How old when you had an AVR

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Joe Parker

I am a newbie so here is the rundown, I am 40 y/o healthy male, three kids, on wife and and going to have my aortic valve replaced in January '04. I've been reading this forum and other and have not really encountered anyone who has had this procedure done at my age and what they chose and why.
I am going to have my surgery done at Mt. Diablo hospital in Concord, CA by DR. Rolf Sommerhaug considered one of the best in the area. He and my cardiologist have told me to go with the St. Jude valve but I am also leaning towards a tissue valve. I am obviously concerned about coumadin and stroke risk and some bleeding. I am an avid fisherman and on a good day i am cut up and stuff. I could get some kevlar gloves for my hands however. I also like to bike ride and have had to pass up the last two 100 mile rides around Lake Tahoe mostly since I don't think I am training as well as I used to. I am also planning of taking my boys backpacking starting next year.
Mostly I am worried about the risk of strokes and bruises go away. Overall I am healthy and have no family heart disease. In fact my mother and father and uncles and aunts are big smokers and drinkers and many in their 80's and have not had a heart attack yet. I don't do those sort of things however. OK I like a good beer once and a while.
So any 40 year olds who have had this done or had it done when they were about 40 and what did you put in and how are you doing?
Joe Parker
[email protected]
 
Hi Joe-

Just wanted to welcome you to the site. It's a great place with lots of wonderful people.

There are several folks about your age and some even younger who have had or are going to have this surgery. And there are enough bike enthusiasts to start a bike cross-country marathon. They'll be along soon to lend a hand.

My husband was in his forties when he had his first valve implant. He had a mechanical aortic valve put in. That valve is still in place. He had many, many years of good health with that valve. In later years, he's had to have mitral valve surgery, and some other things. He had rheumatic fever as a teenager. He's 72 years old now.

He's been on Coumadin since that first valve was put in, going on 26 years. No problems in major bleeding that can be attributed to Coumadin, in all those years.

Valve choice is one of the hotly debated topics on this site. You'll get lots of feedback.

Spend a lot of time reading as many of the posts as you can, using the option of going back longer than the 30 days that is standard. There's a pop-down menu that allows you to go back a long ways.

It's hard reading at first, because it can be scary, but it is the very best thing you can do. Educating yourself is very important.

Best wishes, and hope to see you here often.
 
Hi!

Hi!

Joe,

My name is Kristy. I am currently 41 and I had my AVR done a month before my 39th birthday. My husband, surgeon and I chose the St. Jude's bi-leaflet mechanical valve mostly because I was much more afraid of another surgery than I was of warfarin/coumadin.

A place for you to check on ages and decisions is in the personal stories section of the website

Personal Stories

Many of us have told our ages and our choices in these stories. It's a great resource.
 
Hello Joe and welcome to the forum

I had my first heart surgery when I was 33 which was an emergency repair of a dissecting, then rupturing aortic aneurysm. The surgeon I had then, repaired my valve as best he could because he really didn't hold any hope of me surviving the surgery. I was nearly dead before they got to me. Samething happened to John Ritter and as you know, he is no longer with us.

That repair lasted 7 years and I had to have my valve replaced in July 2002. At 40 years old! I went with a mechanical St. Jude valve because I have no desire to have to go through this surgery again if it can be helped. With the mechanical valve, I hope to make the rest of my life without another surgery.

Coumadin is not the evil monster that it's made out to be. I think the most bothersome thing is having to have your INR checked frequently, but outside of that, I work on cars and cut myself silly all the time. It takes a little longer for the bleeding to stop, but in the year and 3 months that I've been on it, have had no major events to tell you about. Most everyone else with mechanicals here will tell you the samething.

Valve choice is a personal thing and is hard to really decide upon, but it's something you should think through and discuss with your surgeon. Sometimes what you want and what you get are 2 different things. Sometimes there are compatibility or biological issues that won't allow the first choice.

Being young, you'll have a tendency to wear a tissue valve out sooner then someone much older then yourself. The younger bodies calcify the valves sooner.

I encourage you to read around the forum and threads and to ask any questions that you may have. We have all been there, done that, and speak from experience of having the surgery. Of course, we have a few in the "Waiting Room" and your host Steve is keeping it well stocked with fun things to do and magazines to read. You might even check with him and see if they ever got the kitchen straightened out yet. hehe
 
The 40's Pulled a Vacuum.....

The 40's Pulled a Vacuum.....

