Complications in surgery or post surgery

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newarrior

I have severe tricuspid aortic stenosis live in Ba
Joined
Jun 28, 2019
Messages
605
Location
Bangkok Thailand
Dear All,

I live in Bangkok Thailand an am planning on having my tricuspid (caused by high lipoprotein) valve replacement at a university. I am in excellent health but do have a high level of calcification in my heart and aortic valve as well as mild mitral valve regurgitation..I am also about 8 lbs over the BMI...I am 59, no hypertension, low LDL, exercise daily, no drink, no smoke, low fat vegan diet, no caffeine, see doctors regularly, meditate every day, take statins, monitor health at home etc etc.

Will probably go with mechanical valve but dreading the ticking and blood thinners

Any 80 something year old American friend of mine her AVR at a low cost government hospital here in Bangkok and had amazing results, no complications..He advantage: Had a son to take care of her and son's insurance paid for her surgery.

Not sure when I will need surgery..Guess is sometime in my 60's

No reason to go back to USA to do it..no insurance, no family, no one to stay with, no job, no one to take care of me, no home, nowhere to stay.

Concerns are two fold:
1) Cost of any complications as I have to fund the surgery ( surgery itself probably around 15,000 USD)
2) Post surgical recovery--same concerns as anyone...Given my outstanding level of fitness. exercise and diet I expect a rapid recovery (I exercise every day--at least 6000-8000 steps a day plus daily gym workouts + some swimming + my low fat plant based diet).

Also: My LDL's have been as low as 55, blood pressure controlled without meds, tryglicerides good..HDL's low due to bad genetics and because my LDL's are so low..No diabetes--all related diabetes tests are good.. Treadmill tests are great.

Given what I know what if any complications should I expect ? Any way to know in advance what complications may occur during or post surgery ?

Thank you and to your health !

David
 

Chuck C

Well-known member
Joined
Dec 5, 2020
Messages
1,793
Hi Newarrior.

Will probably go with mechanical valve but dreading the ticking and blood thinners

I would strongly suggest that you at least consider going with a tissue valve.

1) You are 59 now and will almost certainly be over 60 when it is time for surgery. The last time you updated us you were still in the moderate range for aortic stenosis, so you could easily have a few more years before it is your time.

2) Almost every guideline for valve choice would indicate that, for the age range of 60 to 70, either mechanical or tissue is a reasonable choice.

3) In that you are dreading the ticking already, I would expect that you could very likely to be one of those rare individuals for whom the ticking bothers them. In my check up with my cardiologist last week, we discussed the issue of how ticking bothers a small percentage of patients with a mechanical valve. It is his opinion that it is psychologicial for the most part. The discussion of ticking comes up often here, and probably 95%+ of those with mechanical valves indicate that the ticking is a non-issue for them. I know that you have read those threads, as you have participated in them. But, despite having this encouraging feedback from those with mechanical valves, still you are dreading the ticking. So, if you are that certain that it will bother you, despite this feedback, I'd wager that it will, in fact, bother you.

4) You indicate that you are also dreading blood thinners, which we like to more correctly refer to as anti-coagulation. If you go with a tissue valve you will probably only need to be on anti-coagulation for a few months following your surgery. So, a tissue valve will allow you to avoid this concern of yours, most likely, although it is not a certainty, as some develop conditions which require anti-coagulation for other reasons.

Best of luck in whatever you ultimately decide and hoping that the day of surgery is many years off for you.
 
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pellicle

Professional Dingbat, Guru and Merkintologist
Joined
Nov 4, 2012
Messages
10,756
Location
Queensland, OzTrayLeeYa
Given what I know what if any complications should I expect ? Any way to know in advance what complications may occur during or post surgery ?
hey mate, welcome back.

Yet again the same questions as per most of your posts since 2019 ... 🤷‍♂️

I personally feel that the biggest complications which I'm certain you will suffer will be from the sound and from the handling of Blood Thinners. Its pretty clear to me that you live on an emotional mobius strip and have in the time since your first posts here made no phsychological progress on the topic of heart valve choices.

