How Many Tissue Valves Don't Last As Long...

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deogloria

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I was wondering how many people got the porcine or bovine tissue valves, who had to have them replaced much sooner than anticipated? And does anyone know if this strikes more often when the person is young/old, male/female, etc? Is there anything that tends to cause this, or predispose someone to having an early-failing tissue valve?

One thing I'm nervous about, is getting a tissue valve, then having it go bad in a year or so. The docs and I agree that tissue is the way to go for me right now, but I'm not anxious to go through this more than once in the next few years!

Also, has anyone had one an unusually long time?

Thanks!
 

froggo

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I think you have to be guided by the doctors right now, we are all different but we are all alive which is the most important thing, mechanical or tissue. Good luck with everything and I am sure it will not be long before the decision is made.
 

abbanabba

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I believe the older you are, the longer the valve will last in general. For some reason they calcify faster in much younger patients. Still - they are improving the longevity of these valves all the time, so today's valves may last longer than yesterday's equivalent.

On rare occasions they may fail within a year or two, but usually they are predicted to last 10-15 years. I believe there have been people who have had a tissue valve still going strong after 20 years! Of course, it can't hurt to have a healthy lifestyle with lots of good food and exercise - but that's true for everyone :)


A : )
 

neil

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hi,agree with abba,my surgeon said anything between 10 and 20 yrs,there have no real knowledge of how long these new valves will last till 10 or 20 yrs down the line,but there pretty reliable, youve more chance winning the lottery than it failing lol,whatever choice you make it will be better than the one you got now,...........neil
 

Gail in Ca

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I just spoke with my surgeon and he still thinks the tissue valves are a 10-15 yrs deal. He is well known.So, he still recommends mechanical. I was surprised at this, since reading about them on this site, I thought they lasted longer now. My sister's friend is a cardio in So Cal, and he has a patient, female, that's had a homograph for 20 yrs. But, that's the only one he has with that luck.
I am facing surgery soon, and he will give me mechanical again if at all possible, that is, if the tissue is okay and can accept another mechanical after they remove the 8.5 yr old one. If not, I will get homograph, and I sure hope I am like that lady with the 20 yr old valve!!
Gail
 

Nupur

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Gail, sorry for the ignorance, but is homograph for all valve positions? YOu might get one in the aortic position or mitral? Is he repairing your mitral?
 

Lynlw

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Deogloria, you asked Also, has anyone had one an unusually long time? I think for the most part people here with tissue valve haven't had the really long, since people tend to look for forums like this when they are having problems or having surgery for the first time.

Gail, I'm not sure how old you are, so maybe if you are younger that is why your surgeon gave you the 10-15 year quote OR he could just be talking about homographs, because I believe now the CE Bovine valves are lasting longer than homographs AND the last generation of the CE perimount already has a proven record of 85% of the patients over 65 still having them at 20 years (or something close to that)
 

roundsgirl

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Hey deogloria,

I have a tissue valve I am a little over a year post op (Jan.3 08) and my first echo post op showed moderate stenosis. I've 2 more echo's since the first one and they all show moderate stenosis, but with each one my gradinet numbers have also risen. They told me the valve is failing, the surgeon explained to me that these valves don't last as long in younger patients because our immune systems are stonger than older patients thus it attacks the valve as being a foreign object much faster.

Anyway, I wish you the best.
 

neil

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hiya,am i right in thinking you got a mech one now? if so how long you had it? choice is so hard to pick isnt it,i hear so many different views whether it be mech or tissue,my conclusion is ones mans meat another mans poiison,and the choice you make is right for YOU,
 

mmarshall

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I got a tissue valve in the aortic position about 4 years ago and everything is fine. It took about a year after surgery for everyting to get back to normal. I have been going for check ups every six months since surgery. On my last visit, since everything is looking great, he pushed my check ups to every 9 months with the plan to then go to once a year. I was 31 when I had my valve replaced.
 

Lynlw

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I know this doesn't help alot BUt Justin got a bovine valve and dacron conduit when he was 17. When he was 19, 1 of the sections of dacron needed replaced but when they looked at the valve it was still perfect, so they left that and the other section of conduit alone. IF there were any signs of calcification or wear they were going to replace it since they were sewing right there anyway.
 

Gail in Ca

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tissue life span

tissue life span

I was told that the newest valves just haven't been in place long enough for the cardios to say just how long they will last. I questioned the bovine, etc., but the answer was the same.
Napur, my surgeon will only give me homograph if he cannot replace my current mech. with mech. He must do homograph if needed because my tissue around the ring may be unusable, and so the whole homograph with attached aortic arch would be placed and my mitral would be repaired if possible or replaced with tissue only if my aorta ends up tissue. Otherwise, both will be mech. Having mech in mitral position is more risky for throwing clots, so having the INR level high end of theraputic is essential. I sorta wish I didn't know this bit of info. I don't know if homographs are used in any other position. But, it's the only tissue valve for me, if my valve tissue is already compromised. I can't get any other tissue valve.
I am not young, boo hoo, but at 54, my surgeon still thought that my valves wouldn't last my lifetime, if tissue.
I just won't know until I wake up which valves I got.
To tell the truth, I wouldn't mind tissue again, but the thought of redo, say, in 15 yrs, at 69. ugh. But, no coumadin, no weekly testing, no clicking loudly, that is soooo tempting.
7 days and counting.....Gail
 

Nupur

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All the best, Gail! Btw, I am seeing Dr. Miller for a consult on Mar 2nd. Hopefully you will
be on your way home by then. Thanks for the information about the mitral mechanical being more risky for clots. And I'll be sure to ask Miller if he is retiring soon. I hope not.

