valves wasn't discussed in the article and why specific numbers weren't used when percentages look so much worse. It's articles like these that make me shake my head and wonder why I'm not dead...or they would if I didn't know the correct information.
Tissue valves have had some great advancements, as have mechanical valves and Coumadin protocol. They are all in a better place than they were 10 years ago. I'm 48 and my 15 year old mechanical is going strong and looking pretty. If for some reason it needed to be replaced in the future I’d gratefully consider every option because they’re all better than 15 years ago.
I don't think QV son's issue is served well by our typical tissue vs. mechanical debate, because when we're speaking of an 18 year-old we are talking aspects with both that are outside the bounds of any of the studies that are done. Let's not forget that any of these studies have a mean age of (probably) 3 times that of QV's son and valve replacement is a totally different ball of wax for someone his age, with totally different life circumstances to manage. Had QV not expressed her concern about additional surgeries and stated that she was certain that a tissue valve was the way to go, I would not have posted anything but good wishes. But I sensed that she was feeling very uncertain, as well as confused and I wanted her to see that there were options and possibly different ways of thinking outside the box.
QV if you haven't read Tobagotwo's famous posts on valve selection, I recommend doing so.
http://valvereplacement.com/forums/showthread.php?t=14330 He takes a really good look at the choices and
is logical and even handed with all with no attempt at promoting any particular valve choice.
) )
