62 years old and meeting surgeon in 10 days to decide on valve type

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Welcome to the forum jlcsn2015 ! I was 60 years old when I got my valve, a pericardial Carpenter Edwards Magna Ease aortic valve. My cardiologist and cardiac surgeon didn't even question me wanting a tissue valve, they were both perfectly happy with my preference. The reason you don't see people walking round with that particular valve from 20 years ago is that those particular valves weren't developed until more recently. Yes they made pericardial valves 20 years ago but they have refined them every few years and now they last longer than they did when they were first invented. I do not mind having a 're-do' though which is surely on the cards for me. The fact that I do not hear ticking in my chest and do not have to take warfarin every day more than compensates for the pain and stress of a 're-do' (and I didn't have it particularly easy when I had my surgery). Right now the only thing that tells me I've got a bio valve is seeing my incision scar and memories of the surgery and ongoing check ups with the cardiologist - I liken it to having a crown on a tooth, it feels your own as you can't notice the difference between it and the natural one.

Harriet - I would hate to hear the ticking of a mechanical valve - it would be no joke to me. I know for some people hearing the ticking is reassuring but for others that would be quite the opposite.
Wow very helpful. I think the ticking would drive me insane...hope you are doing great !
 
Hi !, before all, would like to thank all the people that share here their concerns and thoughts about this event that has crossed our lives taking us to surgery room to have a heart valve replaced.

currently am 62, and every where hear "recommendations" for tissue valves because they will last 20 years, or 17 at least, and on the other side hear that currnet st jude and on-x valves will for sure last 20+ years and warfarin is just a matter of learning how to manage it....

reading and talking have to say a question comes to my mind "if there is no one walking around with a pericardial valve" x 20 years, how can the industry promiss so ?, statistics can say what ever you push the to say, mathematics tell you is all about the sample and the population selected,
so "science papers" mean certain thing but they are just a "reflection" of the reality,..... but there are people walking around with mechanical valves x 20+ years ...

all of that said, still have doubts, will a pericardial valve last 20 years on a 62 years old ?
is taking warfaring the boogie man that will fix one thing and destroy 3 more ?
what about the noise of the mechanical valves ?, st jude or on-x ?

my heart tells me to get a bio, my mind tells me to get a robot l.o.l...

just need to share.....


thank you
I'm 61 and facing the exact same thing. I'm terrified of the ticking the managing INR and my surgeon yesterday here in Bangkok was telling me the mechanical valves also had a lot of problems can fail very suddenly also I'm prone to falling down and getting cuts a lot it's a difficult choice
 
and my surgeon yesterday here in Bangkok was telling me the mechanical valves also had a lot of problems can fail very suddenly
my reaction to this is like


  • a lot of problems
  • can fail very suddently
laughs again ... wipes tears from eyes.

oh that's good.
 
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I'm 61 and facing the exact same thing. I'm terrified of the ticking the managing INR and my surgeon yesterday here in Bangkok was telling me the mechanical valves also had a lot of problems can fail very suddenly also I'm prone to falling down and getting cuts a lot it's a difficult choice
I'm 57 and just passed 27 years with my mechanical valve. Like anything else, a mechanical valve could have a sudden failure but no more so than any other active body part (and, in fact, less likely since it's made from tougher stuff).

I self manage my INR, and try to avoid serious trauma, but I still work with large power tools and drive my car long distances without thinking "this could kill me". Plenty of activities could kill me, or anyone else, regardless of blood coagulation. I've never been one to live in fear but understand not everyone is like that.

I'm visiting Bangkok (from the US), in fact, this month and hiking different places so anticoagulantion hasn't stopped me from travel or outdoor activities.

As for the ticking.. Well, you get used to it. It's there, sometimes it can be annoying, occasionally it keeps me awake, but it is what it is. For me, it's the price if being alive and potentially never needing OHS again.

Good luck!
 
my surgeon yesterday here in Bangkok was telling me the mechanical valves also had a lot of problems can fail very suddenly
Newarrior - Did your surgeon provide any evidence for this statement? I will greatly appreciate if you can provide a reference, because your surgeon's statement is very different from what I hear any cardiac surgeons saying. I've seen some discussion of possible surgical installation errors; however, a knowledgeable and experienced surgeon should avoid those problems.
 
