Choosing valve with active lifestyle and being 21

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T

thecoolkid17

Hey im in the same boat with dave, but just a few paddles back, Im 21 and have a BAV and a dilated upper ascending aorta, I have known of the BAV since i can remember but the knowledge of the dilation is only 3 months old. Honestly i was down about it because its a kick in the nuts to hear about this at such a young age and being in college for Nursing, ironically, I tend to overthink it a little.

So they have to replace both of them, but i live an extraordinarily active lifestyle, soccer, snowboarding, jetskiing, running, skydiving, I work at UPS, I am in the best physical shape of my life.......so I am trying to figure out what type of valve to get, right now surgery is going down in June, so i can rest over the summer and hopefully not miss school, I was leaning on the pig valve because my surgeon has a low invasive approach and I heard the things i wanted to hear from him, and was wondering if this was my best option to go with my life style??

Luke:rolleyes:
 
Sorry i can't be of any help, glad to see you have started a new thread, where you will get help. Just wanted to wish you the best of luck for when you get a date and best of luck with choosing the right valve that will be best for you. Take care
 
Ask about the ON-x valve

Ask about the ON-x valve

I have one and play tennis, workout, etc. with no real restrictions. They have a 150 year warranty (kidding) -- and i bought the extended warranty on mine. call me an optimist.

ask your doc about the on-x. :D
 
Hi Luke,

I'm new here aswell! I found this forum yesterday, and I must say it's an exellent resource! :)

Anyway, I'm 25 years old, and I got a mechanical st.jude valve at the age of 23.
The reason i chose a mechanical valve was mainly because a pig valve only has a lifespan of about 10-15 years. After that you have to change it for a new one.

My surgeon recommended that I choose the mechanical valve, because it gets harder to change the valves for each time. (because of scar tissue, and so on, etc.) Anyway, my experience so far is good. I cant say that I have a super active lifestyle as you obviously have, but im not a lazy guy either.

I wish you good luck, and hope everything goes well :)

Best Regards
Morten
 
We should start a young bucks club!

I'm leaning more towards the mechanical valve. Yes, I'm going to have to give up a lot of my current activities and hobbies, but it won't be the end of the world. I can still be competitive in other things that don't involve getting hit in the head. If I wouldn't have already had one heart operation I would probably go for the tissue valve and hope to get 10 years out of it, then have the mechanical put in. I just feel like having the mechanical put in and being done with it. If the on-x ends up being approved for low or no dose coumadin I'll be one happy camper. If not, it's still ok :cool:

Best of luck!
 
Thanks

Thanks

Thanks everyone, I see my cardiologist later today to discuss why my groin still hurts, i had a cardiac cath done last wednesday and i can't walk unless i do it with a limp like i have a stick up my ass. I see my surgeon again on the 25th to discuss a date for surgery and now i have new questions regarding valves. Since this is my first surgery and pig valves have been shown to last longer than 15 years and offer no change in my lifestyle, hence im kind of partial to that.

Also, who knows what technology will bring in 15 years, they may have a super valve by then and everything will be just fine and we will have no questions or complaints and OHS is like getting your wisdom teeth pulled, call me an optimist:cool: but technology is quickly approaching. But ill see what happens today and in two weeks with the surgeon and will be back to post.

Thanks a ton again for all the info
 
Valve Choice

Valve Choice

Just wanteds to wish you good luck on your valve choice. Although I am a proud owner of bovine valve, please rememebr statistics on how long the valve lasts is age dependent. Generally, the younger you are the shorter the valve's life span. That said, the best valve for you is the one you feel most comfortable choosing...good luck and keep posting!
 
Another On-X patient

Another On-X patient

thecoolkid17 said:
So they have to replace both of them, but i live an extraordinarily active lifestyle, soccer, snowboarding, jetskiing, running, skydiving, I work at UPS, I am in the best physical shape of my life.......so I am trying to figure out what type of valve to get, right now surgery is going down in June, so i can rest over the summer and hopefully not miss school, I was leaning on the pig valve because my surgeon has a low invasive approach and I heard the things i wanted to hear from him, and was wondering if this was my best option to go with my life style??

Luke:rolleyes:
Click to expand...
Hi Luke

21, huh? I can't even REMEMBER 21!!! So you can take whatever I say with a grain of salt as I'm such an old doofus.