So its in cognisance of the above and in 100% honesty I say you should get a bioprosthesis. If you don't you'll rue every day, you'll magnify (not adapt to) the more clear presence of your heart beat (because I personlly don't hear ticking, I just hear a solid lub lub of me heart conducted through my body), every complication of ACT will trigger you and I sincerely doubt you'll learn to self manage INR.

So with that clearly lain out - get a bioprosthesis ... the Magna Ease seems the best on the market and has presently the most track history of all the new bio valves
Conclusions: The Magna Ease valves demonstrated excellent durability and hydrodynamic performance after an equivalent of 25 years of simulated in vitro wear. All study valves successfully endured 1 billion cycles of simulated wear, 5 times longer than the standard requirement for a tissue valve as stipulated in ISO 5840.​

Further:

This study identified three main new findings with respect to the late incidence of reoperation for SVD in patients with bioprosthetic heart valves. First, it formally demonstrated that current models of bioprostheses have markedly better durability than older models that are discontinued. This is an encouraging finding for clinicians and patients... Secondly, the study indicated that smoking has a detrimental effect on bioprosthetic valve durability, regardless of implant site. A related finding had previously been reported in patients with native aortic valve stenosis [11], but so far not in patients with bioprosthetic valves, and this provides another mandate for the cessation of smoking in all valve patient ... Finally, the study also showed that larger aortic bioprostheses have a lower incidence of reoperation.​

[pellicle: my emphasis]

Given that you (still) aren't facing surgery, its likely that by the time you do actually face surgery that you will be nearer to 60yo and the primary beenfits of a mechanical will not be significant for you.

Lastly as this will be your first surgery (not, say like me, a third before 50) a reoperation will really not be the same sort of hazard.

I suggest you do yourself a favor and read through the many many many replies you've had on exactly the same question before as people (including Chuck via whom I noticed this post) have dedicated much time to answering. Why? Because ignoring what people say to you, by simply disregarding their efforts in answering you you send a clear message of "I don't care what you think" and "I don't value your time in the slightest" also because those answers haven't changed either. Indeed that's exactly why you're on my ignore list.

Best wishes
 
Last edited:

newarrior

I have severe tricuspid aortic stenosis live in Ba
Joined
Jun 28, 2019
Messages
605
Location
Bangkok Thailand
hey mate, welcome back.

Yet again the same questions as per most of your posts since 2019 ... 🤷‍♂️

I personally feel that the biggest complications which I'm certain you will suffer will be from the sound and from the handling of Blood Thinners. Its pretty clear to me that you live on an emotional mobius strip and have in the time since your first posts here made no phsychological progress on the topic of heart valve choices.

So its in cognisance of the above and in 100% honesty I say you should get a bioprosthesis. If you don't you'll rue every day, you'll magnify (not adapt to) the more clear presence of your heart beat (because I personlly don't hear ticking, I just hear a solid lub lub of me heart conducted through my body), every complication of ACT will trigger you and I sincerely doubt you'll learn to self manage INR.

So with that clearly lain out - get a bioprosthesis ... the Magna Ease seems the best on the market and has presently the most track history of all the new bio valves
Conclusions: The Magna Ease valves demonstrated excellent durability and hydrodynamic performance after an equivalent of 25 years of simulated in vitro wear. All study valves successfully endured 1 billion cycles of simulated wear, 5 times longer than the standard requirement for a tissue valve as stipulated in ISO 5840.​

Further:

This study identified three main new findings with respect to the late incidence of reoperation for SVD in patients with bioprosthetic heart valves. First, it formally demonstrated that current models of bioprostheses have markedly better durability than older models that are discontinued. This is an encouraging finding for clinicians and patients... Secondly, the study indicated that smoking has a detrimental effect on bioprosthetic valve durability, regardless of implant site. A related finding had previously been reported in patients with native aortic valve stenosis [11], but so far not in patients with bioprosthetic valves, and this provides another mandate for the cessation of smoking in all valve patient ... Finally, the study also showed that larger aortic bioprostheses have a lower incidence of reoperation.​

[pellicle: my emphasis]

Given that you (still) aren't facing surgery, its likely that by the time you do actually face surgery that you will be nearer to 60yo and the primary beenfits of a mechanical will not be significant for you.

