Longevity of Tissue Valves

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There you go JKM, it's kind of like a time lapse video, but they do show the opening from the very start, there's also videos from there that may give you better idea also. Hope this helps. (Warning- not for the faint of HEART) get it?! Sorry, couldn't resist.

See link below, it also shows the closing of the chest.

Also, Matt, will be thinking of you on friday, hope all goes well.
 
Matt123 said:
All - I had my operation at Columbiua Presbyterian on Jan 14 and was released 5 days later. I just wanted to sincerely thank all of you for your support and kind words. Everything went perfect. This is a wonderful site and I hope I can be of help in the future for anyone who ever has a question or would like to contact me. Many thanks to you all again.

-Matt
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Thanks for letting us know how you are doing. Glad to hear things are going so well. Now make sure to do your "jobs' eat, breathing exercises, walks,naps and don't over do, so your recovery keeps going smoothly.
 
Jkm7 said:
Thanks, Ovie.

The link didn't take me to any heart video but I appreciate you trying to help.
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Really? It takes me to it. I wonder if it's because I did it via phone? Dang, it's a good video too.

Matt, thinking of you today, hope everything goes smoothly for you!
 
I have had my aortic homograft for 25 years and 4 months. Two years ago is the very first time any regurg was noticed. Last July, he said it was "noisier in there" than last time (6 months before check up). We are now looking at replacement in June although I feel relatively fine (3 or 4 semi SOB episodes at night). 25 years is apparently phenomenal. Changed my life...had a valvotomy at 11 that did little and the homograft at 20 led me to running and fitness. This has declined due to my own laziness and other issues, but overall. I have a bleeding disorder (coagulation), so we will be looking at Medtronic Free Style. I am reluctant to think of surgery (more than normal) becasue I feel okay, but know it is better to do it when stronger.
 
DBrooks,
Welcome to VR. Happy you found us and have posted.

Sorry to hear your valve seems to be failing now but how wonderful to have gotten so many good years from your current homograft.
 
Thanks...he called with my echo results on Friday at school (as requested) and I didn't really get to ask questions..will in a month. He put me on Lasix which I don't get becasue no edema, only 3 SOB episodes and nt big at that. Had 3 First graders trying to kill each other when talking, so didn't get to ask why Lasix if not edema? could it be that I have fluid accumulating and not know it? Just wondering.....Thanks.
 
Oops...we missed the St. Jude Biocor, which has been in use in Europe for many years.

The following study article was written in 2005, which makes Biocor use at least 26 years old:
1Mykén P. Two Decades With The St Jude Med. Biocor Bioprosthesis. Third Biennial Meeting of the Society for Heart Valve Disease, 2005.

A researcher for Hancock II puts their relative 20-year-use freedom from reoperation for SVD (structural valve deterioration) at Hancock II (92%), CP Perimount (92%), and Biocor (76%). However, there are only a handful of of actual people combined in the entire category of those who've had their valves 20 years. This is largely due to the ripe age of most valve recipients (average 69 years old), which allows them to live a full, long, extended life, but still pass on before the 20 year mark. I was unable to locate an all-cause number for a percentage of living recipients who had reoperations for any reason. From: Twenty-Year Results of the Hancock II Bioprosthesis Michael A. Borger, Joan Ivanov, Susan Armstrong, Debbie Christie-Hrybinsky, Christopher M. Feindel, Tirone E. David. Division of Cardiovascular Surgery, Toronto General Hospital, University Health Network, and Department of Surgery, University of Toronto, Toronto, Ontario, Canada.

Note that the Myken document puts the Biocor 20-year-use freedom from reoperation for SVD at 86%. As such, researchers disagree. From: Twenty-Year Experience With the St. Jude Medical Biocor Bioprosthesis in the Aortic Position, Walter B. Eichinger, MD, Ina M. Hettich, MD, Daniel J. Ruzicka, MD, Klaus Holper, MD, Carolin Schricker, Sabine Bleiziffer, MD, and Ruediger Lange, MD. Department of Cardiovascular Surgery, German Heart Center Munich, Munich, Germany
Freedom from reoperation in our population was 84.0%  4.7% after 20 years. These results are comparable with published outcomes describing other bioprosthetic valves... For the Carpentier-Edwards pericardial valve Jamieson and colleagues published a freedom from valve-related reoperation of 62.3 3.5% at 18 years (mean age, 68.9  10.9 years).
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The answer seems to be that the researchers tend to use what numbers they find for references, and they rarely seem to find the same sources as each other.

Best wishes,
 
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I sure hope these tissue valves last longer and longer as they seem to be used more often at major heart hospitals. My surgeon told me 3 yrs ago to expect 10 yrs from any tissue valve. I have a cardio friend in LA who has only one patient with a valve that has been in place 20 yrs. I think it's a good idea going into surgery to know that the tissue valves may not last as long as we want them to! I know I wanted mine to last at least 15 yrs, but got 11. Of course, it was placed in '89,I exercised religiously and have always been lean. I do know that I felt so normal for those 11 yrs, no thumping, clicking, coumadin. I think we should all ask our cardios how many patients they have whose tissue valves are going on 20 yrs. That might be more telling than all the studies. I know for my 3rd surgery, it was so tempting to get a tissue valve. But, at 54, I was on the cusp and would've probably needed a 4th surgery, or if it lasted only 10-12 yrs I might've needed 2 more surgeries. That didn't sound too fun, but sooo temping to go back to tissue.
 
Bob/tobagotwo, The Hancock II article you reference is from 2006, 4 years before the 2010 "Gold Standard" article by David et al that I've got on a hotkey: It's entitled "Hancock II Bioprosthesis for Aortic Valve Replacement: The Gold Standard of Bioprosthetic Valves Durability?" by Tirone E. David, MD, Susan Armstrong, MS, Manjula Maganti, MS, in Ann Thorac Surg 2010;90:775-781, abstract at ats.ctsnetjournals.org/cgi/content/abstract/90/3/775? . Unfortunately, only the abstract is available online for free, though I've got a fax copy that I've used to type in a bunch of key passages. It follows the same patients (plus some newer ones) at the same institution -- "mine"!

In that newer article, they've got a few twenty-FIVE-year survivors, though too few (like 3?) for any meaningful analysis. And they continue to compare their 15- and 20-yr results to the published "competition", and they continue to find that they're doing better, hence "Gold Standard".

They also point out that "freedom from reop" or "freedom from explant" is NOT the same as freedom from Structural Valve Deterioration, and is almost always misleadingly lower, because quite a few patients with SVD are too infirm to be candidates for surgery -- so they show up, totally misleadingly, in the "success" column!! They present all their own results in terms of "freedom from SVD", and try to compare apples and apples. Mind you, since their freedom from SVD results are generally even better than the other studies'/valves' freedom from reop results, it just makes the difference more striking.

BTW, when I browse "your" 2006 Hancock II article, I see that they report the 20-year freedom from reoperation for SVD for the CP Perimount as 82%, not 92%. (They got 92% for the Perimount SAV at 15 years.) Was your 92% a typo, or am I missing something?
 
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