I am 61 this year and have faced exactly the same thing 3 years ago. The ticking is reassuring as it tells me my heart is still beating and I am still alive. Managing your INR is easier than managing your diet!!! My valve was replaced 3 years ago........in Bangkok..........and as stated before, other organs can fail suddenly, with fatal consequences. I would question any cardiac surgeon that suggested an artificial valve has a chance of failing and I was even recommended at my age to go for a synthetic valve to avoid the potential for further surgery down the line. My experience (20 years this year in Thailand) with the medical profession in Thailand is question everything. As far as being prone to falling down, I haven't changed anything lifestyle wise (except giving up smoking). I still party hard and I still ride my motorbike to school and back and around Thailand which is known as the second most dangerous place on the planet for driving. As someone has said before
"Every minute someone leaves this world behind. We're all in 'the queue' without knowing it. We will never know how many people are ahead of us. We can't move to the bottom of the row".
Living in Thailand you should adopt the Buddhist approach to life - Buddhism teaches that life should be lived fruitfully in the present moment, so that there are no regrets. The Buddha taught that people should not pursue the past or lose themselves in the future.
It is not a difficult choice to choose living with a ticking sound...........or dying!!!!!
 
I'm 61 and facing the exact same thing. I'm terrified of the ticking the managing INR and my surgeon yesterday here in Bangkok was telling me the mechanical valves also had a lot of problems can fail very suddenly also I'm prone to falling down and getting cuts a lot it's a difficult choice
Your surgeon is an idiot. Find someone else.
 
Your surgeon is an idiot. Find someone else.
or... his surgeon knows he's an idiot, has seen over many (based on what I know I expect dozens of) consults, fully knows
  • hes entirely not competent to manage INR
    • will drive every clinician in Thailand bonkers every time his INR isn't exactly target,
    • will drive everyone he knows and trusts on VR bonkers with emails about INR (you know who you are)
    • will post here then delete his posts when he doesn't get what he wants to hear (IE: not adult be responsible for yourself answers)
    • won't properly manage his dose, which will lead to a closed loop on the primary point
  • will whinge up and down about the ticking (the tiiiccckking)
  • whinge about not having a partner to look after him
I suspect his surgeon is directing him to the safest actual option for who he is: bio-prosthesis. In this case, I think that the surgeon actually knows what's best for this (difficult) patient

 
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You guys are making me jealous about the ticking sound.

I've not once in the ten years that I've had it have heard my mechanical valve tick, tock, burp, gurgle, clang, bang, whiz, jangle, whistle, or make any sound whatsoever. Maybe it's not working?

I can however hear the wall clock hanging in this room ticking from 30 feet away (had to take that one out of the bedroom because it was annoying me up there).
 
My personal decision on valve type was an easy one. I didn't want to be on blood thinners.

I'm slowing down on much of the adrenaline inducing stuff I used to do (dirt bikes, snowboard, various other stupid human tricks :ROFLMAO:) but still lead a pretty active lifestyle.
I'm an avid surfer, and surfboards (both mine and the crowds of clueless beginners all around me) have lots of pointy sharp things on them.

The back edge of surfboard fins are pretty sharp. While I'm not getting hit with my board (or theirs) often it does happen and I've been cut pretty good a few times.
Just not something I want on my mind in the water.

There are other reasons too, but that was a biggie.

I opted @ 61 to have my bicuspid valve replaced surgically now, so that in 10, 15, 20 years assuming I'm still kickin' and it needs replaced, they can then do a nice easy TAVR, and Lord willing I just go surfin' soon after! :giggle:
 
About thirty five years ago I had the opportunity to visit Hong Kong where I gave some lectures on certain eye conditions. At that time if you had cataract surgery there you had a choice of three levels of care. You could have the locally made lenses put in with some reusable tubing that was cleaned or US made lenses with reusable tubing or US lenses with new tubing. You had to pay accordingly.
So maybe the doctor in Thailand is talking about a locally made valve - perhaps made of bamboo that has a high failure rate. The more traditional valves made around the world the last 30 or more years have extremely low failure rates. And yes, tissue valves can have rather abrupt failures also requiring re ops.
 
