Second Time Valve Decision

[ddarsch]

I chose a porcine mitral valve in Nov 1991. I have had 11 wonderful years, and have been told that my valve is now starting to deteriorate.

So, I must go in for surgery again. I would love to find someone who chose a biological valve, and then required surgery a second time - whether they chose a biological or mechanical the second time

 

[srwieland]

I too am now faced with that decision but am not sure what my choice will be.

I just spent several days (5/16-18) in the hospital again due to another near fainting episode and increasing symptoms of CHF that landed me in the ER. They did an echo and my heart is enlarging again. My meds have been increased and multiplied to stave off the inevitable as long as possible.

I meet my surgeon and cardiologist this week for follow-up to discuss when to have surgery and what valve to choose. I may have to go with the mechanical although I much prefer tissue. But, since my SynerGraft valve seems to be biting the dust, I may not have much choice.

However, I seem to remember someone on this site relating info/experience about problems associated with implanting a mechanical valve after already having had a homograft implant. Does anyone out there remember that or have any information about it to share with me?

Thanks,

Steve

 

[bruizer]

Hey Steve,

I am so sorry to hear about your latest developments. As I mentioned before, both of the surgeons I talked to recommended tissue valves based on my active life style. One recommended the synergraft. The other recommended a homograft. Both are world renowned heart suregons. My cardiologist, who recently passed away, also recommended a tissue valve. However, his son-in-law who is now my cardiologist (we played high school football together) recommended a mechanical. So, I am still undecided. Neither surgeon indicated that there would be a problem if I decided to go with a mechanical. In fact, one said replacing the aortic valve with a mechanical was much easier.

At any rate, I will see if I can get some more info regarding this from my surgeon. You'll will be in my prayers.

God Bless.

 

[Gail in Ca]

My porcine valve also lasted 11 years. I wish it would've been more!
I got a mechanical to replace it as my cardiologist did not want me to go thru a 3rd surgery. But in life, things don't always go like the doctors want. My mitral valve is leaking and couldn't be replaced during my AVR, since the surgeon felt I was too sick. So, I take cozaar to hopefully keep me from having to deal with the mitral valve. If I need it replaced in the future my surgeon said he would do it thru the rib not the sternum. But, it would still be a 3rd surgery.
I try not to even think about it, since it seems very risky to have valve surgery with a mechanical already in place and needing blood thinners for that.
After only 2 yrs since my mechanical, I don't even want to go there.
Gail

 

[srwieland]

Thanks, bruizer.

Looks like we're in very similar situations. Keep me posted on your surgery plans and valve choice. I'll do the same. I should have an update soon after meeting my surgeon and cardiologist.

Take care,

Steve

 

[sylviayasgur]

hi steve!
i'm so sorry you are going through this. how frightening to wind up in the hospital like that.
you are in our thoughts and prayers. please keep us posted as to what you decide to do and when. wishing you all the best,
sylvia

 

[srwieland]

Thanks sylvia,

I spoke to my surgeon today. He says my heart size is now back where it was before my first surgery, so we will probably be scheduling the resurgery soon.

I will probably go with the mechanical. He says that it would be more difficult to do another homograft, since he would have to remove everything to implant it, whereas the mechanical can just be inserted into what's there.

I must admit that I'm a bit depressed about it, but, on the other hand, my symptoms are increasing to the point where I'm afraid to continue like this.

I've been having a very difficult evening ever since I left work. I could hardly make it to my car in the parking garage and had to rest with my seat reclined for 15 minutes before driving. Since I've been home, I haven't felt well at all; very woozy and fatigued, even while lying down. I think I have some slight edema in my ankles and legs.

This is no fun and so I'm beginning to welcome the idea of going through surgery again to remedy it. I just hope things go better this time.

Thanks again to you and all my heart buddies for your encouragement and support.

Steve

 

[Renee L]

Hi, Steve. Sorry about your difficulties. As much as I've seen and read these last few years, I'm beginning to think that either valve is basically a coin toss. I had a Carpentier-Edwards (bovine tissue) valve in July 2000, and at a checkup 4 months later, it had a small leak (2+). Hmmmm!!!! So I'm kind of back where I started at the beginning of all this- we'll watch and wait and see what happens.

I decided to do the bio valve because of the blood thinners, but so many people have posted that it's really not that big a problem. At least, I'm beginning to think the mechanical may be a bit more reliable, but I guess it's really a crap shoot - speaking of which, I'd like to go to las Vegas, too!!!!

Good luck with whatever decision you make. We'll look forward to hearing from you soon.

 

[srwieland]

Hi Renee,

Sounds like there are a few of us in this same boat of having to have resurgery after a relatively short time. It's really frustrating being back to square one after having gone through such a major surgery.

Crap shoot it is! I've never been a gambler, but I gambled on this one and, sure enough, lost. If I go to the reunion in Vegas, don't expect to see me on the slot machines! Never had the luck for it.

