Anklosying Spondilitis...?

[tabitha]

Hi All,

I have anklosying spondilitis which is as far as anyone can tell, the reason why I have aortic regurgitation. It is a connective tissue disorder that causes inflammation on any and all connective tissue. I have a call into my rhuematologist (who hasn't gotten back to me yet) about her opinion on the 'right' type of valve for me with my condition.

Does anyone have a similar condition? Was there any recommendation as to which valve (bio or mechanical) would be best? I"m mostly concerned with if my condition means that a re-op wouldn't work or if the bio valve could also become inflamed. Like I said, I'm waiting for a call back, but thought I'd put it out there in the meantime.

 

[Fundy]

The tissue vs mechanical valve choice really comes down to a personal decision regarding a number of factors. Age, lifestyle, etc.
If you are a young female and still looking to have children choosing a mechanical valve and being on coumadin is heavily suggested to be avoided. While sometimes your hearts condition at operation time may yield a surgeons opinion that reoperations are too high risk and maybe tissue valves should be avoided. So its possible that your specific connective tissue disorder may usually or often result in that type of situation, but I think its highly possible that the risk wouldn't be any higher than those with the bicuspid aortic valve disorder that many of us have.

Generally, it will come down to your age (tissue valves last longer if your older usually) and your opinion about undergoing subsequent reoperations associated with tissue valves versus your opinion about avoiding anticoagulation therapy(usually with warfarin) with the mechanical valves.

A heart surgeon would be far better than a rheumy to give you information on any AS problems related to reoperation risk of tissue valve choice.

 

[piglet]

Sorry to hear about the AS, I have rheumatoid arthritis which is similar. I had endocarditis, they think from a dental procedure while on immune suppresants. What sort of meds are you on for the AS? I chose a tissue valve mainly to stay away from the blood thinners, the less meds the better for me as I'm currently on methtrexate, sulfasalazine, prednizone, hydrochloroquine and leflunomide for the RA. I am about to turn 52 so my child bearing days are over. I'd ask your rheumy and cardiologist about the valve choice.

 

[Lynlw]

My thoughts would be about like Piglets, what kinds of meds are you on or will you possibley be on and do any of them not work well with Coumadin. Also will you be needing surgeries for the AS? I'm not sure how it could affect a REDO, or how it could effect valve choice, i would definately make sure all your doctors comunicate to come up with the best plans
I wanted to add. I would also ask since you have problems with your back/spine IF the fact Coumadin is a Vit K antagonist, and so can effect bones and their densisty, would this effect you in anyway if you had to be on it longterm