AVR calcification and magnesium supplement

[R1Phrankey]

In May my aortic valve has been replaced by a mechanical valve. The surgeon told me that my aortic valve was calcified in some way and that 2 cusps were adhesed (looks like a BAV to me).
Last couple of days I was thinking about the calcification part. I am 47 years old and calcification is normally seen with elder patients. I do not know in what way my aortic valve was calcified, but I am now asking myself if this calcification might come back and influences the mechanical valve.
I can imagine that with extensive calcification the mechanical valve becomes defective (e.g. a leaflet gets stuck in the open position).

Is there any information on the risk of this calcification to happen after AVR?

Other question I have: I have found some information about vitamine D3, vitamine K2 and magnesium.
Magnesium might prevent for calcification of soft tissues. Is there any information on the effect of taking a magnesium supplement (together with vitamine D and K) to take care of this?
Is there any experience or detailed information on the best way to prevent for calcification?
My goal is to have a healthy lifestyle and to prevent for a 2nd OHS.

Some information I found:
http://drsircus.com/medicine/magnesi...um-thiosulfate

Any information or experiences is appreciated!

Post edited: I mentioned that 2 slips of my aortic valve were adhesed. Slips should have been cusps.

 

[Paleowoman]

In May my aortic valve has been replaced by a mechanical valve. The surgeon told me that my aortic valve was calcified in some way and that 2 slips were adhesed (looks like a BAV to me).
Last couple of days I was thinking about the calcification part. I am 47 years old and calcification is normally seen with elder patients. I do not know in what way my aortic valve was calcified,

Calcification happens in bicuspid aortic valves because of the turbulent blood flow, it's not related to the calcification that older patients get.

I've no idea if mechanical valves can get calcified. I know that bioprosthetic ones can (like mine - bovine pericardial valve). I don't think anyone knows what makes bioprosthetic heart valves get calcfied - do they ? I take supplements of magnesium, vitamin D3, vitamin K2 and vitamin A, this is both for the osteoporosis I have and my general health. Vitamin D3, K2 and A are synergystic and help put calcium in bones rather than in the vascular system. Btw, I had CT angiogram before surgery and I have no coronary artery calcification or plaque, but my bicuspid aortic valve was mildly calcified……..due to the turbulent blood flow though……...the calcification can start quite early on in life.

 

[epstns]

When I was first diagnosed with aortic stenosis, my cardio told me that there were two common causes of the stenosis -- old age and bicuspid valves. When stenosis presents in a younger patient, they typically expect to find a bicuspid valve. The stenosis of a bicuspid valve typically begins to present as a murmur, heard around the 5th decade of life (which is actually age 41-50), sometimes sooner, sometimes later. This is one of the ways they come up with the diagnosis of "probable bicuspid valve" - by hearing a murmur in a patient who is far from elderly.

 

[river-wear]

However, as seen by many patients here (including me), a BAV doesn't necessarily become calcified. Fortunately my surgeon didn't find any calcification on my valve when he fixed it. (Hoping that means it'll be a permanent fix...)

Does stenosis always result from calcification? If so, I find it curious that it would come with older age (which I have also heard) because tissue valves generally calcify faster in younger patients. The shorter life of tissue valves is attributed to the different body chemistry in younger people, as well as (perhaps) a more active lifestyle. Maybe it's just that older people have greater stenosis because they've had more time for the valve to calcify.

In any case, R1Phrankey, in my research I have not come across issues with calcification in a mechanical valve. There is a risk of pannus (scar tissue) build-up that could cause a leaflet to get stuck, but that isn't very common.

 

[ottagal]

You may find this research article of interest, although it dates back to 2005. There may be more current research on this topic.

"Spectrum of Calcific aortic Valve Disease, Pathogenesis, Disease Progressions and Treatment Strategies".

https://circ.ahajournals.org/content/111/24/3316.full

 

[R1Phrankey]

Ottagal, thank you for the research article. Very interesting.

The reason why I started this topic is exactly what Paleogirl says: Because of turbulent blood flow, calcification occurs more in bicuspid valves. My mechanical valve is also bicuspid and definitely has no optimal blood flow through the valve. I am very curious what this would mean for calcification. Of course it is not a tissue valve anymore, but I have not found any information about calcification of mechanical valves. The fact that my research on this did not lead to any hits might be the answer to my question, but maybe you might have more information on it. Internet is big, with a lot of information ....

