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L

Lisa

Hello, all. I have been away for several days thinking about my impending surgery and consulting with my surgeon of choice.

After much deliberation, I have chosen a homograft.

The surgery is going to be performed by Dr. David McGiffin at UAB in Birmingham in a matter of weeks. Dr. McGiffin is ordering a 'range of valves' from the organ bank and he is to call me when he has a satisfactory range. To quote him "we keep the valves in a bank, they are frozen, and we take some out and defrost them as we need them." It was really hard not to laugh at that comment. It gives the impression of going to the grocery and picking out a slab of meat!:eek:

It was easy for me to decide which type of tissue valve after I decided that I definitely did not want mechanical. Eliminating mechanical was the hard part. Here are my reasons for choosing a homograft:

1) I'm only 31. Given my prospect for a long life span, I'm not ready to go on coumadin quite this young. Although I would probably be perfectly fine and not have complications from it, I think the longer you're on it the greater the chance of having serious complications. So mechanical is out for now.

2) The next thought was: Which type of tissue is best? Well another human aortic valve is most like what God gave me to begin with. Yipee, Homograft for me! Also, there are some cases of them lasting up to 20 years now. I hope to be one of them.

3) The Ross procedure is out for me because I know that I will have to have a reoperation (hopefully 15-20 yrs down the road) and I do not wish to have two reasons for the 2nd operation. I would like to lessen my chance of having two mechanical valves in the future.

4) Animal tissue is not completely ruled out. It just does not happen to be my first choice. I am trying to decide between animal tissue or ross procedure for my 2nd choice. I'm keeping positive with only 1 choice because Dr. McGiffin thinks he can get a homograft for me.

5) The other major factor in my decision is childbirth. My husband and I decided before we married last May that there would not be any children. He's 45. BUT you never know what the future may bring. If we change our minds, I want the option to have them. There is also a bit of self-esteem attached to that decision. I don't want to feel that my appeal as wife, lover, friend, mate is any way diminished because I'm not able to carry a child.

Geez, I'm talking a lot here. I have so much to do before this down time. Like get my closet organized! My husband hates these projects I think up for him! I'm having him design cubicles for me so that everything I store on the top shelf of the closet can be brought down and easily reached by me. :p
 
Lisa,

Congratulations on your choice. Sounds like the right combination of reason and emotion went into the decision.

You don't want to see my pre-surgery project list (which doesn't include any items from my wife)!

Let us know what the date is!
 
Lisa,
Congratulations on your choice. Like you, I am fairly young (37) and made the choice to have a tissue valve (porcine) instead of mechanical, knowing I would need a 2nd operation in the future. My surgeon said 90% of the doctors out there would put in a mechanical valve, but he wasn't one of them. He said he would rather see me have 10-20 really great quality, worry free years, than have to deal with coumadin at for the rest of my life at a young age. He said the risks between a 2nd surgery and complications from coumadin use were about the same. I know next time unless there is new technology, I will have to get a mechanical, but for now, I'm happy with my choice.
 
Good for you. I'm glad you made the choice and it's the right one for you because you made it Now you can move on to getting the rest of the job done. Best of luck!

Heather
 
I've had three replacement biological valves but now I'm thinking of the mechanical one for next time. Any advice?
 
Lisa - Congratulations on your decision. I have a homograft and so far so good. It is over three years since surgery. I take only a small aspirin per day.
 
lisa

lisa

Good for you, girl. I like the rational for your decision. Now, if the op seems horrendous to you, then next time you can say, "I want a mechanical this time" and be done with the operations.
For me the operation was not so bad and I would be willing to go thru it again.

Hey that Deb from Brazil had three??? wonder what she thought on those three decisions???:confused: Wonder what her history is. I'm checking her out.:D
 
Good for you Lisa. I will be choosing a tissue valve for my upcoming mitral valve surgery if the repair is not possible. I hope it will give me 15 to 20 years as these guys are predicting. Good luck girl...Hope everything works out for you.
 
