Aortic valve repair or replacement, early 2020

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Astro

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Aug 26, 2019
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84
Location
Adelaide, Australia
Johnmarkos, best wishes with your planning. Hopefully you will remain too busy to over think things.

Since I first read your post, I have been wondering, why when you were 17, your girlfriend‘s father listened to your heart. Was this some “meet the parents” moment before the polygraph test?
 

johnmarkos

Member
Joined
Jul 21, 2015
Messages
16
Location
San Francisco, California, U.S.A.
Thanks! The surgeon says he won't try to do the repair unless he's confident he can get it to a very good state. He thinks the odds are about 50/50 that I'll end up with a repair. Otherwise, I'm getting a mechanical valve.

He also told me that repairs to bicuspid aortic valves are pretty new, so there's no twenty-year data. He said that the data they do have shows them performing quite well, with expected lifespans longer than those of bovine or porcine valves. He thinks it should last 15-20 years or more, even in someone relatively young and active like me. That gets me into my mid-late 60s, and at that point, I could have a TAVR, which could get me into my 80s.

"And then what?" I asked. I guess the answer is whatever they're doing in the 2050s.

If you do a repair, you're betting that, by the time your repair fails, there will be better technology available than you can get today. For example, perhaps a new valve that won't require warfarin will be available. Perhaps a new medication that replaces warfarin and doesn't require weekly INR testing (and that doesn't cost as much as a Chevrolet every year) may be on the market. Perhaps a new transcatheter repair valve will be available with an expected 50 year lifespan.

It may not be that big a gamble to wait -- if the 'repair' doesn't damage your heart while it's failing.

OTOH - you can consider going with a mechanical and probably not having to worry about another surgery (barring things like aortic aneurism and other things unrelated to the valve).

Good luck, whatever route you decide to take.
 
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johnmarkos

Member
Joined
Jul 21, 2015
Messages
16
Location
San Francisco, California, U.S.A.
Well, he's an orthopedic surgeon, and at one point he set a broken hand for me at his house. That might have been when he listened to my heart, but she and I used to spend a lot of time at both of our houses when we were dating, so I saw her family a lot. It could have been any one of countless times I was over there.

We broke up in college, but remain friends to this day, and I still keep in touch with her family. They're good people.

Johnmarkos, best wishes with your planning. Hopefully you will remain too busy to over think things.

Since I first read your post, I have been wondering, why when you were 17, your girlfriend‘s father listened to your heart. Was this some “meet the parents” moment before the polygraph test?
 
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