Scar Tissue

[steve c]

Hi!

I've been told that scar tissue (and the difficulty for a surgeon getting through it) may be anissue with me later in life when possible subsequent replacements are needed.

At 41 I've been told by my cardiologist that a mechanical valve may only need two replacements (relatively easy to get around scar tissue for operation #2). However, he also told me that tissue valves would need more replacements than that and, given my age, once opeation #3 (+?) comes up the surgeons may not be able to get through the scar tissue to do their thing.

I am seeing a surgeon on Friday (to discuss many things) but I wanted to get some people's ideas on this "Scar Tissue Issue" (sorry for the bad pun).

Have a Great Day Everybody!

Steve

 

[DickV]

Steve, that was the main reason my Cardiologist was against me getting a tissue valve. The main drawback was the additional surgery and the scar tissue and possible surgical complications as opposed to the Coumadin issue for mechanicals. He said some people scar more than others which can complicate things and some tolerate Coumadin better than others.

In spite of all the great research on this board, there are two givens.

1) It is all really a crap shoot
2) Time will be the ultimate judge

Dick and his mechanical.

 

[martha]

Hi Steve,

I choose a homograph, only have to take a baby aspirin a day. Realize down the road that a replacement will be neccesary in the future. However, at that time there will have been all sorts of improvements. Had my arotic valve replacement last year on 12-15. At that time I talked to my doctor about the very problems you spoke of. I was informed that yes there was that issue. However, they deal with this thing frequently and not to worry. Good luck with your decission.

 

[Kevin M]

I faced this exact same concern. When I brought up this question, my surgeon was not overly concerned about me facing a third surgery before I was 50. I think this is one of those things where every doctor you talk to will have a different opinion.
Kev

 

[Gail in Ca]

I had my 2nd AVR done at age 46 last year.
My cardiologist did NOT want me to go thru
a 3RD surgery. There was the issue of scar tissue and the removal of the first surgery wires
which were deeply imbedded in my sternum.
The surgery took longer than expected.
But, a week before my surgery, a screwed up
cath recovery put me in CHF and I was at death's door before my surgery. This changed every thing.
Along with the AVR , my mitral was to be repaired
or replaced, so a 3rd surgery was unlikely.
BUT, I was in such bad shape,surgery was taking some time, and my mitral was found to be "unusual looking" so the surgeon did not fix my mitral. Oh Well, so I may have a 3rd
surgery, hopefully a long time from now.
I have only talked to my cardilogist about this 3rd surgery, and he is so vague,just gives me the impression that it would not be a good thing to go thru, and never asked my surgeon about the problems of a 3rd surgery. He just stated that if I need mitral replacement, he would go in thru the rib and he didn't give me the impression that it would be so very risky. But the cardiologists see people and tend to know the real risks and such.
Even with all my health woes I still went home 4 days after surgery this time. In '89 I was in the hospital a week.
So (sorry long winded) I guess you never know what the future will hold.
I try too stay positive and healthy, too.
Gail

 

[ticktock]

again and again

again and again

Hi Steve

I can certainly understand your concern, and what a great place to come with questions. Im floored by all the information here, and the wonderful attitudes of the contributors!! (Im new!) Anyway, repeat surgeries are not a good thing. My first surgery was in 1960 back when valves were NOT done. My own valve was made larger (valvotomy), I was 5 yrs old. I grew to be 16, in 1971 and guess what?? Needed another surger, because I had grown but my AV had not. Another valvotomy, mid sternal entry. The Docs in 1960 never DREAMED I would LIVE! NOW What were they going to do?? ACK!

1978, I am 23 yrs old. Symptomatic. Quality of life was quickly declining. The Bjork Shiley titaniums were the latest and greatest, and thats just what I got! My family and I were informed of the risks of a third surgery, that it should be avoided if possible. Not possible. Again, mid sternal, and I flew through!!! Course, I was 23 years old!!!! I was told it was "good for life", and I suppose in a way it still is. However, a fourth surgery became inevitable. I have never had an infected valve, rheumatic fever, or any of the other things that you would think might invite surgery. However, it would seem I had threadlike scarring across the top of the prosthesis, and a large panus under the prosthesis. I was failing rather quickly.

Dr. Denton Cooley, of the Texas Heart Institute in Houston was my best option. (In mho) He did an entry under my left breast, across my ribs, and up my back! Imagine. It was 21 days in the Unit, and 30 in the hospital, but IM HERE. And it was a fourth surgery!! Thank heavens I opted for the mechanical, as my disease began so early in life that reoperation was inevitable, if I was to survive. He just shakes his head, and calls me a miracle!!

It was clear to me, that longevity of that valve was of optimum importance, IF you are facing the possibility of future operations. I may have provided more information than you would have liked, and if so, I apologize. Know that miracles happen every single day. I wish you the very best of luck. You are on the right track!
mindy jo

 

[Nancy]

Hi Mindy Jo

Hi Mindy Jo

Welcome to the site. Wow! 5 valves-you win the prize! As you have already remarked, there is a wealth of information here for valve patients. My husband Joe is the patient here. He's computer shy, so I do his online research.

Do you still have your Bjork-Shiley valve? Couldn't tell by your short bio. Joe has a 24 year old Bjork-Shiley aortic, cage and ball type. It's still chugging along.

He also has a St. Jude mitral and just had a repair done on it. He's had 3 valve surgeries, 2 thoracotomies and a pacemaker implant.

He had rheumatic fever as a teen. He wasn't supposed to live past 50, but here he is at 70 still fighting his major battles.

The people here are wonderful, and most of all they "get it". There aren't too many people who you can talk to about these problems, they just don't understand.

You'll love the site.

 

[Kevin M]

Questions for Mindy Jo

Questions for Mindy Jo

Hi, your situation is so unique, I hope you don't mind if I ask you a couple of questions publically like this.

I am interested to know which valves you've had replaced. You mentioned the AV early on. Is it your AV that they keep operating on, or did you have several replaced?

What was the reason for the unusual entry across ribs and up back?

You mentioned in a separate post that you had a fifth valve. What is the purpose of this valve?

I can see how someone like yourself would be a huge fan of the mechanical valve.

Your strength and attitude are admirable.

If you are more comfortable responding privately, please private message or email me. I feel like I've kind of cornered you here and I certainly did not mean to. It's just that your situation is so unique, I'm sure I'm not the only one who is so curious.

Thanks,
Kev