Date set, and what to do? Ross or Bentall?

[bw00]

Hi everyone,
I have a little update! I posted before, but a small summery: I am an eighteen year old girl from the Netherlands and I need a new valve. My surgery is planned for April the 15th or 16th, I’m not sure. I just got my wisdom teeth taken out and had surgery on my foot to make sure that I won’t have any infections going on during the surgery.
First I decided I was going to have a mechanical valve put in, because the thought of reoperations did not sound nice, and my surgeon thought that on me the biological valve would only last around 5 to 10 years. Last week I got a call from the hospital that they looked at my scans etc. again and they wanted to speak to me again. I went there today and now I will have to have a different surgery.
It turns out that my aorta is very small, so they will not be able to fit a 21 mm, or 23 mm valve in. They think a 19 mm one is too small to work properly. I now have 2 options:
1. They will put a mechanical valve in, but they will also replace part of my aorta. They call this the Bentall procedure I believe. The downside is that there will still be quite a lot of tissue growth around the valve, so it will probably not last longer then around 25 years. And of course the blood thinners. Another downside is that because my aorta is so small, I will still not have a well functioning heart. When you put a mechanical or tissue valve in, the aorta will get even smaller. There will still be a problem with my valve, the story in Dutch was already so complicated in English it is impossible haha.
2. A Wrapped Ross procedure. When you put in a mechanical or biological valve, your aorta gets smaller. With the ross procedure they will put in a human donor valve and they will not have that problem. If I choose they Ross surgery I will have a better functioning heart then I had ever had before and I don’t have to take blood thinners. The surgeon that performs this is very experienced in this surgery and gets flown around Europe to perform this on others. The downside is that the surgery takes longer and is more risky. Also the valves need to be replaced on the long run as well, and you don’t know when.
Just thought I would give you an update, the forum is a huge help to me! What do you think is the best option? Oh and something completely different. 6 weeks after the surgery there is a large festival in the Netherlands, I bought tickets, but do you think it is realistic to go there? Hope this is in the good thread, and apologies for any spelling mistakes!

Berit

 

[Paleowoman]

Hi Berit,

Goodness - I've never heard that if you have a small aorta that a 19 mm valve is too small to work properly. It must be something unusual to you ? I can't say I quite understand what they told you, but I'm sure others here know much more. I have a 19 mm tissue valve. I was never told that my aorta would get smaller.

PS Maybe because you are young and not completely finished growing that they are advising the Bentall procedure ?

 

[bw00]

Hi,
I am not sure what the problem was. But there was also a problem with my aorta, so I think a 19 mm would fit but would still not work properly. Something like that, it was a conversation with lots of difficult words haha. They were only happy if they could fit a 23 mm in, and if that would be impossible a 21 mm. They also said something about the pressure getting to high for the aorta if they would put in 19 mm, it would have to be replaced a lot sooner.

 

[Duffey]

If it were me, and I had a highly skilled surgeon who performed many of these, I would go with the Ross procedure.

 

[neil]

hi breda, i would listen to what the cardio and surgeon say, none of us on here are medically trained and in this case you should take note what the experts have to say,never the less nice to hear what people have to say, good luck and am sure you will do just fine,

 

[Gail in Ca]

This is a part of what was written for my aortic valve replacement: "The aortic annulus was small, measured at 19mm, and as a result,instead of using a St Jude Mechanical valve graft, we elected to construct our own back-table CVG utilizing a top hat 25mm valve within a 30mm graft, which was then secured to the heart in a supra-anular location in order to provide the patient with the largest mechanical valve that we could.
I just wanted to give you this to read because it is possible to have a larger valve placed. Don't know if your surgeon is experienced in this type of procedure. But you might ask him about it.
Now, if he feels he can't place a larger valve like he wants to, I guess I would consider the Ross, but really check to see the average life span for that valve procedure on someone your age. My surgeon said a homograph might only last about 10 yrs if I had needed one and I was 54, not 18.

 

[mcsf]

Berit,

I had a Ross 17 years ago when I was 22. It worked out well for me. With the Ross you will need a surgery in the future. When I had my Ross they were not supporting the aorta root (I think that is the correct term). The surgery has changed a little since I had mine. With a Ross procedure today you can get a lot of years out of it.

 

[rckrzy1]

Ross worked well for me. The rest of my body is falling apart. And I was quite shocked that the post op pain and recovery for my C4-C7 fusion was far worse than
my ross. And every annual check up has been great, all valves doing great.