Lastly as this will be your first surgery (not, say like me, a third before 50) a reoperation will really not be the same sort of hazard.

I suggest you do yourself a favor and read through the many many many replies you've had on exactly the same question before as people (including Chuck via whom I noticed this post) have dedicated much time to answering. Why? Because ignoring what people say to you, by simply disregarding their efforts in answering you you send a clear message of "I don't care what you think" and "I don't value your time in the slightest" also because those answers haven't changed either. Indeed that's exactly why you're on my ignore list.

Best wishes
I must be communicating poorly. I'm asking what complications I expect and how can I prepare for that financially? What is not clear about my post ?
 
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newarrior

I have severe tricuspid aortic stenosis live in Ba
Joined
Jun 28, 2019
Messages
605
Location
Bangkok Thailand
Hi Newarrior.



I would strongly suggest that you at least consider going with a tissue valve.

1) You are 59 now and will almost certainly be over 60 when it is time for surgery. The last time you updated us you were still in the moderate range for aortic stenosis, so you could easily have a few more years before it is your time.

2) Almost every guideline for valve choice would indicate that, for the age range of 60 to 70, either mechanical or tissue is a reasonable choice.

3) In that you are dreading the ticking already, I would expect that you could very likely to be one of those rare individuals for whom the ticking bothers them. In my check up with my cardiologist last week, we discussed the issue of how ticking bothers a small percentage of patients with a mechanical valve. It is his opinion that it is psychologicial for the most part. The discussion of ticking comes up often here, and probably 95%+ of those with mechanical valves indicate that the ticking is a non-issue for them. I know that you have read those threads, as you have participated in them. But, despite having this encouraging feedback from those with mechanical valves, still you are dreading the ticking. So, if you are that certain that it will bother you, despite this feedback, I'd wager that it will, in fact, bother you.

4) You indicate that you are also dreading blood thinners, which we like to more correctly refer to as anti-coagulation. If you go with a tissue valve you will probably only need to be on anti-coagulation for a few months following your surgery. So, a tissue valve will allow you to avoid this concern of yours, most likely, although it is not a certainty, as some develop conditions which require anti-coagulation for other reasons.

Best of luck in whatever you ultimately decide and hoping that the day of surgery is many years off for you.
Hey Chuck what I'm most concerned about is any complications that happen during or after surgery and how that could add to my cost. That was the point of my message. Thank you I'm not asking about valve choice
 

newarrior

I have severe tricuspid aortic stenosis live in Ba
Joined
Jun 28, 2019
Messages
605
Location
Bangkok Thailand
hey mate, welcome back.

Yet again the same questions as per most of your posts since 2019 ... 🤷‍♂️

I personally feel that the biggest complications which I'm certain you will suffer will be from the sound and from the handling of Blood Thinners. Its pretty clear to me that you live on an emotional mobius strip and have in the time since your first posts here made no phsychological progress on the topic of heart valve choices.

So its in cognisance of the above and in 100% honesty I say you should get a bioprosthesis. If you don't you'll rue every day, you'll magnify (not adapt to) the more clear presence of your heart beat (because I personlly don't hear ticking, I just hear a solid lub lub of me heart conducted through my body), every complication of ACT will trigger you and I sincerely doubt you'll learn to self manage INR.

So with that clearly lain out - get a bioprosthesis ... the Magna Ease seems the best on the market and has presently the most track history of all the new bio valves
Conclusions: The Magna Ease valves demonstrated excellent durability and hydrodynamic performance after an equivalent of 25 years of simulated in vitro wear. All study valves successfully endured 1 billion cycles of simulated wear, 5 times longer than the standard requirement for a tissue valve as stipulated in ISO 5840.​

Further:

This study identified three main new findings with respect to the late incidence of reoperation for SVD in patients with bioprosthetic heart valves. First, it formally demonstrated that current models of bioprostheses have markedly better durability than older models that are discontinued. This is an encouraging finding for clinicians and patients... Secondly, the study indicated that smoking has a detrimental effect on bioprosthetic valve durability, regardless of implant site. A related finding had previously been reported in patients with native aortic valve stenosis [11], but so far not in patients with bioprosthetic valves, and this provides another mandate for the cessation of smoking in all valve patient ... Finally, the study also showed that larger aortic bioprostheses have a lower incidence of reoperation.​

[pellicle: my emphasis]

Given that you (still) aren't facing surgery, its likely that by the time you do actually face surgery that you will be nearer to 60yo and the primary beenfits of a mechanical will not be significant for you.

