T in YVR
Well-known member
Its not really a "raw deal", but I think I know what you mean... Getting terminal cancer at the age of 49 with 2 young kids would feel like a raw deal - which is what happened to a friend of mine who died in June. Inevitably we'll all face health problems over the course of our lives - sometimes sooner than we'd like or expect (I got my valve 1 month ago today at age 47). Its not easy dealing with this, but always remember it could be much worse. Picking a valve is big at the time, but there's many harder life choices you will inevitably have to make.
With respect to the valve choice, unless you are an older individual (such as in your late 60's/70's+) when tissue may make the most sense in most cases, it gets more complicated. All you can do is make the best decision based on (a) what's best for your personal situation and (b) based on the best available information you have to date - both on the valves and on your own state of health/lifestyle.
Frankly, I agree with what some others have said about TAVI and tissue - its no guarantee. As my cardiologist told me: "It has a long way to go to prove it is equal to open heart bioprosthetic valve surgery in a young person like yourself. And a TAVI inside another prosthesis is a particularly special scenario. It may be possible but there is no way to know - and it has a long way to go".
As for mechanical, are they really going to come out with a new valve in the next 10 years that requires little to no anti-coagulation? Who knows...Personally I doubt it given all the approvals/trials it would have to go through. 10 years is not really that long. Now, maybe better data is gathered through trials on existing mechanical valves that enable patients to anti-coagulate at lower levels on certain valves...that seems way more likely to me. But I doubt that comes from a new valve - I would bet it will be based on existing valves in the near term. But that's just my opinion...
I would not argue for 1 valve type over the other as its a personal choice. But both paths re: valve choice have their "unknowns" and pros/cons...and then there are other "unknowns" from a more personal standpoint. Will you be 100% healthy and able to handle a 2nd surgery 10 or so years later as well as your first? Maybe you develop other health problems that make surgery more complicated. Maybe the first surgery goes rough...what does that say about how the second surgery may go in 10 or so years time? Will testing your INR drive you nuts? Will the valve noise drive you nuts? Will you still need Warfarin even if you have tissue? I'm sure you have thought about all of these, but my point is that all you can do is make the best choice based on what you know today - and be careful not to assume that this type of operation will necessarily change that dramatically over the next 10 years during your "time basket".
T
