Double Valve replacement due to past radiation therapy

[beth3nyc]

Hello ,
I am a 43 year old woman who was diagnosed with valve issues 20 years after treatment for Hodgkin's disease. I went into congestive heart failure when pregnant but have been maintained for 10 years on medications. Recently, I had episodes of a-fib and my tests make it clear that it is time for my aortic and mitral valve to be replaced. My surgery date is in a few weeks but I am still having trouble deciding what type of valve to choose. I would like to get the tissue but am afraid that I may need three operations over my life. I am concerned that the scar tissue from the radiation and reoperations, will make the surgery harder. I have reservations about the mechanical since my mother's family has a history of strokes and it is a long time to be on a complex medication. I spoke with my surgeon and other oncologists who have experience with this and they all say that the risks are the same over my lifetime and it is split 50/50 of patients choosing each. I was hoping people would share the pros and cons, especially if they had concerns about scar tissue. Thanks!

 

[markp66]

It is clearly stated in many studies that the risks of tissue/ mechanical are similar for people under 50. This is why surgeons pretty much let the patient decide weather they would prefer to be on warfarin with a mech valve (which has it's risks, more so if you are less compliant in taking meds, looking after yourself) or have repeat surgeries with tissue valves. There are many potential advances in the future with both anticoagulants and non invasive valve replacement and this just adds to the complication. Mechanical valves aren't guarenteed for life, things can still go wrong but in general they are built to last several hundred years. At 43 you would prob get 10-15 years out of a tissue valve. In terms of scar tissue, this seems to be less of a problem now. One comment from the Cleveland clinic was that the number of operations (even 2nd/ 3rd reop) isn't as much of a concern when compared to function of the heart. Basically if you are on your 3rd/ 4th surgery it is pretty safe (clearly not without risks) as long as you are fit/ healthy and your heart is not damaged. Probably more of a concern is the damage to your whole body each time you have this op. Pretty much every part of your body gets a bit of a kicking, especially your lungs and kidneys. The fact that there are many people who have survived over 40 years with old mech valves gives me a lot of confidence in all the newer valves. I don't think warfarin is a complex medication. If you do your research on warfarin in can intact be a very safe and simple drug to control. Home monitoring and awareness of diet, medication etc makes it MUCH less dangerous than it once was.

 

[Greg a]

A heart felt WELCOME to our OHS family glad you found the site most of the community are OHS brothers and sisters,(read no medical professionals) there are some minimally invasive surgeries as well so ask away, there is a wealth of knowledge here for the future ..... ther have been MANY threads on Radiation and valves http://www.valvereplacement.org/forums/search.php?searchid=488519


Bob/tobagotwo has up dated a list of acronyms and short forms http://www.valvereplacement.org/forums/attachment.php?attachmentid=8494&d=1276042314

what to ask pre surgery http://www.valvereplacement.org/for...68-Pre-surgery-consultation-list-of-questions

what to take with you to the hospital http://www.valvereplacement.org/forums/showthread.php?13283-what-to-take-to-the-hospital-a-checklist

Preparing the house for post surgical patients http://www.valvereplacement.org/for...Getting-Comfortable-Around-the-House&p=218802

These are from various forum stickies and there is plenty more to read as well


And Lynw added this PDF on what to expect post op
http://www.sts.org/documents/pdf/whattoexpect.pdf


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[beth3nyc]

Thanks for the info!