Hi Joe and Welcome!
I contracted Bacterial Endocarditis just after turning 40 and had my AV replaced. Had that one replaced 'Out of Warranty" when I was 42. Am now 50, and "clicking" quite nicely...
 
Hi Joe,
Welcome to this wonderful site. I had my aortic valve replaced and a dissection/aneurysm repaired when I was 34 years old. I went with a mechanical valve. I had no desire to go throught surgery again. I have found coumadin to be a non-issue. It really isn't the monster that others make it out to be. My advice to you would be do a lot of research on valve selection and talk with your surgeon/cardio. Your doctor will be able to steer you in the right direction. Also remember that you may end up choosing a certain type of valve, but when the surgeon gets in there and takes a look at what is going on, you may end up with something else. There is no right or wrong choice here, just what is best for you. Good luck with everything and keep us informed on how you are doing.

Take Care!
Gail
 
Hi Joe,
I had my aortic valve replaced at age 45, and had a tissue valve (homograft). My surgery was at Mayo Clinic in Rochester. I am an avid skier and mountain biker and also wanted to avoid coumadin. I am happy with my choice. Good luck to you.
 
I had my AVR at age 25 (16 months ago). Went with the St. Jude's mechanical valve, mostly because the surgeon didn't give me a choice. I think I am one of the few on this forum who has encountered more than one problem because of the coumadin, but it none were directly due to the coumadin. One problem was when I had an ovarian cyst burst (don't think you'll have that problem) and the other was just recently because of a sinus infection. I think that coumadin, for the most part, causes few problems in more "normal" patients, but I have never been one to do things the easy way...

Good luck in your decision!
 
Joe

I am 43, I had my surgery six months back. Mu surgeon recommended St Jude mech valve as I didnot want a repeat surgery. I had no symptoms, active work life. I had Rhuematic Heart Disease at Age 5, which damaged my valve.

I was quite worried before operation. I am very happy that I took this decision. I feel more energetic, I have returned to my active work life, resumed my 1 hour walk.

Good Luck for your surgery.
 
Hi Joe and welcome.. I'm 36 and had my AVR done a year and 4 months ago.. (man time flies) - some where in my life I developed bacterial endocarditist which inturn weakened my bicuspid... my problem is that I had fear of doctors and stopped going to a cardio way back when, when I was healthy (now i'm an avid spokesman for seeing the doc).. my regular exams came out fine through out the years though, so it got missed.. by the time I was diagnosed, I developed heart failure, I had no choice but have a mechanical valve put in.. i'm great now.. since i moved from Dallas to Pennsylvania, my coumadin has been a pain lately, too high, than too low, testing every week for months now.. but i think it has more to do with my funky work hours which inturn keep it hard to eat consitantly.. but i'm getting there.. one of these days, i'll find a 8-5 job again and get some balance back in my life.. until then, I've gotten to know the lab techs by name and which ones can find my veins... :D

christine
 
Welcome

Welcome

Hi Joe

Welcome to VR.Com

I had my AVR in Jan 2002 at age 47

I have a mechanical valve,

Being in the UK we get free medical treatment so i was never really given a choice, but saying that I would have chosen a mechanical valve as I think one surgery is enough for anyone, and hopefully my valve will last for a long time I have no problems with coumadin, it is not such a big deal,

read the past posts and hopefully they will help you reach a decision,

good luck and remember the waiting is the worst

keep smiling

Jan
 
Hello Joe

I'm Evelyn, whose husband, Tyce, had avr surgery at 59. We went with the mechanial and have had no problems since. Hope this helps.

Evelyn
 
It?s a tough decision.

It?s a tough decision.

Hey Joe,

I was 39 years old when my valve was replaced. I ended up with a mechanical valve. My cardio and my surgeon both convinced me that my heart would remain in atrial fib for life and I would have to be on coumadin forever anyway.... :( However... it is now 3 ½ years later and I am doing well. The coumadin is a pain in the a$$!! I hate to complain about it too much here, I wouldn?t want anyone to make a valve decision based on my problems. But even the coumadin/INR has been pretty stable for the last year or so. I still do all the things I did before I started taking it, I still eat a LOT of vegetables... I don?t like most meat. At times my legs are covered with bruises... that?s what I hate more than anything. Grrrrrrrr. I haven?t had a lot of problems with bleeding.. it may bleed a little longer, but not enough to be a problem. BUT......

