39 and need new valve

[texsc]

Hello all. This site is a blessing. I have to have AVR next Tuesday and cant decide which valve to choose. I work in a steel mill and its very hard work. Cuts and bruises are very common. I would really like the mechanical valve but am worried about the comidin with my type of work. I'm leaning towards a tissue valve hoping in 10 years technology is more advanced. Any advice is welcome

Thanks Bryan

 

[Ross]

Before making any choices, study up on the REALITIES of Coumadin/Warfarin. Far too many myths are perpetually being circulated. Make learning about the drug part of your selection. There is plenty of information in the anticoagulation forum, also the "must have links" in the reference forum.

 

[Superbob]

Hi Bryan, welcome to the forum! Before I made my decision, I read everything I could about the choices and made a list of the pros and cons of each. My surgeon left the decision entirely to me, but of course he could have overriden it if necessary.

You can get good info from the "stickies" on this forum and from the anti-coag forum, as Ross suggested, or from doing some searches. Or best yet, ask away if you have questions and I am sure members will be happy to give you their perspectives.

All best wishes to you for your pending surgery. Are you having it in Charleston?

 

[dick0236]

Brian, I like what the others have posted, do as much research as you can and make a list of the pros and cons for someone of your age and doing the type of work you do. You and your doc have a better insight as to whether coumadin/warfarin poses a risk in your line of work...but "don't let the tail wag the dog".

 

[NealR]

Best Valve

Best Valve

Hello all. This site is a blessing. I have to have AVR next Tuesday and cant decide which valve to choose. I work in a steel mill and its very hard work. Cuts and bruises are very common. I would really like the mechanical valve but am worried about the comidin with my type of work. I'm leaning towards a tissue valve hoping in 10 years technology is more advanced. Any advice is welcome

Thanks Bryan

Bryan, at 39, is a tough call. The valve will wear out, eventually. I listen to Robicove and Schwartz on XM radio, two well known thoracic-cardio surgeons. If you can get XM, I would suggest to listen to them if you can. They are both at NYU medical center. They had a patient who had his AV replaced at 25, and lasted 17 years! Had a second, also lasted about 16 years, then, had a third OHS, and this time they went minimall invasive, and he was out shopping four days later! Obvioulsly, they both prefer tissue over mechanicals, and are on the same page as the cleveland clinic. The magic age seems to be 45, but there is reason to support the age being as low as 35. The new gereration valves last much longer, more durable, and for some reasons, most of the surgeons I know, prefer to use these. However, there are many people on this site who went with mechanicals and are doing extremly well, including taking the comoudin. Best advise, would be to have a heart to heart talk with the surgeon. Ask, which valve would he (or she) choose.

Good Luck.

 

[james]

Hey Bud,
I am 39, work in the construction field and just had a mech valve put in two months ago. My choice came down to the fact that I will never be able to get a cath injected valve due to my aortic size and I needed an aortoplasty done too. The mech valve gave me better assurance to not have another OHS again. This was #2. That being said if I could do the cath based implant in the future I would have thought more about the piggy. The coumadin is not a horrid thing but, it does have retraints and issues-not a deal breaker. The mech valve has a lot higher chance of lasting longer especially if you are active-you are active if you are worried about getting cut. Anyhow I don't have an answer for you but, some advice.
1) Get a recliner to sleep in after surgery.
2) Go to cardiac rehab after you get a little better.
3) Take as much time off afterward as you can. You will not be able to lift what you used to for a long while.

Good luck and God Bless.

 

[Philip B]

Choices

Choices

You've received some good replies concerning looking at the realities of coumadin rather than believing the misconceptions and bad information that's out there.

Bottom line...if you get cut, you're going to bleed...if you get hit, you're going to bruise. The reality is that you'd bleed and bruise even if you're not on coumadin. Sure, if you're on coumadin, cuts will bleed a little longer and bruises will be a little bigger.

AVR surgery has no guarantees. There have been members here who've opted for tissue valves in an attempt to avoid coumadin use, but found themselves on coumadin anyway. We've had other members who opted for mechanical valves in an effort to avoid future re-ops, but found themselves needing OHS again. Sorry, there are no easy answers when it comes to making a decision concerning valve choice.

I was given a choice of mechanical or tissue. I opted for mechanical and have not regretted my decision. So far, despite getting some bad cuts, I've not yet bled out. I've been hit so hard that I've had bones break and still healed-up okay.

Good luck with your decision. Hopefully, your decision will be based upon a perspective grounded in fact rather than fiction.

