Age and AVR

[mhubbard]

Hi all!,

Just wanted to let you know how much help this site has been for me. When I do have AVR surgery, I will be better prepared for it all because of all of you. Not to age discriminate, but I am curious of what valves and procedures were recommended for people in their 20's to early 30's. I am 29 and will more than likely have my aortic valve replaced within a few years. My stenosis is measured as mild; my regurgitation is measured as moderate to severe. I want to see what people had done in my age range (or had it done when they were my age) and how they feel about.

Thanks again for all of the great info.

Marty

 

[Peachy]

Hi Marty

I'm on the waiting list for my AVR surgery. I'm older being 40 but anyway the surgeon recommended a mechanical valve as they do for most people unless you are a good bit older, in which case they recommend a biological valve. The mechanical valve as they tell you "lasts a lifetime". However you have to take Coumadin for the rest of your life which has to be monitored regularly. The biological valve on the other only lasts around 10 to 15 years and perhaps longer in older people. People over say around 70 usually get offered a biological valve. They do not normally need to take Coumadin and the valve should also "last a lifetime". It really comes down to personal choice. I don't want a mechanical valve as I do not want to have to take Coumadin. I asked the surgeon for a bioligical valve which after explaining to me that it would only last 10 to 15 years and I would then require surgery again, agreed to this as it was obvious that I had been doing my homework and had already made up my mind. I think the Ross Procedure is quite common for someone your age. There are a few younger people on the site who have had this procedure and no doubt they will be in touch. Me being in Scotland however have limited choice. I now have the worst part at the moment and that is the wait. I should hopefully get my surgery around Springtime. You will learn a lot from this site as there is a wealth of information and this will help you decide. It certainly helped me to come to a decision.

Peachy

 

[Peter Easton]

Marty,

Given your relative youth and (I suspect) good health, you may want to look into two alternatives described elsewhere on this website (e.g. in the New Advancements forum and in the "Making the Choice" thread on Heart Talk somewhere back there):

(1) The Ross Procedure, where the aortic valve is replaced by your own pulmonary valve and then a homograft is used to replace the pulmonary (which undergoes less stress than the AV). Since it's your own valve that is put into the aortic position, there is in principal no problem of calcification or rejection.

(2) The Cryovalve Synergraft solution (described by Steve Wieland in the New Advancements Forum) where a genetically washed and reprocessed human pulmonary valve is used to replace the aortic valve -- on the thesis (so far confirmed) that your own body will repopulate it with your own stem cells and thus turn it into a "native" valve.

Both have real virtues and avoid the necessity of taking Coumadin (with which some people live quite happily, however).

Peter

 

[Herb M]

Technology relating to valves replacements is advancing fairly rapidly. I waited long as I could without risking any heart damage. I had my valve replaced in 1988 when I was 57. I chose a mechanical because of the better record for longevity than a biological valve at that time. This may be less true today. I personally do not think Coumadin should be the major factor in deciding which type of valve. For most of us Coumadin is not a problem and it looks as if there will be a replacement type of blood thinner in a few years which would eliminate some of the disadvantages of Coumadin.

 

[LUVMyBirman]

Hi Marty

Think I was pretty close to where you will be 'by age' when you have your surgery. Was 30 when I had my Mitral Valve replaced with a prosthetic valve.

Due to my age....there was a great possibility that I could necessitate multiple surgeries if going with the tissue valve. These valves tend not to last as long in younger patients. Lifespan anywhere 5-15 years. What I did was round that up out to about 10 years per valve. Figured I would be on my 3rd by age 60. Each time you have surgery the risks increase due to scar tissue making subsequent replacements risky.

With the mechanical if all goes well it will last about 25+. There is an exchange for the mechanical valve...daily dealings with the Coumadin. But like some mentioned here.... there are so many advancements on the horizon that will make anticoagulants a snap.

It's a very personal decision.

All the best in your decision process....

 

[Seabush]

Age

Age

My 67 year old mother just received a biological valve.