Lastly as this will be your first surgery (not, say like me, a third before 50) a reoperation will really not be the same sort of hazard.

I suggest you do yourself a favor and read through the many many many replies you've had on exactly the same question before as people (including Chuck via whom I noticed this post) have dedicated much time to answering. Why? Because ignoring what people say to you, by simply disregarding their efforts in answering you you send a clear message of "I don't care what you think" and "I don't value your time in the slightest" also because those answers haven't changed either. Indeed that's exactly why you're on my ignore list.

Best wishes
Actually I don't think you're reading my messages carefully I'm not asking about valve selection. I'm talking about the fact that I live in a foreign country and I don't have coverage at all for valve replacement so I'm worried about the cost therefore I'm trying to anticipate any surgical or post surgical problems that might come up that will add to the cost. I've never seen a single person on the message board here say that they're going to have to pay 100% for their own surgery. Nobody's ever answered that question. The reason I click ignore on a lot of people is because all I've seen is attacks on my character. People are not responding to my original concern was that I live overseas in a foreign country and the insurance here does not cover pre-existing conditions therefore I have to fund my own surgery. Am I being unclear in any way?
 
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newarrior

I have severe tricuspid aortic stenosis live in Ba
Joined
Jun 28, 2019
Messages
605
Location
Bangkok Thailand
I think the best thing is to talk to a medical professional and ask him my main heart doctor here what if any complications he would anticipate during or after surgery that would add to the cost.
 

newarrior

I have severe tricuspid aortic stenosis live in Ba
Joined
Jun 28, 2019
Messages
605
Location
Bangkok Thailand
Pellicle--Chuck..I appreciate the time you took in regards to illustrating the pros and cons of tissue vs mechanical valve as this goes to my larger concern: Cost....Is tissue more costly than mechanical ? Won't getting a tissue valve require me to get a 2nd open heart surgery ?

I am expect to 100% pay for all heart surgeries for the rest of my life therefore I am trying to budget for this. Thank you for understanding
 

newarrior

I have severe tricuspid aortic stenosis live in Ba
Joined
Jun 28, 2019
Messages
605
Location
Bangkok Thailand
Hi Newarrior.



I would strongly suggest that you at least consider going with a tissue valve.

1) You are 59 now and will almost certainly be over 60 when it is time for surgery. The last time you updated us you were still in the moderate range for aortic stenosis, so you could easily have a few more years before it is your time.

2) Almost every guideline for valve choice would indicate that, for the age range of 60 to 70, either mechanical or tissue is a reasonable choice.

3) In that you are dreading the ticking already, I would expect that you could very likely to be one of those rare individuals for whom the ticking bothers them. In my check up with my cardiologist last week, we discussed the issue of how ticking bothers a small percentage of patients with a mechanical valve. It is his opinion that it is psychologicial for the most part. The discussion of ticking comes up often here, and probably 95%+ of those with mechanical valves indicate that the ticking is a non-issue for them. I know that you have read those threads, as you have participated in them. But, despite having this encouraging feedback from those with mechanical valves, still you are dreading the ticking. So, if you are that certain that it will bother you, despite this feedback, I'd wager that it will, in fact, bother you.

4) You indicate that you are also dreading blood thinners, which we like to more correctly refer to as anti-coagulation. If you go with a tissue valve you will probably only need to be on anti-coagulation for a few months following your surgery. So, a tissue valve will allow you to avoid this concern of yours, most likely, although it is not a certainty, as some develop conditions which require anti-coagulation for other reasons.

Best of luck in whatever you ultimately decide and hoping that the day of surgery is many years off for you.
Chuck thank you and I hope you are well !!)
 

MdaPA

Well-known member
Joined
Jul 8, 2020
Messages
273
Given what I know what if any complications should I expect ? Any way to know in advance what complications may occur during or post surgery ?
Have you seen the replies when you asked the same question in prior posts?
For example:
Getting closer to needing aortic valve repalcement surgery still uninsured living in Thailand

I think the best thing is to talk to a medical professional and ask him my main heart doctor here what if any complications he would anticipate during or after surgery that would add to the cost.
Sounds like a good plan.