-Philip

 

[texsc]

Thanks for all the advice. I'm still considering my options. One more question, do all doctors offer the On-X valve. I dont think mine mentioned that one. Also if I choose to go with a tissue valve which has had the best results. thanks agin for all the advice.

 

[Ross]

Not all Doctors do offer the On X valve, but hey, it's your body and your life. If that's what you want, request it! The people at On X are usually more then happy to instruct a surgeon on it's implantation. As for the best tissue valve, that's debatable, so I'll let the tissue folks hash that one out.

 

[westie]

hi bryan

do not worry about taking warfarin, it is not a problem.

i have a mechanical valve and lead a totally normal life, i have a motor trade business and a small farm. i am always using workshop equipment and using farm tractors/implements.

sure, i walk into things and get bruises and cut myself etc but that is no drama. i do bruise more than before ohs, but they are only small bruises, no nightmare stuff. cuts and scratches are no sweat either. just make sure you do not sever an arm etc!! (but that would be a dire problem with or without wafarin)

but, i do suggest that home monitoring/doseing is essential to best practise inr management.

personally i would be much much more worried about the prospect of re ops to replace tissue valves every 10 years than the problems of taking warfarin!!

 

[nngbwh]

personally i would be much much more worried about the prospect of re ops to replace tissue valves every 10 years than the problems of taking warfarin!![/QUOTE]

Totally agreed... Not fun having to re ops every 10years.

 

[Ross]

Lets be fair, none of us can say he'll have a surgery every 10 years if he goes tissue. He'll be facing more surgeries at some point, could be less then 10 or more then 10 years. It's another, "If I had a crystal ball" moment.

 

[neil]

lots of negative vibes about tissue,but a hell of a lot of us go down that route,personally wafarin puts me off going mech,if there had found a perfect valve we wouldnt be commenting about this,until there do its take your pick,heads or tails, my main point is this,EITHER is sure better than the one you got now,

 

[nngbwh]

There is no guarantees on a Mech or tissue valve.

 

[texsc]

I have decided

I have decided

First of all let me say thank you for opinions and advice. After reading all your comments and speaking to my surgeon at length. I have decided to go with the pericadial tissue valve. I am very happy with my decision, my surgeon believes I will get 10 to 20years out of it although I know there are no guarantees. He felt like with my type of work (steel mill and own my own Pressure Washing Business) tissue valve was the best choice for me. He said if i went with the mechanical I should consider giving up the P/W business. It requires alot of roof walking ladder climbing and risk of a fall when noone was around is great(its happened a few times).

SO now that part is over and the count down begins. Mar 16th seems like a year away. Waiting is very hard to do, but its nice to have this site to past the time. Thanks again for all your support.

 

[Ross]

SO now that part is over and the count down begins. Mar 16th seems like a year away. Waiting is very hard to do, but its nice to have this site to past the time.

You hit the nail on the head dead center. Waiting IS the hardest part. Focus on all the good things that will come after recovery. In the meantime, treat yourself like royalty. Go do things that you've wanted to do and didn't, go out for that special dinner, do whatever it takes.

 

[Freddie]

Next Tuesday isn't that far away Bryan. It will be here before you know it.

In the meantime follow Ross's suggestion and go do what you want to do. And don't forget to cut your toe nails

 

[nngbwh]

You will be in my prayers. Keep us updated.

 

[Lily]

. . . SO now that part is over and the count down begins. Mar 16th seems like a year away. Waiting is very hard to do, but its nice to have this site to past the time. Thanks again for all your support.

Best wishes to you for a successful surgery and recovery, Bryan .

 

[Jkm7]

Bryan,
Indeed, the waiting is very difficult for most of us. This site has been so wonderful to help many of us along until our surgery date.

I opted for tissue valve (two years ago) and am so happy I made that choice. Despite all the many people who handle coumadin just fine, I strongly wanted to avoid it. My surgeon told me I would have to take coumadin for three months post op until my own tissue grew and I couldn't wait to end it. Ultimately, he let me stop at 2 1/2 months. It is very common (but not all) for tissue valvers to have a brief coarse of coumadin. Of course, a case of a-fib and we could end up on it anyway.

I also feared loud ticking from a mechanical valve. Most folks have little to no issue about it but a ticking clock drives me loony and my surgeon was clear he could not say in advance if a mechanical valve would click loudly in me or not. He said there is no correlation between how loud and body build. He's had petite, slight, little ladies who's valve he could hardly hear and big, barrel chested muscular men who's valve clicked loudly. It's unpredictable.

Sending you best wishes your surgery goes well and you have a bump free, easy recovery.
Please ask away any questions you may have. There's almost always someone who has good info to help with the answer.