Now my son is facing heart surgery.... He is a very healthy, very active 20 year old college kid. If the valve needs replaced I believe I will encourage him to go with a tissue valve. First of all... he?s too much like his mother.... I know he?ll keep right on rock climbing, skiing, etc... I think he?s young enough to get through a second surgery with no problems and who knows what kind of things they?ll learn about the heart between now and then.... ?

This time you are in (pre surgery) was absolutely the most difficult of the whole heart surgery for me.
 
in the same boat as you

in the same boat as you

Hi Joe,

I was 39 when I had my aortic valve replaced in 2000. I also have one wife and three kids but I had a congenital defect of my valve and it had to go - no discussion! I talked over the options with my surgeon and eventually decided that the mechanical option was best for me - I've had no reason to doubt that decision since despite the anticoagulation therapy.

Good luck in making your decision,

Simon
 
Wow, what a positive and informative group of replies I have gotten. Than You so much. I am not worried about bruises and stuff but am wondering about the stroke risk. Anyone have problems? I do know that the way they make the valves, materials etc, the risks are much less now since it is harder for that ol' blood to "stick" around but was curious.
I agree to some extent about one surgery and be done with it. Your never know what your health would be like in 10 or so years when you need another "valve job".
Keep up the replies.
Joe Parker
[email protected]
 
Joe as long as your Coumadin is being dosed correctly and you play your part of having your INR checked frequently, the risk of stroke if very very small, almost non existent.

As for future surgeries--I'll be the first to tell you to avoid it if at all possible. This is one surgery that you really only want to have done one time. After the first, each subsequent time is more and more dangerous. Not to say that it can't be done, because it is everyday, but it's like playing Russian Roulette and it's not worth the risks in my opinion. Even with a mechanical valve, there are no guarantees that you won't require another down the road at some point, but that risk is small. With a tissue valve, it's a sure bet in the future.
 
I also want to say that from my husband's experiences, minimizing any additional thoracic surgeries in the future would be in your best interest. My husband has had 5 thoracic surgeries, 3 valves (mechanical) and 2 lungs. The surgeries themselves went off smoothly, and couldn't have been any better and they were all done to save his life, couldn't be avoided, so were a necessity. But the toll they took on Joe's body was serious.

Repeated trauma seems to have a cumulative effect on the body. Each subsequent recovery took longer and longer, and was less and less complete. He has a lot of scar tissue inside now.

Joe Parker (my husband is Joe also), you are so right when you say that you don't know what your health will be 10-20 years down the road.

Perhaps a lot depends on the underlying cause of your heart problem.

I think the choice of valves needs to be assessed very carefully, and discussed at length with the cardiologist and surgeon, especially what might be awaiting down the road.

My husband had rheumatic fever, and that does it's own destruction inside the body. So his case will surely be different than those with some other conditions.
 
The big choice

The big choice

Joe,
This is a great place to for very practical information related to valve replacement. Your doctors are the ultimate experts, of course, but then again they most likely have not been on the receiving end of the open heart experience. Most people here have so you will get alot of very valuable information here.
Tissue or mechanical is the first decision we all face when we are diagnosed. On this site you'll find alot of people who decided to go with mechanical but also a lot who picked tissue. The interesting thing is that almost everyone seems to feel comfortable with the choice they made.
I went with a tissue valve because I was not comfortable with coumadin. I am 49 and decided that I was could handle one more surgery when the time comes.
I don't want to take coumadin but I have had some arhythmia since the surgery and have been forced to take coumadin anyway. The truth is coumadin isn't a big deal. I would rather not be taking it and will be happy when I get to stop. If I don't get at least 15 years out of my tissue valve I'll go mechanical next time and certainly could adjust to having to take it for the rest of my life.

Gerry
 
Hi Joe,

Welcome to the site. I was 49 when I had my surgery. I have a St Jude's mechanical valve. I was and continue to be extremely active, I boat, fish, ski, snow mobile, hunt. use a chain saw.

Although I didn't have a choice in the valve selection, I am pleased with the one they provided. I have not had any problem managing my Coumadin. I self test and self medicate. I test weekly and can quickly make adjustments to my dose if required.

I must also admit that while I am still extremely active, I no longer have that " Have No Fear" attitude. I am more calculating in my activities, and think a little more cautiously. I think the fact that I am on Coumadin, and that a serious accident could be very life threatening to me if I had serious open wounds is the main reason for this. Of course I could also chalk it up to being a little older and wiser. Naw... Peter Pan is still my hero. I'll never growup!

Good luck with your choice!

Rob
 
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