Cost of any complications as I have to fund the surgery ( surgery itself probably around 15,000 USD)
Costs will vary greatly, whether going through insurance or not, from hospital-to-hospital and from country-to-country so best to confirm in writing with the hospital you plan to go with.
 

tom in MO

Well-known member
Joined
Jan 17, 2012
Messages
1,964
Location
MO USA
I must be communicating poorly. I'm asking what complications I expect and how can I prepare for that financially? What is not clear about my post ?
If they are complications, by definition they are not expected. You cannot know the future. We can't know what medical costs will be for unknown procedures. I had no "complications" thus I'd say don't expect any and the financial impact will be zero.
 

newarrior

I have severe tricuspid aortic stenosis live in Ba
Joined
Jun 28, 2019
Messages
605
Location
Bangkok Thailand
Hi Newarrior.



I would strongly suggest that you at least consider going with a tissue valve.

1) You are 59 now and will almost certainly be over 60 when it is time for surgery. The last time you updated us you were still in the moderate range for aortic stenosis, so you could easily have a few more years before it is your time.

2) Almost every guideline for valve choice would indicate that, for the age range of 60 to 70, either mechanical or tissue is a reasonable choice.

3) In that you are dreading the ticking already, I would expect that you could very likely to be one of those rare individuals for whom the ticking bothers them. In my check up with my cardiologist last week, we discussed the issue of how ticking bothers a small percentage of patients with a mechanical valve. It is his opinion that it is psychologicial for the most part. The discussion of ticking comes up often here, and probably 95%+ of those with mechanical valves indicate that the ticking is a non-issue for them. I know that you have read those threads, as you have participated in them. But, despite having this encouraging feedback from those with mechanical valves, still you are dreading the ticking. So, if you are that certain that it will bother you, despite this feedback, I'd wager that it will, in fact, bother you.

4) You indicate that you are also dreading blood thinners, which we like to more correctly refer to as anti-coagulation. If you go with a tissue valve you will probably only need to be on anti-coagulation for a few months following your surgery. So, a tissue valve will allow you to avoid this concern of yours, most likely, although it is not a certainty, as some develop conditions which require anti-coagulation for other reasons.

Best of luck in whatever you ultimately decide and hoping that the day of surgery is many years off for you.
Chuck--thanks again...Regarding clicking...I've already suffered from really bad tinnitus due to hearing loss so having a 2nd ticking sound in my body terrifies me
 

Chuck C

Well-known member
Joined
Dec 5, 2020
Messages
1,793
Chuck--thanks again...Regarding clicking...I've already suffered from really bad tinnitus due to hearing loss so having a 2nd ticking sound in my body terrifies me

It is for this reason that I believe that you should at least consider a tissue valve. If you are terrified of the ticking sound already, then I expect it will likely bother you.
Won't getting a tissue valve require me to get a 2nd open heart surgery ?

It really depends on how old you are when you get your surgery and your life expectancy at that time. If you are 62 when you get your procedure and expect that you will live to 85, then I think that you will likely need another surgery. When? No one can say for certain. Probably age 72 to age 82. The Resilia valve is expandable, designed to accomodate TAVR, so that might be an option down the road if you go that route, but it is still not a certainty that you will be eligible.

If you end up being 65 when you need your operation and expect to live to 75 to 78, then I would estimate that a tissue valve will probably take you to the end. So, age and life expectancy are some of the biggest factors. Of course, in that you are concerned about the potential cost of another operation, this would be something that you might face with a tissue valve.

My cardiologist has hundreds of patients with mechanical valves. Only a couple of his patients regret their decision because the ticking sound bothers them. So, the vast majority aren't bothered by it. I'm just concerned that you will be one of those individuals who can't stand the ticking and is very aware of it. As I've said before, I don't even hear my valve 98% of the time. The room is quiet right now and I can't hear my valve at all, no matter how hard I try. But, if I take a very deep breath, there it is, I hear about 4 beats. There is no way to know for certain if you will end up being like me or like the small % who are bothered by the sound, but when you use terms like "terrified" to describe your concern about the sound, it makes me think that you might be wired such that maybe you should avoid it all together and just go tissue. Given that you will be 60+, tissue is considered a reasonable choice. But, it is your choice and your choice alone to make.

