Longevity of repaired valves

[pellicle]

Hi

Hi Pellicle, you're totally right. 10-15 years doesn't sound like longterm to me either. For me, longterm would be 50 years or so.

it is very encouraging that people like mike59 are around to say they got 33 years out of theirs. Sometimes just reading reports is discouraging. Always nice to read the good results

 

[Mike59]

Thanks. Pellicle appreciate the compliment

Hi



it is very encouraging that people like mike59 are around to say they got 33 years out of theirs. Sometimes just reading reports is discouraging. Always nice to read the good results

 

[Marco]

Hi Marco
There's a lot of literature. Here are some recently published papers. You can access the abstracts with the provided link.

de Meester at al. 2014. Valve repair improves the outcome of surgery for chronic severe aortic regurgitation: A propensity score analysis
Conclusion: AV repair significantly improves postoperative outcomes in patients with AR and whenever feasible should probably be the preferred mode of surgical correction. http://www.ncbi.nlm.nih.gov/pubmed/24656668

Saczkowsky et al. 2013. Systematic review of aortic valve preservation and repair. http://www.ncbi.nlm.nih.gov/pubmed/23977553

Svensson et al. 2014. Long-term durability of bicuspid aortic valve repair. http://www.ncbi.nlm.nih.gov/pubmed/24680032
Conclusion: BAV repair is safe and durable with low mortality, low prevalence of reoperation, and good long-term survival. Cusp prolapse from technical errors and natural progression of disease are the most common causes for reoperation, but progressive natural increase in valve gradient accounts for a substantial proportion as well.

Aicher D et al. 2011. Quality of life after aortic valve surgery: replacement versus reconstruction. http://www.ncbi.nlm.nih.gov/pubmed/21450311

The current literature influenced my decision a lot. With repairs I think it's very important to be at a center that has extensive experience. Hope this helps.

Thanks for the links. Am now even more convinced that I want a repair if that option is offered to me - I will hopefully find out in the next few weeks.

 

[johnnycake23]

Does anyone have info on the longevity of repaired valves? I had pretty much decided on mechanical, but my cardiologist thinks there is a good chance the surgeon can repair my mitral valve. At first I liked the idea. The more I think about it though, the less trust I have that a repair will last. So, are there any statistics on how long repairs can hold up?

I will meet with the surgeon in 4 days. Surgery in a week.

Blair, I can tell you that my repaired aortic valve in 1993 lasted 14 years until it had to be replaced. All the best on your decision and your future.

 

[Marco]

Blair has been operated already - and it's a repair!,

 

[Midpack]

Blair has been operated already - and it's a repair!,

Good news!
For MITRAL valve, a good repair is allways preferable over a replacement.

 

[cldlhd]

Good news!
For MITRAL valve, a good repair is allways preferable over a replacement.

How about an aortic valve?

 

[Marco]

Blair, I can tell you that my repaired aortic valve in 1993 lasted 14 years until it had to be replaced. All the best on your decision and your future.

,

Hi Johnny, I would be grateful if you could please share you thoughts and experience with your (bicuspid aortic valve) repair? Would you do it again if you ahd the chance? Or would you have done straight for a replacement?

 

[cldlhd]

I was all set for an aortic valve replacement with a mechanical valve myself but after meeting with my surgeon I'm on the fence as he heavily advocates repair. He says techniques improved a lot in 2004 and my valve has minimal leakage and no stenosis. I assume even if the repair lasts for life you can get stenosis. Also I was under the impression that even a 'perfect' BAV doesn't open all the way and restricting the flow could cause the heart to wear out prematurely. It would be great if there was some info comparing LVEF of a mechanical valve and a properly functioning BAV. I'm sure that's a tall order as there are many different mech valve designs and each persons native valve is unique. I would just hate to gain the current convenience of no warfarin and lower infection risk for a higher risk of reop or a worn out heart in the future. Do the surgeons who recommend repair over replacement only factor in the next 10 to 15 years? If so the data definitely seem to back up their position but what about someone in their 40's or younger who wants another 40 quality years?

 

[river-wear]

All I can say is that "our" surgeon advocates repair for patients younger than us too. When I told him of my expectation to fly home two weeks post-surgery, he told me about a younger patient that he made stay longer. But he had to fly back to Italy, so at least I have a somewhat shorter flight.

He never answered my email regarding stenosis, however, I don't think there is any real risk of the the heart "wearing out." If the valve gets stenotic, then it will need to be replaced. The first TAVR valves were approved for stenotic valves, so maybe that would be a reasonable choice in fifteen years (although I personally am not going to count on that).

 

[Marc]

When you are going to start with statistics do not forget that you have a (bleeding/stroke/endocarditis) risk for serious complications with a mechanical valve of around 2% per Patient/year in most of the studies done. That is not too much especially when you have no choice of choosing repair or replacement it is an acceptable figure for the patients. The younger you are, the higher your risk to have a complication with a replaced valve along your lifespan is (thats simply statistics). So especially for the younger ones (who at least would under normal circumstances survive a reOp as well) a repair is the way to go not only from the "practical" side but from all statistic data we have. There are lots of scientific publications you can read about this so for me it is logical that your surgeon as well as nearly all surgeons prefer repairs over replacements - especially for the younger ones.