R
Richard L
Hi
I'm 41 London based and born with a bicuspid aorta which has stenosed and needs replacing within next 2 months.
I also have Crohns disease- symptoms of which are intermmitant gastrointestinal inflammation and bleeding, so my cardiologist (at University College Hospital, London) has recomended against a mechanical valve in my case as long term dependancy on anticoagulants would probably worsen my GI condition. (My Gastroenterologist backs this up).
I've also gone for a second opinion with a cardio-thoracic surgeon based at Harefield hospital.
What all this is leading to is my choice of Valve replacement.
which are;-
- Single tissue valves either Xenograft or Homograft
- Ross Procedure
Or.....
A new option being offered to me by the surgeons at Harefield Hospital. - A Stentless Aortic Valve constructed from my own pericardial tissue treated for 10 minutes in Gluteraldehyde. based on a new procedure/ template pionered by Cardiomend LLC, a company based in Santa Barbara, USA.
Although pericardial reconstructions have been used before this is apparently the first Company to come up with a constitent reproduceable template & device for harvesting, shaping and fixing an aortic valve........ But it hasen't been tried before! - so I would be taking a risk.
I'm also very interested in the idea of an aortic Synergraft based on a cell depopulated homograft but this isn't being offered over here in the UK . Cryolife have just set up in Europe and have only had CE approval(Europpean Certification) for their Xenograft based Cryorpreserved valve.
Anyway how to choose- I don't know!
There are 2 points that are key to me
Firstly/
I'd want maximise the time between between my first operation and re-surgury which preferably would never need to happen...... but I have to be realistic.
Secondly
I want to be as sure as possible that any decision I make now doesn't adversely affect and limit my choices in X years time when the valve needs replacing.
The new Autologous Valve reconstruction seems to me to involve a lot less collateral damage than the Ross Procedure - but has no track record, however I have seen articles that imply that treating tissue with Gluteraldehyde increases the risk of calcification. but Can anyone confirm this?
My Doctors are quoting 10-12 years as an average life for Xenografts and homografts. is this realistic?
I can't seem to find a consistent estimate for the durability of a Ross procedure, either for the new Pulmonary Allograft Aortic valve, or for the replacement tissue Pulmonary Valve.
Any input I can get that helps me make up mind about which valve to go for is gratefully ppreciated, especially info on
- Autologous Pericardial Valves. Cardiomend LLC
- durability of Ross Procedures
- information & projections about the durability Synergrafts
Sorry if this was a bit long winded, but I have to admit it was also a bit of a rant, - frustration at not being able to get quality info to help me decide what valve to choose
Many Many Thanks
Richard
[email protected]
I'm 41 London based and born with a bicuspid aorta which has stenosed and needs replacing within next 2 months.
I also have Crohns disease- symptoms of which are intermmitant gastrointestinal inflammation and bleeding, so my cardiologist (at University College Hospital, London) has recomended against a mechanical valve in my case as long term dependancy on anticoagulants would probably worsen my GI condition. (My Gastroenterologist backs this up).
I've also gone for a second opinion with a cardio-thoracic surgeon based at Harefield hospital.
What all this is leading to is my choice of Valve replacement.
which are;-
- Single tissue valves either Xenograft or Homograft
- Ross Procedure
Or.....
A new option being offered to me by the surgeons at Harefield Hospital. - A Stentless Aortic Valve constructed from my own pericardial tissue treated for 10 minutes in Gluteraldehyde. based on a new procedure/ template pionered by Cardiomend LLC, a company based in Santa Barbara, USA.
Although pericardial reconstructions have been used before this is apparently the first Company to come up with a constitent reproduceable template & device for harvesting, shaping and fixing an aortic valve........ But it hasen't been tried before! - so I would be taking a risk.
I'm also very interested in the idea of an aortic Synergraft based on a cell depopulated homograft but this isn't being offered over here in the UK . Cryolife have just set up in Europe and have only had CE approval(Europpean Certification) for their Xenograft based Cryorpreserved valve.
Anyway how to choose- I don't know!
There are 2 points that are key to me
Firstly/
I'd want maximise the time between between my first operation and re-surgury which preferably would never need to happen...... but I have to be realistic.
Secondly
I want to be as sure as possible that any decision I make now doesn't adversely affect and limit my choices in X years time when the valve needs replacing.
The new Autologous Valve reconstruction seems to me to involve a lot less collateral damage than the Ross Procedure - but has no track record, however I have seen articles that imply that treating tissue with Gluteraldehyde increases the risk of calcification. but Can anyone confirm this?
My Doctors are quoting 10-12 years as an average life for Xenografts and homografts. is this realistic?
I can't seem to find a consistent estimate for the durability of a Ross procedure, either for the new Pulmonary Allograft Aortic valve, or for the replacement tissue Pulmonary Valve.
Any input I can get that helps me make up mind about which valve to go for is gratefully ppreciated, especially info on
- Autologous Pericardial Valves. Cardiomend LLC
- durability of Ross Procedures
- information & projections about the durability Synergrafts
Sorry if this was a bit long winded, but I have to admit it was also a bit of a rant, - frustration at not being able to get quality info to help me decide what valve to choose
Many Many Thanks
Richard
[email protected]