Pellicle--Chuck..I appreciate the time you took in regards to illustrating the pros and cons of tissue vs mechanical valve as this goes to my larger concern: Cost....Is tissue more costly than mechanical ?

My understanding is that the cost of each valve type to the hospital is about the same. The procedure itself is about the same, so I would not expect much difference, but I suggest that you ask the hospital that question.
 

newarrior

I have severe tricuspid aortic stenosis live in Ba
Joined
Jun 28, 2019
Messages
605
Location
Bangkok Thailand
Have you seen the replies when you asked the same question in prior posts?
For example:
Getting closer to needing aortic valve repalcement surgery still uninsured living in Thailand


Sounds like a good plan.


Costs will vary greatly, whether going through insurance or not, from hospital-to-hospital and from country-to-country so best to confirm in writing with the hospital you plan to go with.
I have a lot of memory loss from having been hospitalized with Covid last year + I had some long haul Covid plus I have a lot of anxiety about living overseas/not having insurance that will cover it;..I have seen the replies from others..
 

newarrior

I have severe tricuspid aortic stenosis live in Ba
Joined
Jun 28, 2019
Messages
605
Location
Bangkok Thailand
It is for this reason that I believe that you should at least consider a tissue valve. If you are terrified of the ticking sound already, then I expect it will likely bother you.


It really depends on how old you are when you get your surgery and your life expectancy at that time. If you are 62 when you get your procedure and expect that you will live to 85, then I think that you will likely need another surgery. When? No one can say for certain. Probably age 72 to age 82. The Resilia valve is expandable, designed to accomodate TAVR, so that might be an option down the road if you go that route, but it is still not a certainty that you will be eligible.

If you end up being 65 when you need your operation and expect to live to 75 to 78, then I would estimate that a tissue valve will probably take you to the end. So, age and life expectancy are some of the biggest factors. Of course, in that you are concerned about the potential cost of another operation, this would be something that you might face with a tissue valve.

My cardiologist has hundreds of patients with mechanical valves. Only a couple of his patients regret their decision because the ticking sound bothers them. So, the vast majority aren't bothered by it. I'm just concerned that you will be one of those individuals who can't stand the ticking and is very aware of it. As I've said before, I don't even hear my valve 98% of the time. The room is quiet right now and I can't hear my valve at all, no matter how hard I try. But, if I take a very deep breath, there it is, I hear about 4 beats. There is no way to know for certain if you will end up being like me or like the small % who are bothered by the sound, but when you use terms like "terrified" to describe your concern about the sound, it makes me think that you might be wired such that maybe you should avoid it all together and just go tissue. Given that you will be 60+, tissue is considered a reasonable choice. But, it is your choice and your choice alone to make.



My understanding is that the cost of each valve type to the hospital is about the same. The procedure itself is about the same, so I would not expect much difference, but I suggest that you ask the hospital that question.
Regarding the noise I already have long standing tinnitus since age 33 along with hearing loss-terrible afflictions...So I have already had to deal with a terrible hissing sound in my head for 25 years
 

newarrior

I have severe tricuspid aortic stenosis live in Ba
Joined
Jun 28, 2019
Messages
605
Location
Bangkok Thailand
It is for this reason that I believe that you should at least consider a tissue valve. If you are terrified of the ticking sound already, then I expect it will likely bother you.


It really depends on how old you are when you get your surgery and your life expectancy at that time. If you are 62 when you get your procedure and expect that you will live to 85, then I think that you will likely need another surgery. When? No one can say for certain. Probably age 72 to age 82. The Resilia valve is expandable, designed to accomodate TAVR, so that might be an option down the road if you go that route, but it is still not a certainty that you will be eligible.

If you end up being 65 when you need your operation and expect to live to 75 to 78, then I would estimate that a tissue valve will probably take you to the end. So, age and life expectancy are some of the biggest factors. Of course, in that you are concerned about the potential cost of another operation, this would be something that you might face with a tissue valve.

