Ease of Re-op Which?

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esvaja

Well-known member
Joined
Feb 19, 2011
Messages
135
Location
ann arbor michigan
Is there a difference between having a re-op with a tissue or mechanical? Have you heard if it's easier or shorter time replacing with new between the two? Do surgeon prefer one over the other?
Daiva
 
Hi Daiva,
I personally don't know the answer to your question. A few random thoughts: typically when a mechanical valve is used first time around, the hope is that it will for life so one wouldn't have to think about a re-op.
I recall reading in some posts that when endocarditis was involved, a tissue valve was used for the OHS re-op. I don't know if this is the case for all OHS re-ops for those with endocarditis or not. I am not sure why this is was the choice for those cases.
Hopefully someone else with more knowledge on this subject will be able to help you out.

Is this question impacting your decision making?
 
Last edited:
Hello,
Is it impacting my decision? Yes & no. I guess my thought is to get as much info as I can, stew about it, & finally make a decision. I'm a seat of the pants kinda girl, of course the surgeon will make the final choice at the time, but asking all these questions makes me feel like I possibly could have some control over this darn situation.
Daiva
 
THE DECISION you face is VERY personal and should depend on various points ...and no one really knows what he future will hold as stem cell research is changing the face on medicine at head spinning speed. One only need to look at the spread of the internet and look at how it has affected our lives.
Just looking at this search of historic cardiac surgeries http://www.google.ca/search?hl=en&rlz=1T4HPIA_enCA331CA331&q=historic+cardiac+surgeries&btnG=Search&aq=f&aqi=&aql=&oq= amazes me with the number of hits
 
In which position? I've discussed this with a few surgeons in both NY and Cleveland (specifically for a re-op). I know with the mitral valve, they all agree tissue is the way to go now. As for the aortic, depending on your age, I'd probably take the mechanical route.
 
esvaja - Another important cnsideration in this choice is . . . "Once you choose a surgeon, which valve(s) is he/she most experienced with?" This can make a large difference in the quality of the job done. If we force a surgeon outside their comfort zone to accommodate our valve choice, the surgeon may not be able to do as good a job in the OR as they would if we chose their "favorite" valve. So, I guess the choice would be that if you have a preferred valve, find a surgeon who is highly experienced with it. If not, choose a surgeon and see where their greatest experience and technical comfort lies.
 
From what I know and my experience with 3 OHS's, I had been told to expect 3-4 hours in surgery per valve, if it's done the sternal route. (oh, and also expect 3-4 hours added on during redo's to get thru the scar tissue).
Also, I think it depends on how sick you are going into the surgery. The expert surgeons are excellent in the stitching dept. I'm not sure it matters to the best ones which valve they give you. I know my surgeon didn't back away from whatever I needed or wanted. I found out before my 3rd surgery that the mechanical had been placed inside my deteriorated porcine valve during the 2nd surgery to replace my aortic valve. When I needed my mech replaced after endocarditis, Dr Miller cleaned out the whole area of that 2nd valve, and then moved the new valve higher up on the aorta to avoid that used tissue with the new mech aortic valve and graft. I agree with the others that picking the best surgeon you can is always the only way to go!
 
You have not said which way you will go. With mechanical, I had my chest cracked opened and took a year for the muscles to heal well from the trauma. I have been fine since. It does take time when you have the bypass. Keep asking questions, make YOUR OWN decision. You will be fine. Take care and have a great day.
 
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