I had the same operation in May of 2006. I had an On-X inserted and a dacron sheath put in to replace my ascending aorta. I am curious about the surgeon having a 'low invasive approach'. I was not aware that a mininally invasive approach was possible for repair of the ascending aorta.

Anyway..back to the valve. I have heard anecdotal evidence of tissue valves now lasting longer than 15 years. But I don't know how reliable those anecdotes are. To be safe I would assume a lifetime of 15-20 years. That means that you being 21 almost guarantees two more surgeries over your lifetime, and maybe more. A third OHS at age 60+ is a daunting prospect.

The On-X is currently in an FDA approved clinical trial to determine if one can safely stop using warfarin with that valve implanted. There have already been some studies done where patients who had the On-X implanted were not able to maintain an appropriate anticoagulation regimen. The results were very impressive. There were very few (if any) cases of thrombosis. Here are some links you might check out:

www.onxvalves.com
www.heartvalvechoice.com

A major reason I chose the On-X was that given the existing data I really felt that within a few years I might be able to stop using warfarin completely.

Anyway, this site has a wealth of information (and opinion!) about valve selection. I'm sure you will be hearing from other subscribers soon!

Ed "Fast Eddie" Friedman
 
thecoolkid17 said:
Since this is my first surgery and pig valves have been shown to last longer than 15 years and offer no change in my lifestyle, hence im kind of partial to that.
Click to expand...
Tissue valves will not last that long in someone your age. 8 to 10, maybe 15 years. If your dead set on tissue, plan on having it replaced 3 or 4 times.
 
thecoolkid17 said:
Thanks everyone, I see my cardiologist later today to discuss why my groin still hurts, i had a cardiac cath done last wednesday and i can't walk unless i do it with a limp like i have a stick up my ass. I see my surgeon again on the 25th to discuss a date for surgery and now i have new questions regarding valves. Since this is my first surgery and pig valves have been shown to last longer than 15 years and offer no change in my lifestyle, hence im kind of partial to that.

Also, who knows what technology will bring in 15 years, they may have a super valve by then and everything will be just fine and we will have no questions or complaints and OHS is like getting your wisdom teeth pulled, call me an optimist:cool: but technology is quickly approaching. But ill see what happens today and in two weeks with the surgeon and will be back to post.

Thanks a ton again for all the info
Click to expand...

Is your Doc talking about one of the "New and Improved Pig Valves" or a straight from the pig, no modifications or additives?

Straight from the Pig valves have a proven longevity of only 8 to 12 years in OLDER patients. The younger you are, the FASTER Tissue Valves (of any kind) will wear out.

From a performance point of view, the Medtronics Freestyle offers a very low gradient and I believe it has an anti-calcification treatment to help extend it's durability. Hopefully some of our members who have those valves can add more insight.

'AL Capshaw'
 
How much do you love your lifestyle?

If you went tissue you will be unlikely to get 15 yrs out of it, they don't last as long in the young....like ross said think 8ish....could get 10, may only get 5...pot luck really. Not sure if being really active will make it last longer or shorter....

Mechanical is the only choice if you want a shot at one surgery only.

But there is nothing to say you couldnt go tissue now and enjoy your 5+ years and then make a decision then...tissue again or mech?

It's always great to hope on future developments but you should base your decisions on what is available today and not what MIGHT be available in the future. For example don't choose on-x hoping it will be warfarin free in the future when it may not be and don't choose tissue cos you think they can somehow inject the next valve and not have to open you up again.

I was active at 21 but didn't need surgery until 37 and by then my body was buggered and used up through injuries so mechanical wasn't really an issue.

If you are happy to have two tissue valves that may stand a chance of getting you to 35 and then go mech on the 3rd surgery and you understand the risk of additional surgeries then go for it.

There is no wrong choice, only a choice that you are happy with.
 