My cardiologist has hundreds of patients with mechanical valves. Only a couple of his patients regret their decision because the ticking sound bothers them. So, the vast majority aren't bothered by it. I'm just concerned that you will be one of those individuals who can't stand the ticking and is very aware of it. As I've said before, I don't even hear my valve 98% of the time. The room is quiet right now and I can't hear my valve at all, no matter how hard I try. But, if I take a very deep breath, there it is, I hear about 4 beats. There is no way to know for certain if you will end up being like me or like the small % who are bothered by the sound, but when you use terms like "terrified" to describe your concern about the sound, it makes me think that you might be wired such that maybe you should avoid it all together and just go tissue. Given that you will be 60+, tissue is considered a reasonable choice. But, it is your choice and your choice alone to make.



My understanding is that the cost of each valve type to the hospital is about the same. The procedure itself is about the same, so I would not expect much difference, but I suggest that you ask the hospital that question.
Hello Chuck--thanks for your feedback. Cost is my #1 concern for obvious reasons (financial).. I am torn between staying overseas and going back to the states...It's a tricky sitatuation..Mechanical makes more sense for financial reasons and avoids a 2nd surgery
 

newarrior

I have severe tricuspid aortic stenosis live in Ba
Joined
Jun 28, 2019
Messages
605
Location
Bangkok Thailand
It is for this reason that I believe that you should at least consider a tissue valve. If you are terrified of the ticking sound already, then I expect it will likely bother you.


It really depends on how old you are when you get your surgery and your life expectancy at that time. If you are 62 when you get your procedure and expect that you will live to 85, then I think that you will likely need another surgery. When? No one can say for certain. Probably age 72 to age 82. The Resilia valve is expandable, designed to accomodate TAVR, so that might be an option down the road if you go that route, but it is still not a certainty that you will be eligible.

If you end up being 65 when you need your operation and expect to live to 75 to 78, then I would estimate that a tissue valve will probably take you to the end. So, age and life expectancy are some of the biggest factors. Of course, in that you are concerned about the potential cost of another operation, this would be something that you might face with a tissue valve.

My cardiologist has hundreds of patients with mechanical valves. Only a couple of his patients regret their decision because the ticking sound bothers them. So, the vast majority aren't bothered by it. I'm just concerned that you will be one of those individuals who can't stand the ticking and is very aware of it. As I've said before, I don't even hear my valve 98% of the time. The room is quiet right now and I can't hear my valve at all, no matter how hard I try. But, if I take a very deep breath, there it is, I hear about 4 beats. There is no way to know for certain if you will end up being like me or like the small % who are bothered by the sound, but when you use terms like "terrified" to describe your concern about the sound, it makes me think that you might be wired such that maybe you should avoid it all together and just go tissue. Given that you will be 60+, tissue is considered a reasonable choice. But, it is your choice and your choice alone to make.



My understanding is that the cost of each valve type to the hospital is about the same. The procedure itself is about the same, so I would not expect much difference, but I suggest that you ask the hospital that question.
My life expectancy has gotta be low given that my parents only made it to 74/75 and my brother died at 46....I've got a million other health challenges as well plus I am lonely and single and severly depressed and have no family/girlfriend/wife/kids and am very disabled
 

newarrior

I have severe tricuspid aortic stenosis live in Ba
Joined
Jun 28, 2019
Messages
605
Location
Bangkok Thailand
If they are complications, by definition they are not expected. You cannot know the future. We can't know what medical costs will be for unknown procedures. I had no "complications" thus I'd say don't expect any and the financial impact will be zero.
Tom...Thanks...I look at the surgery like when they find one problem with your car's engine and then dig in and find a bunch of others..I know I have heart disease but lifestyle and statins probably have my heart disease in check....I also have mild mitral valve prolapse but I don't expect any surgical repair... I had angina but that disappeared when I went on a vegan diet in 2020..I don't drink smoke and eat a low fat vegan diet and have exercised like mad since age 24 so I expect I'd bounce back fast with little no to complications...I and take statins, magnesium aspirin...I got off my blood pressure meds last year due to low salt plant diet
 
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