maths. Addition from his age plus the statistically demonstrated probablity of replacement. Due to the well established point of valve degredation called SVD
Agree!
I was not implying that I heard of a mechanical valve being replaced specially for "wear and tear" or even some failure (I really hope not because my wife has 2 and she has many, many years years of life to get out of them).
I personally know of 3 people who had to get another open heart after mechanical valve replacement, all within 30 years, and all because of pannus formation and very elevated velocities. In 2 of the cases there was an aneurysm formed in the aortic arch also so it, the arch, had to replaced. When there is a problem in the arch it may be somewhat pre ordained from this originally being a bicuspid valve at birth, although one of these individuals was told at a large hospital in Seattle that it was from the jet caused by the bi leaflet mechanical valve.
Hi pellicle,
yes, but I thought that was when you did the placement over a calcified native valve (in someone quite elderly), rather than when doing a valve in valve of a previous bio-prosthetic.
however I'm keen to get additional information and clarification.
Sorry, I don't know enough about TAVR to know about this.
Probably, I must of glazed over this.
it is not, it works entirely differently and underscores why I dislike the fully incorrect "simplification" of "Blood Thinners"
interesting (and sad).
Still waiting for the Lp(A) report.
My surgery was performed at Emory University Hospital in Atlanta. I’m not sure of the technical term, but they made a smaller incision in my chest, which made the healing process much easier and faster. They didn’t break open my chest as extensively as in a normal procedure. You definitely want to inquire about that.
Uh, I got my St. Jude's aortic leaflet valve at 33, am still fine with it at 58, no need to replace it. Been on Warfarin since 36 in 2001. Does not mean I will be getting a replacement anytime soon. I am on warfarin due to the Mechanical valve. That is also real world. I would never do anything over, since the aortic valve had a defect when I was born. You are right, you cannot predict when things will happen.
I was 53 when I had my open heart AVR. !2 years later now at 65 it seems to be doing well. I was in relatively good health otherwise but was about 75 lbs. over weight. My surgeon also recommended the tissue valve for me over the mechanical. He said life style would be easier to deal with. with tissue valve no need for warfarin blood thinners and frequent INR testing. When you first start warfarin, you may need to have blood tests every few days or weekly. When your INR and warfarin dose are stable, blood tests are often done every 2 to 4 weeks, sometimes longer. If your dose changes you may need to have your INR tested. When on warfarin you also have to be cautious of not eating certain foods as they can have an effect on your INR levels. I think his thought was that "for me" at my age, the quality of life with tissue would be better. If I needed a re-do in 10 - 20 years I would still only be in my 60's or 70's and given I remained healthy could tolerate a re do open heart surgery. No a days they are doing Trans Catheter minimally invasive procedures see link (Transcatheter aortic valve replacement (TAVR) - Mayo Clinic). My initial recovery after surgery was 4 - 6 weeks. It was tolerable. The mechanical vs. tissue valve is a very personal decision. I say at your age, and with your otherwise good health I would go with the tissue option. What ever you do, get a surgeon who has performed a lot of these surgeries. While I am sure there are many good surgeons across this nation, this is a big deal and if you have the ability and resources to go to one of the best facilities to get it done you owe it to yourself to do so. If you have any other questions and want to reach out you are welcome to email me. I am not an medical professional but I have been thru this and learned a lot n the process. All the best to you. [email protected]
1. How long was the recovery after the surgery?
In one case I believe this patient was non compliant with his warfarin monitoring. So that situation, his need for a redo, was probably on him. His redo was around 26 years. He had an arch replacement also. He chose a bio valve the second time and he was about 50 when he did that. I don't know the compliance on the other two cases at all. I think you have provided data here that suggests pannus is from poor inr control and I agree, and I think it's obvious. All three pateints got their valves under age 40. Mechanical valve+ excellent inr control will lead to the patient having that mechanical valve "last" even longer.
did you not start the warfarin for 3 years?
Thank you for this information.
Im sure non of them were on x because i know the hospitals they were at didnt use those back that long ago. Pretty likely St. Jude. A bit off topic but my opinion is that the approach to tissue valves and no anticoagulation has been an error. The medical community didnt think clots were forming on those valves because they werent looking for them until the last several years. All the more fuel for folks who got mechanical valves to feel justified they made the right choice.
