S
spillo
Hello Everyone,
I am spankin' new to this wonderful web site. I have read many replies, many opinions, facts and experiences. I have done much research and have finally decided on a bovine pericardial aortic valve. I am 48 and will be driving up to Cleveland in about 3 weeks to let Dr. Cosgrove have at it.
I worked at CCF from 1980 to 1990 in the Dept. of Artificial Organs. We designed, fabricated and implanted artificial hearts in calves back then ( calves had a chest size close to a adult male in case your wondering on animal model choice ). We did a million other projects but the artificial heart lends itself best to my helping my decision.
One model we used was made out of titanium. Until the interior was coated with a protein layer it threw clots and sheared red cells at a high rate. The calves also had to be kept anticoagulated. If there was a clot there was a stroke. Too many red cells breaking (from the mechanics of the heart) was not good for the kidneys. Too much or too little anticoagulant causes problems we are all aware of.
When we took protein and cross-linked it using gluteraldehyde the subjects tolerated it much better. It was more natural, smoother corners, less anticoagulant, less hemolysis.
I feel the same way about the St. Jude or others mechanicals versus the tissue valves. Tissue valves are more natural. Bovine pericardium is treated with gluteraldehyde. The protein is then formed into a valve not too unlike the one that took millions of years to perfect and has gotten me 48 years with structural defects and calcium layering on.
In tissue valves there are less corners where flow patterns can change like around pivot points, or where flow can stagnate and form cell globs. This can create embolisms. Plus no need for anticoagulants is nice.
Bad problematic events with anticoagulation over a 15 yr. period occur at the same rate as severe problems with 2nd surgeries, about 2-3%.
I looked at a web site for valve sales people. You know the guys in the suits or in the scrubs that sell valves to hospitals. They say mechanical valve sales are losing 3% per year while tissue valves are picking up as much. There has to be a reason.
I have 4 sisters who are nurses. One of them went to a meeting last Wednesday and spoke to the head of cardiac surgery at the Mayo Clinic. I'm sorry I forgot to ask her his name. But he is 46 and he told her if he needed AVR surgery at his age he would go with tissue. That is when he told her about the problem rates I mentioned earlier.
Another of my sisters worked for years at the Cleveland Clinic in Cardiac surgery. She said she would take a second surgery over coumadin any day. She has seen problems with both and when things went well with both for years.
Now I own a medical lab in Southern Ohio. I can get pt/inr's for free whenever I show up for work. But I also draw people or see my clients come in to be checked. We average 50 or so pt/inr's a day. Some inr's are pretty out of whack. Some people are pretty bruised. Alot of people don't like coumadin. It is a powerful drug, not just a pill you have to remember to take.
I also have my own unfounded problems with mechanical valves. I don't like noises. I have super sensitive hearing and terrible eyes. I don't like the idea of having something as rigid as steel and carbon in my heart when I can have soft protein "tissue" in there. I feel there is a "crush" factor to deal with. Like a seat belt in a car wreck pushing on the carbon and bruising the heart. ( I said they were unfounded ! LOL ).
I also think medical research is spending more on biomedical research than it is on mechanical engineering. In other words I think changes in tissue or homograft durability will occur before they figure out how to put steel in your heart without clotting.
Finally, I want the chance to have a new model. Why buy a car now and listen to an 8 track forever when you can lease one and look forward to xm radio?
This is such a great site. Everyone is kind and have a wealth of info. they share with others. Thank you for allowing me to express my views. Everyone is different. It has been said over and again here but it really is true. Whatever you decide is right for you. My journey has been much easier with this website and with all of you. Thank you.
Spillo
This is my first post I am sorry if I included errors
I am spankin' new to this wonderful web site. I have read many replies, many opinions, facts and experiences. I have done much research and have finally decided on a bovine pericardial aortic valve. I am 48 and will be driving up to Cleveland in about 3 weeks to let Dr. Cosgrove have at it.
I worked at CCF from 1980 to 1990 in the Dept. of Artificial Organs. We designed, fabricated and implanted artificial hearts in calves back then ( calves had a chest size close to a adult male in case your wondering on animal model choice ). We did a million other projects but the artificial heart lends itself best to my helping my decision.
One model we used was made out of titanium. Until the interior was coated with a protein layer it threw clots and sheared red cells at a high rate. The calves also had to be kept anticoagulated. If there was a clot there was a stroke. Too many red cells breaking (from the mechanics of the heart) was not good for the kidneys. Too much or too little anticoagulant causes problems we are all aware of.
When we took protein and cross-linked it using gluteraldehyde the subjects tolerated it much better. It was more natural, smoother corners, less anticoagulant, less hemolysis.
I feel the same way about the St. Jude or others mechanicals versus the tissue valves. Tissue valves are more natural. Bovine pericardium is treated with gluteraldehyde. The protein is then formed into a valve not too unlike the one that took millions of years to perfect and has gotten me 48 years with structural defects and calcium layering on.
In tissue valves there are less corners where flow patterns can change like around pivot points, or where flow can stagnate and form cell globs. This can create embolisms. Plus no need for anticoagulants is nice.
Bad problematic events with anticoagulation over a 15 yr. period occur at the same rate as severe problems with 2nd surgeries, about 2-3%.
I looked at a web site for valve sales people. You know the guys in the suits or in the scrubs that sell valves to hospitals. They say mechanical valve sales are losing 3% per year while tissue valves are picking up as much. There has to be a reason.
I have 4 sisters who are nurses. One of them went to a meeting last Wednesday and spoke to the head of cardiac surgery at the Mayo Clinic. I'm sorry I forgot to ask her his name. But he is 46 and he told her if he needed AVR surgery at his age he would go with tissue. That is when he told her about the problem rates I mentioned earlier.
Another of my sisters worked for years at the Cleveland Clinic in Cardiac surgery. She said she would take a second surgery over coumadin any day. She has seen problems with both and when things went well with both for years.
Now I own a medical lab in Southern Ohio. I can get pt/inr's for free whenever I show up for work. But I also draw people or see my clients come in to be checked. We average 50 or so pt/inr's a day. Some inr's are pretty out of whack. Some people are pretty bruised. Alot of people don't like coumadin. It is a powerful drug, not just a pill you have to remember to take.
I also have my own unfounded problems with mechanical valves. I don't like noises. I have super sensitive hearing and terrible eyes. I don't like the idea of having something as rigid as steel and carbon in my heart when I can have soft protein "tissue" in there. I feel there is a "crush" factor to deal with. Like a seat belt in a car wreck pushing on the carbon and bruising the heart. ( I said they were unfounded ! LOL ).
I also think medical research is spending more on biomedical research than it is on mechanical engineering. In other words I think changes in tissue or homograft durability will occur before they figure out how to put steel in your heart without clotting.
Finally, I want the chance to have a new model. Why buy a car now and listen to an 8 track forever when you can lease one and look forward to xm radio?
This is such a great site. Everyone is kind and have a wealth of info. they share with others. Thank you for allowing me to express my views. Everyone is different. It has been said over and again here but it really is true. Whatever you decide is right for you. My journey has been much easier with this website and with all of you. Thank you.
Spillo
This is my first post I am sorry if I included errors
