Jumping the gun but???

[kevin21]

If I need surgery soon, should I ask for a stentless mech. valve? I have seen several aticles on these and seen that the stentless seems to allow more flow and reduce clotting. This seems like a good option for me given my age and activity level.

Any comments??

I of course will ask the surgeon and Doc. It is gonna' be funny to wow the doc with my extensive knowledge and to make sure he doesn't BS me (not like a Dr. would BS someone, hopefully??).

 

[Ross]

From St Jude:

Surgeons and patients must consider many factors when deciding on the type of valve to use for replacement (e.g., patient's age, size and location of the natural valve, condition of the heart, heart rhythm abnormalities, and much more). Talk with your surgeon if you have questions about your valve choice.

In other words, you can ask for it, but you may not get what you ask for, so it is important for you to discuss this thoroughly with your surgeon.

 

[Marty]

Ask and you may not receive

Ask and you may not receive

Prior to my mitral surgery I asked for repair and if that not possible a pork valve. I woke up with a St.Jude mechanical and now 4 years later I am very satisfied with my surgeons choice.
Hell, I'm 76 and don't want another operation if I can help it and the Coumadin is fine. I think its good for you. I self regulate with a Coaguchek.

 

[ALCapshaw]

Hello Kevin,

Assuming you have some time, this is your opportunity to explore all the options.

I asked for, and my surgeon agreed upon, a Bovine Pericardial Valve. This is one of the preferred valves at The Cleveland Clinic. It has a 90% durability record at 15 years and counting.

I ended up getting a 21mm St. Jude Mechanical valve due to 'other concerns' once the surgeon had me opened up. This valve is one of the most reliable long term valves. It does have a 'reduced' aperature, limiting maximum blood flow to about 60-75% (?) of a healthy original valve. I find I can do most 'normal' activities but my HR maxes out at moderate exertion levels such as walking up a 5 degree incline at a good pace.

John Cochran and others on this forum have opted for Homograft valves which may also be of interest to you.

Hopefully your surgeon will be willing to discuss your options with you.

'AL'

 

[valverep1]

Hi, Kevin21.

There's no such thing as a mechanical stentless valve. The stentless valves available in the U.S. are porcine (i.e., pig) tissue valves and there are three choices from various manufacturers. Medtronic has one called a FreeStyle valve; St. Jude has a Toronto SPV and Edwards has the Prima Plus.
Your surgeon should be well-informed on the published materials regarding this valve and , for that matter, all others. The cardiac surgeons I work with all have a pretty good idea about what's being said about current valve technology.
I can tell you there are perceived hemodynamic (i.e., blood flow) advantages to a stentless porcine valve. However, the latest durability studies are less than 10 years and this is typically not long enough for anyone (surgeons, cardiologists, manufacturers, etc.) to draw experienced conclusions. A stentless valve is also more difficult to implant (than a mechnical or stented tissue valve) and, therefore, can be challenging to the surgeon depending upon the number of stentless valves he/she has implanted.
Valve selection is sometimes a difficult exercise and there are many dependent factors to consider. I suggest you ask your doctors a lot of questions and don't settle for being "uneasy" about their answer(s). You will most likely get very good advise...

Valverep1

 

[Marty]

Valve rep 1

Valve rep 1

Welcome aboard! We need an expert like you with us. I am surprised at how much input and choice patients have these days. I'm of the old school that believed these decisions are best left up to the surgeon.I am 4+ years post mitral replacement with a mechanical St.Jude and am happy with the surgeons decision.
I manage my own Coumadin with the Coaguchek and have not been to the lab for a vein stick in 4 years. Its really no big deal.
At any rate there has been so much conflicting information on this site re: valves ,you can help clear up questions like the "stentless" mechanical valve.

 

[Andy in Montana]

Hey Kevin,
Thru my research I decided to have the Medtronic Mosaic - when I saw the Cardio the week before my operation he told me of a new valve they wanted to use - the Medtronic Mosaic as I had opted not to go mechanical. I woke up with a repaired Mitral Valve and they had used an annuloplasty ring.
Another patient who had the same problem as I received the Medtronic Mosaic - he is in his 40's. He is doing very well and I also am doing very well. I keep track of him as that was my valve of choice. They are supposed to last longer as far as pig valves go - they say 15 to 25 years?
Keep researching - but in the end they'll probably do what's best for you. good Luck.
Andy MVR June 2001.
http://www.svhs.org/heart news/heartvalvelast.htm
Here's a link that talks about the valve a little.

 

[richie rich]

HEY GUYS

I ALSO GOT THE MEDTRONIC MOSAIC VALVE. THEY HOPE THAT THIS VALVE WILL LAST 25 YEARS. SO FAR SO GOOD. IT HAS LASTED A WHOLE TWO WEEKS.

GOOD LUCK KEVIN. KEVIN YOU ARE YOUNG. YOU SHOULD LOOK INTO MINIMAL INVASIVE WHEN YOU START LOOKING FOR SURGEONS. IT IS A MUCHER QUICKER HEAL. UNFORNATELY ONLY CERTAIN HOSPITALS DO IT. I WENT WITH THE TISSUE DUE TO THE FACT THAT THE SURGERY IS GOING TO GET EASIER HAS THE YEARS GO.

TAKE CARE
RICHIE RICH