Lisa,
You've "earned" your choice by seeking information and weighing all the pros and cons of the various alternatives. Quite apart from the objective merits of your choice, just going through that decision tree process is the key to feeling settled, I think. Is your surgery scheduled yet? It seems like I saw you posted it, but I can't find it with a quick perusal and I don't see it on the calendar. I'm having mine done at UAB as well (Albert Pacifico next Wed.) and I'm encouraged to understand we can both expect excellent care. Won't it be nice to have it behind us though!
Sue
 
Type of valve

Type of valve

Hi everyone! Although I only started my research on types of valve a few weeks ago, I've learned quite a lot but nothing compared to you folks who by what I've noticed, get detailed information from your doctors. As I have stated in my home page, patients don't have access to their records so easily and if I hadn't insisted on piecing my history together, I too would still be wondering what sort of surgery they performed on me. Doctors here really do believe that by omitting what they strongly consider irrelevant, they are sparing the patient from a lot of suffering. Anyway, it should still be a while to go before I have to opt for my next mitral valve, but the more I read about it, the harder it is to make a decision. I think the mechanical one will end up being the solution, however, I love eating things which contain a lot of VK and I don't like the idea of having to give them up. I hope that by the time I have to get it done, there's something else available for me. By the way, sorry for any mistakes I may have made, but as well as the fact that I had never even dealt with a computer before,(just over a month ago) I only have 25% eyesight so, typing isn,t as easy. Well, good luck to all of you who will be going through surgery in the near future and I hope to hear from you again. Débora
 
Hi Debora-

You don't have to give up vitamin K things when on Coumadin. You just have to not eats loads of it and then not eat any for a while, in other words you have to be consistant with what you eat. The doctor adjusts the Coumadin according to the patient, the patient doesn't adjust their lifestyle according to Coumadin.
As long as you are reasonable in what you eat, everything should be fine.

Coumadin fluctuates anyway, no matter what you do. A lot of it has to do with your activity level and how you are feeling on any given day and some other things.

My husband has been on it for 26 years. He thinks it's the least of his worries. Other may disagree, but that's how it is for him.
 
Thanks

Thanks

Thank you Nancy for answering my question. I'm sure that little by little I'll gather all the information I need in order to make my final choice when the time comes. Of course I'd rather never to need an operation again after this next one for I'm quite fed up and would love to close this chapter of my life once and for all Sorry if I may sound a bit under the weather, But I suppose that after thirty years of dealing with it I really do need a BREAk. débora
 
I agree with Nancy

I agree with Nancy

Deb,
If you want information on coumadin, Al Lodwick's website is
the only place that has the correct information. I have seen a number of posters on many different website that have made statement that were factually not true. Many heathcare professionals are not even well informed about the subject.
Having dealt with my own heart problem for almost 50 years,
I understand how tiring it can be. However, there is no "fix",
no matter what you decided that will leave you so you never have to "deal" with it again.
Best thing I can tell you is you are not alone and the medicine
is getting better every years. My hope is that in twenty years,
Bio-engineered valves ( using one's own bone marrow stem cells
to grow one's heart valve) will end the mech vs. tissue decision
for most of people in the industrialized world. It will be too late for me, but it least the young will not have this problem to affect their life.
Take care of yourself and good luck!
 
Vitamin K

Vitamin K

Thank you RCB for the hint and opinion. Could you send me the address to that website you mentioned? I will look it up as soon as you let me know where to find it. Débora
 
Hello everyone, and thanks for the support. Dale & Sue: you'll be in my prayers. My own surgery is going to be March 19th. I got the phone call this morning from Dr. McGiffin's office...they were pleased to tell me that they have a homograft for me!

Deb: I don't have a lot of advice as this is my first surgery. I can say that I agree with everyone else here and think the fewer the operations the better. Al's website is very informative. I'm saddened to hear that you've been through this so many times. I'm praying for you to find some peace and the right the decision.:D
 
Lisa, congratulations on making your decision. It is never easy, but now it is one less thing you need to fret about.
Kev
 
19th of March

19th of March

Hi Lisa, first of all, thankyou for answering my question. I guess it makes sense seeing that operations of any sort can be rather delicate especially the heart ones. March 19th is also my birthday so I'll have two reasons to celebrate because your operation will be a success, I'm sure! Will there be anybody who can keep us posted while you're in hospital? Bye for now. Débora
 
Hello Debora,

Regarding mechanical valves, the standard St. Jude mechanical is the historical 'gold standard' with a LONG and reliable reputation. St. Jude has a 'new and improved' model (the Regent I think) which offers better 'hemodynamics'. There is another newer mechanical valve that has very impressive design claims regarding reduced damage to blood cells, less likelyhood of producing clots, and better hemodynamics from ON-X. There is some discussion of this valve, and a website reference, in the VALVE SELECTION Forum.

FWIW, you will probably get better response to your questions if you start a NEW Thread in the appropriate Forum vs. asking a question in a response to an existing thread. Starting a new thread also makes it easier to track and search for future reference.

Good luck in your quest for information.

'AL'
 

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