Only 28 years for me...

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Protimenow

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Practically a rookie compared to some. Congrats just the same!

I know I shouldn’t be, but I’m still annoyed that my aorta wrecked any chance at a long unbroken streak.
It depends on how you define 'unbroken.' If you just say 'mechanical valve,' it may not matter all that much if this refers to two different ones.

Thanks
 

Protimenow

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Thanks, everyone. All I did was host this valve in my chest -- somehow stay alive for the last 28 years - and (for the last decade) really pay attention to my INR.
 

Keithl

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Congrats and very inspiring as to the benefits of mechanical valves. If mine makes it 28 years I will likely be dead by then.
 

Protimenow

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Yes, the mechanical valves have probably kept millions (?) of people going - at least, until other things brought them down. For me, 28 years - or 3 years - or 100 years is just a testament to how well the rest of the body keeps running with that ticker doing its job. (Yes, I know that some fail, or some have to be replaced for other reasons, but mechanically, these things are pretty solid).

Now - twisting this thread into another direction:

I'm sort of glad that I had to make a choice between mechanical and tissue 28 years ago. At that time, I was 28 years younger (of course), the only choices were tissue -- which would have probably lasted a decade or so and would have had to be replaced with another surgery; or mechanical - which clicked with every heartbeat and required anticoagulation management in order to prevent clots from forming on the valve (and warfarin was a 'rat poison' with lots of negative, often wrong, publicity); or, of course doing nothing and probably gradually slowing down, with reduced cardiac function and, eventually, death. For me, option #2 - the mechanical valve was a no brainer.

Now - if I was facing valve replacement today, the choice would be, possibly, more difficult. If I was in my early 40s, I wouldn't choose a tissue (bioprosthetic) valve because, if I live another decade or so, I'd have to replace the valve. And if I chose tissue in order to avoid having to take warfarin, I'd be kicking myself because anticoagulation management isn't that big a deal - and it wouldn't be worth MY LIFE to avoid it and possibly face another OHS just for that reason.

I may also have to consider a tissue-in-tissue valve - STILL a tissue valve, but less invasive. Or, perhaps another valve that may or may not involve cracking my chest to install. I would be gambling that, by the time my tissue valve fails, a better replacement can be used. Ultimately, a gamble to put in a 'temporary' valve, with the possibility of replacing it, non-invasively, with something permanent would still, in my mind, be a gamble. I'm not sure that, even if I was young, I would choose to take that gamble. OTOH - at my current age (I feel like I'm about 110 or so), using a TAVI or similar procedure, with the possibility that I'd live long enough to need it repaired or replaced, may be a good, sensible choice.

What do you think?
 

Keithl

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So I am 58 and recently had my BAV and aneurysm surgery 5 months ago. My cardio and the surgeon as well as my second opinion surgeon all leaned heavily toward OHS with tissue all saying next one would go up through groin. While tissue valves have decent track records they do vary and TAVR also has good results, but for me I truly wanted one and done. The odds and risks with mechanical just convinced it would be the best option for me.
 

Protimenow

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Personally, Keithl, I think you probably made the best choice. Although it's possible that a superior valve repair or replacement technology could be developed and approved in the next few years, it's still a bit risky to count on this magic fix happening before whatever tissue replacement you get fails. If I had a choice today, at my age (and I'm older than you), on good days, I'm still not comfortable thinking that 'hey, I'll probably be dead in ten years anyway, so why not get a tissue valve?'

OTOH - if a TAVI or valve in valve device will probably last a few (or more years), and there are minimally invasive ways to repair/replace the valve if it should fail in a few years, with one that will last a few more years, this may be a viable option -- as long as you can STILL replace these failed valves with a mechanical some time down the road. You've avoided worry about another OHS, but there WAS a possibility that, between the time of surgery and the time that you can't have yet a third or fourth TAVI to replace the ones that failed earlier, some other fix may have come along.

I'm kind of glad I wasn't presented with the choices that you had to work through.

---

Shortly after I wrote this, I saw a new post about the Foldax valve. Potentially, this can be a long term (lifetime?) valve that is either inserted surgically or through a catheter. This still has a LONG way to go before it gets FDA approval, but it's certainly interesting.
 
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dick0236

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I'm kind of glad I wasn't presented with the choices that you had to work through.
I agree with Protimenow's quote. When I had the surgery there was only one choice and I got it. They told me the artificial valve was designed to last 50 years....but I really thought it would last until I was about 50 and then I would die. I had no confidence that the valve would really last my lifetime, nor did I have any knowledge that a reop, if needed, was even possible "down the road". Virtually everything I thought then turned out to be incorrect......some good, some not so good. Once you've done your homework...sit back and enjoy your new lease on life.......one day at a time:)
 

pellicle

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Dick, those thoughts must have haunted you.
in context of Dicks last line and reading his response I think its important (well I personally think its life critical) to not let things haunt you. By let I mean when your subconscious drags them up, examine them see them for what they are and know that the ultimate truth is that every day is a gift. True Irony would be to obsess over how long your heart valve will last only to be hit by a car crossing a road texting to someone how worrrriiiieeeedddd you are about your valve.

One day at a time, the next is not guaranteed for any of us, and death seldom comes while we're sitting up waiting for it.

We all die, it is how we live our lives that defines who we are and the journey we have had.
 

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