More questions...

[starkone]

I have been in meetings with doctors all week. I am finally accepting that this surgery may be sooner rather than later.
So far, I am getting alot of resistence about my request of a tissue valve.
The surgeon went so far as to say that I may have too small an opening for a tissue valve to be hemodynamically adequate. Apparently, when you are small framed there is a chance that the annulus of the valve would require such a smalll valve that the calcification would come back quickly. I am 5'4" and 120 lbs.
Have any of you had resistence to your requests for tissue valves.
I still am going to Brigham on March 1 for 2nd opinions on everything and I think they will be the deciding factor.
Thanks for any input you have here....I am getting angry over all this!
Thanks again,
Karen

 

[tobagotwo]

It's a tough call. There are still a lot of cardiologists who don't want their younger patients getting tissue valves regardless. Both of mine didn't. However, surgeons are usually more open-minded about tissue valves. The size reason given may be why he's not.

Certainly see what they say in Boston. It is a fine hospital, and may have a larger view of things. But it does sound like they are sharing a concern here. It may be that they are trying to keep you from making a mistake, but they should try to explain it so the reasoning works for you as well as them. Do they have a reasonably accurate measure of your anulus size? (Cath? echo?)

Small size is a fairly rare issue. You may have to adjust your thinking for the choice that will serve you best. In the end, bloodflow must be the deciding factor.

Best wishes,

 

[Nancy]

I may be in the minority with this answer, but if your second opinion doctor has the same feelings, then there must be a very good reason why they have reservations.

You also have to accept the fact that even though both you and the surgeon have agreed on a tissue valve, once they get in there, things can change, as many have found after surgery when they were told that the tissue valve just wouldn't work out, and they now have a mechanical.

So go with your first choice, but always keep in mind that it might not work out, and they cannot wake you up to ask your opinion.

These guys and gals are paid big bucks because they really understand all of the fitting problems inside the heart and how the heart has to function optimally. It's a tricky business.

 

[Bionic Man]

had some strong resistance

had some strong resistance

I think in younger people they just pretty much refuse. My surgeon said that due to the fact that I'd need part of my aorta replaced that a tissue valve would be a poor choice. Also my doc seemed to be worried about a re-op.

Given how I faired in surgery and my overall experience I'd say I'd take surgery again over having a mechanical valve and the blood thinner issues.

Having said that I do trust my doc. He was extraordinary and did a near perfect job. My new mechanical valve is working fantastically and the blood thinner issues don't seem so bad. I guess when things were progressing too fast to fight with my doc I just decided to trust the right thing would happen. I don't know how, but I think it probably was the right thing in the end. I don't expect I'll ever need a re-op and things are working quite well.

David C

 

[Bionic Man]

Oh, that's right.... my doc said they wouldn't know right away how much stretched tissue they'd have to cut out around the valve seat area that it would be nearly impossible to get a good fit with the tissue valve. Anyway I don't know that you have a weakened aorta like me but that seemed to be a big negative for me and the tissue valve.