Another newcomer checking in

[NealR]

Hello Tin Man,

Sorry to hear you need a valve replaced. Me personally, was scared to death! However, by the good grace of medical technology I am able to function quite well today, about 14 mos after surgery. Having a surgically, or in my words, a "rebuilt" heart has afforded many luxuries that a generation ago was simply not possible.

You have choices, two of them. Both are good, just not perfect. Trade-offs on both, that is why this can be such an emotional topic. I always recommend, the valve your surgeon and their staff feel most comfortable implanting. Get a second opinion. I got mine from the Cleveland Clinic. It was free. All I did was send them the date, (report from my cardio, disk of my angiogram, if you need one, and of course the all important results of the echo.

Visit the ICU (heart floor) of the hospital you are considering and check out how patients are being cared for. They usually post the results of the each units success rate and evaluations.

The most impressive news here, is that what you have is "fixable", and please weight this a a positive. No matter which valve you chose,,works well.

Good luck with your decision.

 

[tobagotwo]

The stats are so far that both types produce the same longevity. The risks of resurgery and the risks of anticoagulation balance each other out over time. For every story of a reop that tragically fails, there is someone who quietly passes over the weekend from a GI bleed.

You may be best served by looking at your lifestyle and determining how you want to manage your risk. Some people feel that ACT (anticoagulation therapy) is a way of controlling their situation, and that it's usually not much of a bother. Their contention is generally that avoiding surgery is the most important thing. Some choose tissue because they feel that they want to be as distanced from their valve issues on a day-to-day basis as possible, or that they don't want to be tied down by required medication. Their contention is usually that the return to apparent normalcy, even if not permanently, is the most important thing.

In each case, there are compromises. The person on ACT has to deal with dentists and doctors who are not always knowledgeable about how act works, may need to bridge medications for certain treatments or tests, and may even wind up with another surgery eventually due to pannus, vegetation, or a clot on the valve. The person with a tissue valve must go through the same symptoms she or he is feeling now for a year or more when the replacement valve begins to fail. And other issues with the heart, arrhythmias, or arteries may cause that person to wind up on ACT over time anyway.

Lest you think it's all bad news: either way, your lifespan is still likely to be the same as someone who did not have a valve problem, once you've been fixed. I'm alive today only because I had my first surgery six years ago. I've had to have another surgery since, which was not planned, but I am still alive enough to have blown and shovelled a ton of snow yesterday (and to be headed back out to get all the stuff that drifted back onto our 200'+ driveway last night from the 4' drifts). And I helped the neighbors down the street, even though I think they should smarten up and pay to get plowed out.

Life can be good on the other side of the surgery. Think about how you tick, and what will work best with your personality. Go with that and never look back.

Best wishes,

 

[ShezaGirlie]

Hi and welcome to our little website Tin Man. Well now, only a week from today and you'll be pressing on toward recovery. After 11 years for me, recovery is a dim memory as I focused on what I was going to do and where I was going to vacation at 6 months to celebrate a new, healthy life. All the best to you and your family during this time..

 

[Lily]

Just wanted to welcome you to the site, Tin Man

 

[normofthenorth]

Bob=tobagotwo, I love the sentiments and info and wisdom in your post -- EXCEPT that I want to challenge you on one statement: "The stats are so far that both types produce the same longevity. The risks of resurgery and the risks of anticoagulation balance each other out over time." My understanding is that the results of the comparison are AGE-dependent, and that "the lines cross" (making your statement true) somewhere in the 50-60-year-old range. But younger than that, and the risks of resurgery have historically exceeded the risks of anticoagulation, and older than that it's the other way around, advantage tissue. A 75-year-old (or older) who doesn't need ACT for other reasons, can avoid the risks of anticoagulation by choosing a tissue valve, in return for essentially NO risks of resurgery, unless they live to be 100, right?

There are reasons to believe that the historical longevity data is too pessimistic to reflect HVRs done today, but that's true for both mechanical and tissue valves alike. There are also other reasons to doubt the historical stats, or to go against the best odds for reasons of personal preference or values. But am I not right about the fundamental longevity stats? I don't have a reference or a study in front of me, but I'm pretty sure that's what I read, and it also seems perfectly logical, given the "ingredients".