Given your lifestyle, you are at a tough choice. At 21, your tissue valve will probably not last as long as you hope. The studies that refer to longevity of a tissue valve are most often referring to a mean age of around 65. The body chemistry of a 21 year-old is not nearly as kind to a tissue valve as a 65 year-old's. Like Magic said - you could go tissue and then choose mechanical for your next. There is an unknown in just how the degradation of a tissue valve will affect your lifestyle as it nears it's replacement time. A mechanical is not a guarantee that you won't have to have surgery for a very long time, but it's a pretty good bet. And you will have to be smart about Coumadin use - but it's not rocket science. Just how much of your activity will you have to tone down on or drop completely is something only you can decide. We have many very active Coumadin users. The majority of the medical community will try to scare the crap out of you and make you feel like you need to be a couch potato. Our tendency here is to say - do what you love, wear the correct safety gear and live life. We have lots of active Coumadin (warfarin) users here. But we do have members who have chosen tissue so as not to have to have that worry in their most active years. It is a trade-off that only a magic ball will answer.

You are in control of your life (for the most part:rolleyes: ) and make your own choices. Making one decision doesn't mean that the alternative is a worse decision - it's just a different decision. Life is truly what you make of it.

The most important thing to remember is that you are saving your life by getting this replacement done. It is a very positive thing, not something to be mourned. Look at it as a new lease on life.
 
Surgical material between heart and sternum

Surgical material between heart and sternum

My intention is not to recommend any particular type of valve to you younger ones who have posted here but I thought I would mention something that my surgeon did for me that you may want to ask your surgeons about...

My surgeon placed a surgical material between my heart and my sternum, in anticipation of an eventual reop, to hopefully cut down on the possible complications of scar tissue fusing with the sternum. I don't know if this extra step is commonly performed, or not.

Best wishes to those of you with questions, as you make your valve type decisions, weighing your options, considering your personal preferences, and as you hopefully are able to consult with excellently experienced and highly recommended surgeons.

By the way, it's also evidently not uncommon for members here to consult with more than one surgeon.
I saw three.
 
Hey,

Have been in a situation similar to yours twice (surgeries at 17 and 24). I completely understand your preference for a tissue valve. Have you looked into the Ross Procedure? It could be something you are interested in. It didn't work out for me, but it has worked out for 15+ years for other young people. It tends to be popular among young athletes.

My surgeon at the Mayo Clinic told me to expect no more than 10 years from my homograft valve. Maybe the pig valve you are getting is supposed to last a little bit longer. I don't know. Good luck an don't hesitate to ask any questions you might have.

Brad
 
Tissue valves in younger patiens WILL require reops. Mechanical valves MAY last a lifetime. When my valve was replaced at 31, my docs placed no lifestyle restrictions on me, other than to use common sense. I have "physically" built a lake house, waterskied, played contact sports (with my kids), etc. I doubt that I would have played adult football, soccer, etc. regardlas of which valve (mechanical or tissue) they put in me. OHS will never be "a simple surgery" and it becomes a more serious surgery as we age. Personally, I don't want to go under the knife anymore than absolutely necessary.

If I were going under for my FIRST surgery at my current age of 72, I would probably choose a tissue valve since the likelyhood of a reop would not be likely. If I were 31 again :cool: I would obviously choose the mechanical since I have required NO reops :) :) up to this time.

When making this decision, consider that your habits and hobbies will change over time. Age, not heart valve, will cause most of those changes.:D :D :D
 
Welcome Luke,

I'm 46, and I wouldn't tell what to do....... but I'll tell you what my surgeon said to me........

"I'll repair it if I can, if not, I'll be replacing it with a mechanical valve. Cause I don't think you would want to go through this surgery again".

After a year (almost) I'm just as active as I was before surgery. Yea, sure I have to take warfarin for the rest of days, but thats no different than taking your vitamins everyday.

Its important for you to feel comfortable with your decision and to consult with more than one surgeon.

Good Luck and post often
 
I'm 31, 10+ yrs olders than you and I am totally on the fence on valve choice. I think my Dr's will want to go mech for me.

I'm not totally active but I like to build things, do tons of yard work, rough house with my kids, and ride my ATV. I don't like the coumadin thing but this will be my thrid OHS (one at age 6 for a hole and one at 10 for stenosis) so a 4th isn't too happy sounding.

I suck at a taking my meds but with a routine I'm sure I can manage. Someone mentioned a bruised penis after sex when being on coumadin and that almost makes me say "no freaking thanks" to mechanical. My wife is hot so no way can I cut that part out!! LOL!!!! Seriously.

I may see if he'll go with an On X for me. I go tuesday to his office to discuss it.

My a-hole cardio better call me today also!!!!
 
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