Hi !, before all, would like to thank all the people that share here their concerns and thoughts about this event that has crossed our lives taking us to surgery room to have a heart valve replaced.

currently am 62, and every where hear "recommendations" for tissue valves because they will last 20 years, or 17 at least, and on the other side hear that currnet st jude and on-x valves will for sure last 20+ years and warfarin is just a matter of learning how to manage it....

reading and talking have to say a question comes to my mind "if there is no one walking around with a pericardial valve" x 20 years, how can the industry promiss so ?, statistics can say what ever you push the to say, mathematics tell you is all about the sample and the population selected,
so "science papers" mean certain thing but they are just a "reflection" of the reality,..... but there are people walking around with mechanical valves x 20+ years ...

all of that said, still have doubts, will a pericardial valve last 20 years on a 62 years old ?
is taking warfaring the boogie man that will fix one thing and destroy 3 more ?
what about the noise of the mechanical valves ?, st jude or on-x ?

my heart tells me to get a bio, my mind tells me to get a robot l.o.l...

just need to share.....


thank you
I wish I had gone mechanical at 54. Instead I did tissue and at near 8 years it is showing stenosis. I’ll have to do it again soon and I can’t express how much I dread it. I’ll do mechanical this time.
 
I probably had one of the earliest tissue valves placed in 1977 for aortic stenosis. I was 29. Five and a half years later it failed and I had my first St.Jude. It went from 1983 fo 2006 when I needed an aortic aneurysm repaired at age 58. Could have had a tissue but the surgeon who was very experienced said you don’t want a fourth open heart. Now things are a bit different due to longer lived tissue valves along with TAVR so the decision making process is a bit less clear cut.
I personally hated surgery and I wanted a more predictable future so I had another St. Jude.
It also turned out that I developed chronic AFib so I required long standing anticoagulants. So even with a tissue valve I would need anticoagulants.
There is no free meal.
Going for a 30 mile bike ride this morning.
 
Newarrior - Did your surgeon provide any evidence for this statement? I will greatly appreciate if you can provide a reference, because your surgeon's statement is very different from what I hear any cardiac surgeons saying. I've seen some discussion of possible surgical installation errors; however, a knowledgeable and experienced surgeon should avoid those problems.
No which is strange because this guy is a veteran here he's trained in America he did a surgery for an elderly American friend of mine here who is very satisfied. I'd like to get more evidence about that as well as I'm getting surgery on the 21st. Thanks for following up with me. I'm going to see him on the 10th. I'll let you know what I find out.
 
My personal decision on valve type was an easy one. I didn't want to be on blood thinners.

I'm slowing down on much of the adrenaline inducing stuff I used to do (dirt bikes, snowboard, various other stupid human tricks :ROFLMAO:) but still lead a pretty active lifestyle.
I'm an avid surfer, and surfboards (both mine and the crowds of clueless beginners all around me) have lots of pointy sharp things on them.

The back edge of surfboard fins are pretty sharp. While I'm not getting hit with my board (or theirs) often it does happen and I've been cut pretty good a few times.
Just not something I want on my mind in the water.

There are other reasons too, but that was a biggie.

I opted @ 61 to have my bicuspid valve replaced surgically now, so that in 10, 15, 20 years assuming I'm still kickin' and it needs replaced, they can then do a nice easy TAVR, and Lord willing I just go surfin' soon after! :giggle:
I'm 61 a California Native extremely active as well and I'm getting my surgery done in a couple of weeks and the surgeon is pushing me towards the resilia valve but of course I dread having another open heart surgery probably in my mid to late seventies and I'm not sure if I'm the best candidate for tavr.. I sometimes get paranoid and wonder if these people are just trying to sell us on tissue valves. Thailand is very sales oriented even more than America in some ways.
 
