mechanical? tissue? cleveland clinic avr April 29th (2nd ohr surgery) but now w kids

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The choice is yours ... I personally would opt for the choice that gave me the best chance of not having to have another surgery ... regardless, some people here are passionate about a particular valve, remember they are not doctors/surgeons ... make your choice with your research and the advice of your doctors ... good luck and best wishes.

Cooker has given excellent advice.
Go with the valve that gives you the greatest hope of avoiding another surgery for the longest period of time.

BTW, Philip mentioned weekly INR tests. I believe that he has his own INR testing machine. Those of us who have our own usually opt to do more frequent testing because it's convenient and we can do it "whenever."
People who don't own an INR tester go to their doctor or a lab at whatever intervals the doctor advises.
 
My own experience is that my valve was implanted at age 31 and has required no attention, other than periodical checkups, since that time. Warfarin is not a problem and has seldom interfered with my life or activity. I was surprised when I jointed this forum, a couple years ago, about all the fear and misunderstanding that surrounds this drug. I do agree that this is that this is a surgery that I don't want to repeat.....so far, so good.
 
hi there, agree with cooker none of us on here are docs, but you will cert get plenty of opinions, remember thats all there are, i choose tissue as didnt want to be on coumadin,a lot on here do well but it can have side effects,as a lot have said theres pros and cons with both,talk to your cardio and surgeon,them spin the coin lol,only joking,its a very personnal choice and the one you pick will cert be better than the one you got now
 
As far as the vacation, of course the docs will give you an opinion. Things to consider: plans for lots of hiking, physical expenditures, and high altitudes are not good when the heart is not functioning well.

That said, we went to Cozumel shortly before my first VR, and spent most of our time snorkelling, which my cardiologist at the time assured me would kill me. It is my belief that he was wrong.

It's important to have time away, especially with this looming over him. If you decide Australia will wait, then still go somewhere.

Best wishes,
 
This is one of the hardest decisions you will make.
When I had to make the choice, it was my second OHS so knew well what to expect going through another OHS.
I said to my surgeon, 'The good part is I have a fair idea what to expect. The bad part is I have a fair idea what to expect." Despite it being my second surgery, I more wanted to avoid coumadin and the chance of a loudly clicking valve than was desperate to avoid a possible additional surgery. What I've read about bridging from coumadin for some medical procedures and other surgeries, makes me very queasy. It wasn't anything I wanted to deal with if I could avoid it.
For me, the choice was very strongly in favor of tissue valve and I am so grateful I made that choice.

Each of us has to weigh all the info we can assemble and make our own choice. It is one of the few instances where surgeons almost always cede to the patient's choice.
 
The choice is yours ... I personally would opt for the choice that gave me the best chance of not having to have another surgery ... regardless, some people here are passionate about a particular valve, remember they are not doctors/surgeons ... make your choice with your research and the advice of your doctors ... good luck and best wishes.

Cooker -

Are you suggesting that Doctors / Surgeons are the ONLY knowledgable sources of Valve Information?
Are you also suggesting that ALL Doctors and Surgeons are well informed about ALL the different Valve Options on the market, without bias?

Personally, I do NOT believe that Doctors are the ONLY source of valve information and KNOW Surgeons who only recommend certain valves, for whatever reason.

I agree that minimizing the chance of future surgeries is desirable and that doing ones own research is advisable.

ALL of the Valve Manufacturers have websites which extol the virtures of their products. My advice is to read them all, ask questions, and decide for yourself which best meets your needs and goals.

'AL C'
 
Al, I appreciated your reply to this post. I am still wavering on valve choice, I am still 50/50 on the decision. Following on from your reply to this post, could you also refer me to some websites or papers from an independent source that would also give the pros/cons of tissue valves as well? Many thanks in advance.

Finding "papers from independent sources" is somewhat problemetic. We have had MANY posts recommending a similar search but NO ONE seems willing to Do the Original Independent Research and posting their Results at NO Cost to the public.

OTOH, ALL of the Valve Manufacturers have websites describing their products and extoling their virtues. That is a good place to start, if for no other reason than to compare the options and features. Finding the manufacturer's FDA Submission Data is another good idea. Hopefully they are all honest in their reports to the FDA! I expect that each manufacturer Knows what has been reported to the FDA by all of their competitors. Some make that information available for the asking.

Member "dtread" has posted the websites of All of the Manufacturers in the USA somewhere in the Valve Selection Forum. You could probably find that post by doing a Search on VR.com (see the blue line...oops, now it's a Red Line... at the top of the page) and search for Keywords "Valve Manufacturers" or just "manufacturers" and include "dtread" as the poster. Be sure to click on "Any Date" in the lower left corner of the Search Option Box. That's what I would have to do to find the information.

'AL C'
 
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Thank you for all of the advice, it has been very helpful and has helped me relax. I'll let you know how it goes and what he decides, I guess he is leaving the final decision until the day before surgery when we meet with Pettersson. Mary
 
I'm glad to see that your husband is seeing Dr. Pettersson. He has an excellent reputation and seems to be Extremely Well Qualified in all matters pertaining to the heart. Be sure to raise the hereditary stroke risk issue with him.
 
Thank you for all of the advice, it has been very helpful and has helped me relax. I'll let you know how it goes and what he decides, I guess he is leaving the final decision until the day before surgery when we meet with Pettersson. Mary

Hi Mary,
CC is a great place. Pettersson is the quintessential surgeon and will be a comforting force. I too had a difficult time selecting a valve type and Pettersson listened to my concerns and provided suggestions on valve choice that addressed those concerns; he did not push either type of valve given my circumstances. I suggest that you provide him with the concerns you raised in an earlier email and see if any of them are deal breakers. If not, then try to assess the risks that your husband is willing to take with either choice. In my opinion valve selection is accepting the risks associated with each choice; the hardest part is objectively assessing those risks. It's not an easy choice, but feel confident that either choice will provide a vastly improved quantity and quality of life.
My Best,
John
 
I didn't make the decision until 8PM the night before surgery! And the surgeon was perfectly comfortable with the late notice. In fact, he said i could wait until morning if I wanted to. The choice was never perfectly clear. There are many situations in life like this. I've learned to just make the choice, whatever it is for whatever reason seems best, even if it is a toss-up, and from then on be happy with it. Best wishes for a very successful surgery.

Bill
 
I selected a mechanical valve nine years ago at age 47 primarily to avoid future re-ops. Coumadin has really been a non-issue for me.
I started doing triathlons three years post-op and did my first half-marathon last year.
I have no regrets about my decision. Although my first surgery was textbook and went well, I never want to go through it again if I can avoid it.
Mark
 
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