A New Leak in my replaced Aortic valve.

[KatrinaE]

I had open heart surgery in October 2015. My Aortic valve was replaced with a pig valve. I have to count my blessings, the only meds I have had to take is a Aspirin once a day. I have
had no trouble at all. I have went to my checkups once a year doing a echo in those visits. When I went in for my yearly this past week my Doctor heard a leakage. I had a echo done
and yes there is a small leakage. My next dr. appt is in January. My question is has anyone else had this problem? if so what did they do for it and did it get worse as time went on?
What would be the cause for it to start leaking?

 

[nobog]

KatrinaE,

Sorry about your situation however this is not atypical. A tissue valve can last 2 years - or 20 years - there has been much discussion about such on these boards. In your case I think there are two most likely things going on.

1) it is simply wearing out and thus causing a central leakage jet.
2) calcification of the leaflets causing stiff leaflet(s) leading to incomplete closing - and the resulting leakage.

I doubt you have a paravalvular leak (leakage from the cuff area) as it is going on 7 years now.

The good news is that with a tissue valve things develop or change very slowly so for now it is just something to watch however it will not get better. Most porcine (pig) valves have a very good track record for durability but again, individual results "may vary".

JK

 

[tom in MO]

nobog is spot on. You watch and wait and if it gets worse the valve is replaced. Make sure you don't skip your echos and that the doctor followsup with you after each one.

 

[Chuck C]

Hi KatrinaE.

Very sorry to hear this. If I understood one of your previous posts, you were about 55 or 56 years old when you received your tissue valve. The positive about tissue valves is that you usually will not need to take warfarin, which many seem to fear. Unfortunately, one of the downsides of tissue is that they do not last forever and at some point you will start to get calcification and possibly leakage and/or stenosis. Getting a tissue valve at the young age of 55/56, it is not surprising that structural valve deterioration, due to calcification, would manifest itself in 5 or 6 years after surgery. So, this is not anything that should be surprising and I would expect pretty normal for someone getting tissue in their 50s.

The good news is that you have been getting your echos and your team is aware of the leakage. Closely monitoring is the best thing to do at this point, with echos every 6 months, so that you are able to get surgery in a timely manner when it is time. Hopefully that day will be several years away, but at your young age it is a certainty that you will need valve replacement at some point. Hopefully you are fortunate and you are able to get a TAVR when that time comes.

 

[pellicle]

Hi

What would be the cause for it to start leaking?

I'm guessing that (as others have mentioned) that its just the onset of SVD, unfortunately this happens.

I'll also add that if calcification has also set in that

• you may not be a candidate for Valve in Valve TAVI
• that also may be an indicator that a TAVI would have the lower end of the life expectancy too.

Get some more imaging done, talk thought it and see where it goes. You will likely get another few years on it before it begins impacting your health.

Best Wishes

 

[carolinemc]

I had open heart surgery in October 2015. My Aortic valve was replaced with a pig valve. I have to count my blessings, the only meds I have had to take is a Aspirin once a day. I have
had no trouble at all. I have went to my checkups once a year doing a echo in those visits. When I went in for my yearly this past week my Doctor heard a leakage. I had a echo done
and yes there is a small leakage. My next dr. appt is in January. My question is has anyone else had this problem? if so what did they do for it and did it get worse as time went on?
What would be the cause for it to start leaking?

I was born with a leak in the aortic valve, called murmur. It can be controlled in many ways without meds. And they won't do surgery till there is a major problem. And since you got a tissue valve, they do not last very long. They may replace in the future with a mechanical valve. Till then just take it one day at a time and do as the cardio doc says for you to do.

 

[carolinemc]

Hi KatrinaE.

Very sorry to hear this. If I understood one of your previous posts, you were about 55 or 56 years old when you received your tissue valve. The positive about tissue valves is that you usually will not need to take warfarin, which many seem to fear. Unfortunately, one of the downsides of tissue is that they do not last forever and at some point you will start to get calcification and possibly leakage and/or stenonsis. Getting a tissue valve at the young age of 55/56, it is not surprising that structural valve deterioration, due to calcification, would manifest itselt in 5 or 6 years after surgery. So, this is not anything that should be surprising and I would expect pretty normal for someone getting tissue in their 50s.

The good news is that you have been getting your echos and your team is aware of the leakage. Closely monitoring is the best thing to do at this point, with echos every 6 months, so that you are able to get surgery in a timely manner when it is time. Hopefully that day will be several years away, but at your young age it is a certaintly that you will need valve replacement at some point. Hopefully you are fortunate and you are able to get a TAVR when that time comes.

She will probably be checked twice a year, I was for many years since I was born with a leaky aortic valve called murmur.

 

[KatrinaE]

KatrinaE,

Sorry about your situation however this is not atypical. A tissue valve can last 2 years - or 20 years - there has been much discussion about such on these boards. In your case I think there are two most likely things going on.

1) it is simply wearing out and thus causing a central leakage jet.
2) calcification of the leaflets causing stiff leaflet(s) leading to incomplete closing - and the resulting leakage.

I doubt you have a paravalvular leak (leakage from the cuff area) as it is going on 7 years now.

The good news is that with a tissue valve things develop or change very slowly so for now it is just something to watch however it will not get better. Most porcine (pig) valves have a very good track record for durability but again, individual results "may vary".

JK

Thanks for info!

 

[KatrinaE]

nobog is spot on. You watch and wait and if it gets worse the valve is replaced. Make sure you don't skip your echos and that the doctor followsup with you after each one.

Thanks so much!

 

[KatrinaE]

Hi KatrinaE.

Very sorry to hear this. If I understood one of your previous posts, you were about 55 or 56 years old when you received your tissue valve. The positive about tissue valves is that you usually will not need to take warfarin, which many seem to fear. Unfortunately, one of the downsides of tissue is that they do not last forever and at some point you will start to get calcification and possibly leakage and/or stenosis. Getting a tissue valve at the young age of 55/56, it is not surprising that structural valve deterioration, due to calcification, would manifest itself in 5 or 6 years after surgery. So, this is not anything that should be surprising and I would expect pretty normal for someone getting tissue in their 50s.

The good news is that you have been getting your echos and your team is aware of the leakage. Closely monitoring is the best thing to do at this point, with echos every 6 months, so that you are able to get surgery in a timely manner when it is time. Hopefully that day will be several years away, but at your young age it is a certainty that you will need valve replacement at some point. Hopefully you are fortunate and you are able to get a TAVR when that time comes.

Thanks so much!

 

[KatrinaE]

Hi

I'm guessing that (as others have mentioned) that its just the onset of SVD, unfortunately this happens.

I'll also add that if calcification has also set in that

• you may not be a candidate for Valve in Valve TAVI
• that also may be an indicator that a TAVI would have the lower end of the life expectancy too.

Get some more imaging done, talk thought it and see where it goes. You will likely get another few years on it before it begins impacting your health.

Best Wishes

Thanks so much!

 

[Deepak khanka]

Hi Katrina
Echo and monitoring is the way forward till the leak gets severe and you start to show signs I.e short of breath , swelling in legs , difficult to breath when lying flat
Control BP use ramipril and control pulse I.e can use beta blockers
Pls consult the cardio for medication advise and carry on till you need to change the valve