I'm 61 and facing the exact same thing. I'm terrified of the ticking the managing INR and my surgeon yesterday here in Bangkok was telling me the mechanical valves also had a lot of problems can fail very suddenly also I'm prone to falling down and getting cuts a lot it's a difficult choice
You're asking very good questions. This is exactly what I'm thinking about. I'm 61 and my surgeon is recommending the resilia valve but at some point that's going to have to be replaced. I believe I've got a small annulus which would require enlargement which could be very problematic putting me under anesthesia longer more chance of bleeding.. if I can't get my valve opening to be larger than I'm probably not a good candidate for tavr. Regardless in your early 60s if you go tissue you're almost undoubtedly going to face another surgery either through the leg or through the open heart again in your 70s or 80 at the latest. I'm planning to live to be at least 90 maybe even into my 100s
 
Welcome to the forum jlcsn2015 ! I was 60 years old when I got my valve, a pericardial Carpenter Edwards Magna Ease aortic valve. My cardiologist and cardiac surgeon didn't even question me wanting a tissue valve, they were both perfectly happy with my preference. The reason you don't see people walking round with that particular valve from 20 years ago is that those particular valves weren't developed until more recently. Yes they made pericardial valves 20 years ago but they have refined them every few years and now they last longer than they did when they were first invented. I do not mind having a 're-do' though which is surely on the cards for me. The fact that I do not hear ticking in my chest and do not have to take warfarin every day more than compensates for the pain and stress of a 're-do' (and I didn't have it particularly easy when I had my surgery). Right now the only thing that tells me I've got a bio valve is seeing my incision scar and memories of the surgery and ongoing check ups with the cardiologist - I liken it to having a crown on a tooth, it feels your own as you can't notice the difference between it and the natural one.

Harriet - I would hate to hear the ticking of a mechanical valve - it would be no joke to me. I know for some people hearing the ticking is reassuring but for others that would be quite the opposite.
i Had a Bovine valve replacement in 2000 and was told it would last 7-10 years. i took my chances because i wanted another child, well it lasted 23 1/2 years and i am going in for my secons replacement soon . Rat poison or Redo ill chose Redo!
 
Hi !, before all, would like to thank all the people that share here their concerns and thoughts about this event that has crossed our lives taking us to surgery room to have a heart valve replaced.

currently am 62, and every where hear "recommendations" for tissue valves because they will last 20 years, or 17 at least, and on the other side hear that currnet st jude and on-x valves will for sure last 20+ years and warfarin is just a matter of learning how to manage it....

reading and talking have to say a question comes to my mind "if there is no one walking around with a pericardial valve" x 20 years, how can the industry promiss so ?, statistics can say what ever you push the to say, mathematics tell you is all about the sample and the population selected,
so "science papers" mean certain thing but they are just a "reflection" of the reality,..... but there are people walking around with mechanical valves x 20+ years ...

all of that said, still have doubts, will a pericardial valve last 20 years on a 62 years old ?
is taking warfaring the boogie man that will fix one thing and destroy 3 more ?
what about the noise of the mechanical valves ?, st jude or on-x ?

my heart tells me to get a bio, my mind tells me to get a robot l.o.l...

just need to share.....


thank you
Have them check your LPa levels. I (age 51) have the same decision to make. I have had my doc add the LPa to the blood work I am getting tomorrow in prep for a heart cath on Friday. My surgeon says I don't have to decide until the day of valve replacement surgery, but I personally can't wait that long to decide.
Best wishes on your decision and your surgery!
 
You're asking very good questions. This is exactly what I'm thinking about. I'm 61 and my surgeon is recommending the resilia valve but at some point that's going to have to be replaced. I believe I've got a small annulus which would require enlargement which could be very problematic putting me under anesthesia longer more chance of bleeding.. if I can't get my valve opening to be larger than I'm probably not a good candidate for tavr. Regardless in your early 60s if you go tissue you're almost undoubtedly going to face another surgery either through the leg or through the open heart again in your 70s or 80 at the latest. I'm planning to live to be at least 90 maybe even into my 100s
You realize you responded to yourself here? No wonder you thought that they were good questions. 😂

Probably why it’s exactly what you’re thinking about. 🤔
 

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