Crystal

 

[Gail in Ca]

I had my 1st AVR done at age 34. I was prepared for either a porcine or a mechanical, and gave the surgeon the option depending on what he saw when he went in. I got a porcine valve at that time in '89. I think he did this because he wanted to give me the option of having another child, which I elected not to do anyway, later.
It lasted 11 yrs. I received my mechanical valve in '00. My recovery at age 46 was much longer than it was when I was 34. I was also much sicker going into the 2nd surgery, due to a screw-up by the recovery nurses who were there during a strike, during my cardiac cath. (fluid overload, CHF!)
Looking back, I must say I am glad I didn't have to take coumadin for 11 yrs anyway, and I seemed much more back to normal than I do now.
You are lucky that there are so many options for you in the 21 century!
Good Luck,
Gail

 

[RonP]

MHubbard:

My cardiologist stated the mechanicals were better for those under 60 because one should do you. The only drawback with the mechanical valves was the need for coumadin. As long as you allow the monitoring, there usually isn't any problems with that.

They recommended the biological valves for the older folks.

I was 49 when I got my St. Jude Mechanical aortic valve.

RON P.

 

[sylviayasgur]

hi marty!
welcome! you will find, as peter easton mentioned, a ton of info. regarding alternatives in valves selection on the "making the choice" thread started by peter on sept. 28 (i think) on the heart talk forum. check it out; it was so valuable to us in making our choices.
my husband, joey, is 49 and felt very opposed to taking coumadin for life. as you'll read on some of these threads, it's usually the non-coumadin takers who make a big deal of this. in fact, joey had a few bouts of a-fib and is now on coumadin for another 2 weeks (precautionary).
he is a very young 49 yr old and is extremely active. so, we did our research and opted for the ross procedure. this will probably, hopefully, give him another 20 years or so before having to worry about any replacements again. as a cardiologist friend of ours put it: "they're cloning ears right now, by then they'll give you your very own valve!"

whatever you decide, there really doesn't seem to be a right or wrong decision, based on what i've read on this forum. everyone (even those who wake up to an unexpected mechanical valve) is satisfied in the end. you make adjustments where you have to and live your life as fully as you can.

good luck and please let us know what you decide. even though we may be in different " valve groups or categories" (i.e. rp, mechanical, tissue_different ones too), we are all on the same team and want everyone here to be well.
God bless you,
sylvia

 

[Jessica_B.]

Hi,

I had MVR at age 24 (Feb. 2000) and AVR about a year later (Jan. 2001).
Both valves were mechanic. I desperately needed the replacement(s) because I had very bad regurgitation. After the surgeries I felt great -- like I could take on the world. My biggest complaint by far was the coumadin but eventually I learnt to live with it.

Unfortunately I developed a very bad case of cardiomyopathy in June so I underwent a heart transplant 7 weeks ago. I have never regretted the valve replacements. But in the end the decision is yours alone.

Take care!

/Jessica

 

[gary47]

Peter!

Peter!

Good explanation! My valve is fine-though-My aortic root became dialated because of a rear end car accident 55 to 60 mph. I am an avid runner and weight lifter-by chance (once their in there who knows) which procedure would you recommend for an athlete( I have 3 leaflets and minimal leakage-about the norm range for a 47 year old)---I will see my doc one more time -before my surgery on Jan 8th-Dr. Deeb out of U of Mich. thanks!

 

[mhubbard]

Thanks for all of the great responses. I just finished reading the thread started by Peter and all of his research on the various valves that he was to choose from. That info was so valuable and I feel like I can make a more informed decision because of that. I see my cardiologist tomorrow for my stress echo. He says he can better gauge how bad the regurgitation and stenosis is by that test. Hopefully he can give me a time of when to expect surgery. That may be wishful thinking though. Thanks again to all.

Marty

 

[Turkey Hunter]

mhubbard

mhubbard

Last year, for my Aortic Insufficiency and ascending aortic aneurysm, at 27 years old I had the Ross Procedure done.

You will find the more answers you get the more age groups vary on what their choice was.
The decision is so individual, I do not think there is a way to catagorize them by age and type. Although there are some new studies out (found on Cleveland Clinics Heart Center home page) that will enlighten the younger folks in the use of aortic homographs to replace your aortic valve. They say the valve tends to calcify rather quickly in patients under 35 or so.

It is difficult to give any real assitance in the decision for most people, bec ause it is so individual. I for one was scared to death of coumadin. (I have wised up since- can live completely normal with it)

I also looked at the possible advancements in the next few years. Who knows I may or may not need another repalcement.

God Bless,