 

[ottagal]

R1Phrankey,
My understanding is that bioprosthetic valves are prone to structural deterioration from calcification (especially in younger patients); not mechanical valves. I may stand to be corrected.
Although rare, I have read of members developing pannus growth around mechanical and bioprosthetic valves. In the bileaflet valves, this occurence is less than 1 percent.:
http://www.cardiothoracicsurgery.org/content/7/1/62
"The improvement of durability and hemodynamics of currently available prosthetic valves reduced the incidence of structural valve failure to a minimum [1]. However, prosthetic valve dysfunction caused by either pannus formation or thrombosis or both is still seen in clinical practice. Prosthetic valve dysfunction at aortic position is commonly caused by pannus formation which is an uncommon, but serious complication. Its incidence varies between 1.8% in tilting disc to 0.73% in bileaflet valves [2]. All types of available prosthetic valves can be affected by pannus formation.
The exact etiology of pannus formation is not known. Multifactors are involved in its formation. Basically, pannus represent a bioreaction to prosthetic valves associated with coexisting factors such as surgical technique, thrombus organization from inadequate anticoagulation, infection and wall shear stress [3,4].
Recent study by Teshima and colleagues [4] found that patients with prosthetic valve dysfunction secondary to pannus are associated with significant increase in the level of transforming growth factor beta(TGF-B1). This cytokine is essential for regulation of cell growth, differentiation, and matrix production. Thus, the increase production of these cytokines is implicated in the formation of pannus by inducing exaggerated healing, fibrosis and scar tissue formation.
Pannus usually originates in the neointima of the periannular tissue [5]. Histologically, it is mainly formed of collagen and elastic fibrous tissue accompanied by endothelial cells, chronic inflammatory cell infiltration and myofibroblasts [5].
In most of the previously reported cases, the formation of pannus arose from the left ventricular aspect of the prosthetic valve. In rare cases they appear to grow from the aortic side [6]."

Hope this helps!

 

[NewbieSlo]

Hi all,

interesting discussion, I was also reading lately on magnesium and K2 and D3. I read, that it might be better to take magnesium chloride than magnesium sulfate.
http://www.ncbi.nlm.nih.gov/pubmed/16259379 also: http://drsircus.com/medicine/magnesium/magnesium-chloride-benefits

Paleogirl - what form of magnesium are you taking? Sulfate or chloride?

I also read about a studyabout experimental treatment of aortic valve stenosis in mice. Tey administread a compound that mimics HDL, also reffered to as "good cholesterol." Results were particularly impressive as, after only 28 days of treatment, the aortic valve opened more fully in the treatment group compared to the control group. The aortic wall in the treatment group had also reduced in thickness compared to the control group.Furthermore, microscopic analysis also revealed that the extent of the scar lesions (or accumulated collagen) in the valves was significantly smaller in the treated subjects than in the control subjects.
http://www.sciencedaily.com/releases/2013/07/130718101242.htm

So increasing a HDL level might be good for our heart valves as well, I read that consumption of 750 mL but not of 250 or 500 mL orange juice daily increased HDL-cholesterol concentrations by 21%.
http://ajcn.nutrition.org/content/72/5/1095.full

Orange juice anyone?

 

[Paleowoman]

Paleogirl - what form of magnesium are you taking? Sulfate or chloride?

So increasing a HDL level might be good for our heart valves as well, I read that consumption of 750 mL but not of 250 or 500 mL orange juice daily increased HDL-cholesterol concentrations by 21%.
Orange juice anyone?

Hi NewbieSio

I'm taking magnesium citrate.

My HDL level is really high, currently 3.6 nmol/L or 140 mg/dl in US numbers. Seven years ago it used to be lower, still good, around 2 nmol/L or 80 mg/dl, but then it steadily rose and rose. Not from orange juice - oh no, never touch the stuff as I have diabetes and that's too high in carbs. My HDL went up and up after I started following an extremely low carb diet, which included cutting out grains - I went Paleo (hence my screen name). My diet, or rather way of eating, is high in fat and protein: meat, oily fish, green veggies, nuts, eggs, some dairy, and fats like coconut oil which all help raise HDL (saturated fats actually increase HDL believe it or not - a litle secret they don't like people to know). I also have optimal levels of vitamin D which raises HDL a bit, plus I do a lot of exercise which also raises HDL...and I have a glass of red wine with my evening meal, red wine is supposed to increase HDL. It was not an overnight rise but a really steady rise, every lipid test I've had every six months my HDL has steadily risen - so has my total cholesterol but since my HDL is almost half the total I'm not complaining.

 

[slipkid]

Interesting topic. I had a bicuspid valve & it had "calcified" to some degree - thus they replaced it when I had my heart attack this year. I'm 57. No one mentioned anything about a possibility of my mechanical valve eventually calcifying too. I'm assuming that it would take another 57 years before that happens, or more, and I'll be dead of old age before that happens!

Note that my dad was only in his forties when he died of a heart condition. I don't know the details of exactly what was wrong with him but I had heard things like he had a "calcified heart valve" or "hard heart" from my relatives of his generation when I asked about it while growing up. It was only this year after my heart attack that my aunt told me he collapsed & died of a "heart attack" while playing tennis! I suspect perhaps he had a bicuspid aortic valve like me, calcification degrading it, maybe even had a heart attack too due to blocked coronary artery (?). Back in those days though they didn't have bypass surgery or valve replacement, you just died I guess.

 

[epstns]

I think that a lot of us suspect that our parents had similar or the same heart conditions we do, but the medical information from our parents' generation is sketchy and often impossible to obtain. I can think of at least 3 members of my father's immediate family who all died from heart issues with symptoms similar to those of untreated aortic stenosis. I'll bet that's where mine came from. . .

 

[clay_from_nj]

My Dad had his aortic valve replaced just a couple of months before I had mine.