All the best to you Gail.
 

tobagotwo

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Hey deogloria,

I have a tissue valve I am a little over a year post op (Jan.3 08) and my first echo post op showed moderate stenosis. I've 2 more echo's since the first one and they all show moderate stenosis, but with each one my gradinet numbers have also risen. They told me the valve is failing, the surgeon explained to me that these valves don't last as long in younger patients because our immune systems are stonger than older patients thus it attacks the valve as being a foreign object much faster.

Anyway, I wish you the best.
I'm so sorry for your troubles.

Your doctor sounds like he's full of beans. The valve shouldn't have had moderate stenosis right after surgery, under any circumstances. That valve was too small for you when they put it in. It's called patient-prosthesis mismatch. It's uncommon, but it can happen with any type of valve.

This isn't from valve wear. 39-year-olds didn't even wear out the older type tissue valves in a year. The rising pressure gradient isn't because the valve is failing, it's because your heart (ventricle, actually) is enlarging, due to the stenosis (that shouldn't have been there after surgery), and as it enlarges, it pushes the blood harder throguh the valve, raising the gradient.

Mine's doing the same thing, but my cardiogist isn't misleading me about why it's happening so I won't be mad about it. Sounds like yours is.

Find out what size they used. If you're getting another, make sure they're using a larger size this time.

Best wishes,
 

marilyn

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I believe the older you are, the longer the valve will last in general. For some reason they calcify faster in much younger patients. Still - they are improving the longevity of these valves all the time, so today's valves may last longer than yesterday's equivalent.

On rare occasions they may fail within a year or two, but usually they are predicted to last 10-15 years. I believe there have been people who have had a tissue valve still going strong after 20 years! Of course, it can't hurt to have a healthy lifestyle with lots of good food and exercise - but that's true for everyone :)


A : )
Why do the valves calcify faster in younger patients? Is it because older patients are not as active? Mine was very calcified. The surgeon said he had to chisel it out.
 

abbanabba

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I'm really not sure. I did wonder if it was tied to bone production, since up until our mid 30's or so, we form stronger bones, then after that age they begin to weaken... perhaps this is something to do with how the body utilises calcium (thereby causing more calcium to build up around the valve)? Then again, it may have nothing to do with it. I don't know enough about the human body to do much more than theorise.

Meanwhile, one of my first surgeons told me that due to existing scar tissue around my heart from previous surgery that he would have to "chisel" it out, so maybe that's just a term (a crappy one at that!) they like to throw around for dramatic effect..! After all, I never had any calcified valves or anything else at the time.


A : )
 

Elcarim

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I had a porcine valve that lasted me 5 years and got me through two pregnancies. At the 5 year follow-up it was found to be 'falling apart'. The second surgery left me with nerve damage and I now also have a pacemaker. I was 22 when I got my porcine valve.
 

ExC.Andrew

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Thanks all for your comments. To summarize, then, it could be chemical (immune system reaction to foreign objects, stronger with younger adults who have stronger immune systems) and definitely physical if the size is too small, creating abnormal tensions and whatnot.
From another post on the subject
https://www.valvereplacement.org/threads/whats-the-longest-someones-bovine-aortic-valve-has-lasted.39389/page-2#post-725371 :

One point I was told by an attending doc after my aortic valve replacement: it is not clear what causes calcification, but there are indications that the blood flows near the surface of the valve are a contributing factor. Sort of makes sense if you get the physics of it.

The only practical thing I figured I could do was to ensure my blood is as thin as possible (besides keeping in best phys condition as possible). I do not take coumadin or other anti-coagulants anymore, but I figured anything, eg foods that promote thinner blood are good.

And conversely, with the caveat that vit K is essential to good health (and in fact helps prevent calcium deposits in arteries according to some research). Also I believe taking K with D3 or cod liver oil is best (see Weston A Price foundation on this - google used to be good about being open to non mainstream medical information, but it is unfortunately changing - I will quote more specific info later).

Diagnosed BAVD w/ AFIB 2014 @ age 68, bio (porcine) aortic valve replacement 2017 w/maze procedure etc. All good so far, EF normal, no AFIB - knock on wood
 

DebbyA

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When this thread started in 2009, my porcine valve was 1 year old and I had been assured it would last 15 years and the next replacement would be transcatheter. But the valve failed after 6 years and I got to experience open heart surgery again. In the last couple of years I learned that a side effect of that second surgery was ventral septal defect too near the valve seat to make a closure feasible. The doc says that if anything needs to be done, it will be transcatheter....
So far, though, I'm doing well, even after a brush with cancer a few years ago.
 

Superman

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When this thread started in 2009, my porcine valve was 1 year old and I had been assured it would last 15 years and the next replacement would be transcatheter. But the valve failed after 6 years and I got to experience open heart surgery again.
Too many surgeons spouting this stuff. Should be some regulatory requirements around what they are and aren’t allowed to say when making recommendations like in the investment community.

“Hey, you promised transcatheter, now I’m facing OHS again. This one should be on the House.”

“Did I say that? Guess I was wrong. Oh well. Here’s your bill.”
 
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