Oh well. I guess we should just be glad we have the opportunity to have this surgery and any of the available valves, since none of this was possible a short time ago. When I was born (1950), none of these options were available.

Good luck with your choice. I'll keep you posted on mine.

Thanks,

Steve

 

[srwieland]

By the way, I do intend to vote in this poll at some point, just have made the definitive decision yet.

 

[ddarsch]

Steve/Bruizer/Gail/Sylvia/Renee/Fred

I thank you all so much for sharing your experiences.

At 45, if I go biological, then I will be facing a third surgery in my 50's (good Lord willing). I am certain that I will go mechanical then (I do not want to risk a 4th), but I am still undecided now.

I am leaning towards another biological - but will have another 30-60 days to decide - I am still asymptomatic with mild-moderate leakage

 

[ddarsch]

Best of luck - Steve

Best of luck - Steve

Hi Steve:

It sounds like your decision and surgery are much more imminent than mine. I am happy for you that you are getting stronger for the procedure.

Either decision is a good one - they both give the gift of life.

If you ever want to talk on the phone, let me know and I can give you a call (there is a six-nine hour time difference, so early morning your time is best for me)

 

[ddarsch]

Gail - what did you think when you changed from porcine to mechanical

Gail - what did you think when you changed from porcine to mechanical

Gail:

I am sorry to hear about the problem with your mitral - stay strong and positive, each of life's twists seem to always contain "good and bad".

Your situation seems so similar to mine - I am happy that you had 11 years from your porcine. From what you said, it was two years ago, but what was your assessment of the life-style changes after the porcine - did the new 'click' bother you?

Dave

 

[srwieland]

Thanks Dave.

I really appreciate your perspective, encouragement, and support.

There's nothing like a heart buddy who's going/gone through similar experiences!

I have fond memories of Spain, having traveled there often in the late 70's and early 80's. It would be a great place to recover from valve replacement surgery!

I'm feeling much better today. My symptoms seem to wax and wane quite a bit. I am becoming serious about scheduling my surgery, though, perhaps as early as June.

I'll keep y'all posted.

Steve

 

[Gail in Ca]

Hi Dave,
Hmm did the click bother me? OH yeah, big time.
Does it still, after almost two years, yes occationally it really sounds so loud. Like, in the middle of performing with a wind symphony, I hear it and wonder if the players next to me can hear it, but only in the soft sections of music.
Sometimes I am bugged by it and surely wish I could've had a different quiet valve.
But these feelings are slowly going away. Maybe because I am a musician, the clicking just bothers me more. It is becoming part of me, and for the most part, no longer feels foreign.
About the only lifestyle changes have been to stop snow skiing as I feel the risk of me falling and bruising or breaking would be too great.
I really bruise easily now, and always have a few 1" diam or bigger , mostly on my legs. I have had some doozies, like 3" in diam and really ugly.
I now use saline nasal spray daily to keep the bleeding low in my nostrils. This is a side effect of the coumadin for me.
My first surgery was age 34, second was 46. Just celebrated my 48th birthday and my 20th anniversary, and am so glad to be as healthy and happy as I am.
I know you have a big decision to make.
My cardiologist really did not want me to go thru a 3rd surgery, but the surgeon didn't seem too bothered by the fact that I might need another or he probably would've taken the risk and replaced my mitral during my last avr. Maybe because it will be on another valve so no scar tissue issues there, I don't know.
Hope this helps,
Gail

 

[Jean]

Next time!?

Next time!?

As I sit here with my homograft working just fine, thank you, after two and a half years, I think I would again choose a bio. I am so paranoid about coumadin. My mother-in-law takes very low doses of it for an artificial hip and has had untold problems with other drug interactions for her arthritis and now heart problems at 86 she is having more and more problems. I may change my mind if this valve has problems early, but I am counting on a long relationship with this guy! A friend's brother has a 21 year old porcine!

 

[greggo32]

How are you?

How are you?

Dear Steve,

My name is Greg Golden and I live in Boca Raton. I underwent a mechanical valve implantation in the aortic position about 7 weeks ago. I have been to many doctors and conducted my fair share of research. I have spoken with several surgeons and cardiologists in NY, Chicago, LA, Miami, and Cleveland. As a VR member, I am here if you want to talk. My cousin is a cardiologist in Chicago and my father is an MD of 50 years. Let me know if I can be of any assistance.

Truly,

Greg Golden

 

[ddarsch]

Gail - I am feeling real similar

Gail - I am feeling real similar

Gail:

My first surgery was at 34, it appears that my second will be at 46, the first was a porcine, the second (that is the decision) - last month, I celebrated by 23 anniversary.

I am leaning to bovine because I am extremely preoccupied (and scared) that the click and the life style changes will be too much for my personality - as you can imagine, I am consumed with the decision just as I would guess you were.

I will have a Trans esophegeal on the 21st of June, then I will know the leakage, set the date, and make the decision.

I would love to talk to you, send me an e-mail if you would like to chat, and we can set a time. My e-mail is [email protected]