Valve choice for 23 yr old active male

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...... is it possible to get a mechanical valve replaced with a tissue valve? If my mechanical valve decides to break down when I am 50 or 60 or 70 can I get it replaced with a tissue valve? Has anyone ever done this on this forum or does anyone know someone that has done that?

P.s. Thanks for adding me to the calendar Greg. It feels good to be a part of the family.

I believe there are cases where a mechanical has been replaced with a tissue for a variety of reasons and, hopefully, someone will address this for you........and me. I have also thought of the valve type I would select if I needed a reop at my age. I would likely choose a tissue valve to stay off warfarin in "old age".....and I understand that the switch from mechanical to tissue would present no additional problems beyond what could be expected with any major surgery on an old man. However, it is becoming more and more likely that my current valve will never need replacing.....so hopefully that is a "what if" I may never have to address.
 
Hey all,

Thank you for all of your support and help. I think I want to go mechanical because I don't know if I want to go through another open heart surgery so soon. I can at least have better odds of avoiding a re-op with a mechanical valve. Based on what most people have said the coumadin does not seem like the monster that some people make it out to be. It makes me feel better seeing the people on this forum that have been taking coumadin for a long time and have no or had relatively few bumps in the road. But, is it possible to get a mechanical valve replaced with a tissue valve? If my mechanical valve decides to break down when I am 50 or 60 or 70 can I get it replaced with a tissue valve? Has anyone ever done this on this forum or does anyone know someone that has done that?

P.s. Thanks for adding me to the calendar Greg. It feels good to be a part of the family.

Yeah i had a mechanical valve put in when i was 13, and taken out and replaced with a tissue one when i was 17, so it is possible :)
Love Sarah xxx
 
But, is it possible to get a mechanical valve replaced with a tissue valve? If my mechanical valve decides to break down when I am 50 or 60 or 70 can I get it replaced with a tissue valve? Has anyone ever done this on this forum or does anyone know someone that has done that?

It certainly is possible although usually not because of a mechanical valve "breaking down" but other complicating factors such as endocarditis and pannus development. In any case, it is still very low odds overall that a mechanical valve will need replacing. I actually asked my surgeon a somewhat crazy but similar question: is it possible to get a mechanical valve at a young age then elect to replace it with tissue later, even if there were no problems requiring that replacement? In concept, I thought the idea had some merit, since potential mechanical valve/anticoagulation complications such as stroke and hemorrhage are much more common at older ages, and tissue valve longevity is very much more of a gamble at a young age. Anyway, my surgeon said it had happened once in his career (over 35 years) and the problem isn't the replacement, it's having it covered by insurance!

I chose tissue pretty young, but was 12 years older than you. At a young age, the tissue-reop-tissue route is not easily imagined as the best long term option based on present day facts, hope has to enter in instead. Perhaps it might buy time for future advancement in valve technology, perhaps it might buy time for easier surgery methods available to all. But that's a big risk to take. You know, I could make a pretty good argument for either valve choice at nearly any age, but at your age, I would be much less inclined to do so.

Glad to hear you already seem to be coming to a conclusion, and you should be well positioned for a very normal long-term future with minimal impact from anticoagulation. You've also found a great resource for any questions that do come up for managing ACT over time. I too am very impressed with how well you seem to be handling this...life is crazy enough as it is at the age of 23. Best wishes to you for the surgery and a smooth recovery.
 
I am 64 but 6 years ago also had a tissue valve...homgraft implanted at Cleveland Clinic. It lasted just 6 years and I am undergoing a second surgery on March 22nd at Shands hospital of UF, in Gainsville. I was told this earlier valve might last 15 or 20 years by the surgeon which was not the case and learned Shands stopped implanting homografts 10 years ago becasue of high failure rate. I am very upset about this reop but have chosen the On-X mechanical valve which I hope will last the rest of my life. I am part of a clinical trial which will be using aspirin and another drug, rather than coumidin. I would think carefully about the tissue valve route.
 
I am 64 but 6 years ago also had a tissue valve...homgraft implanted at Cleveland Clinic. It lasted just 6 years and I am undergoing a second surgery on March 22nd at Shands hospital of UF, in Gainsville. I was told this earlier valve might last 15 or 20 years by the surgeon which was not the case and learned Shands stopped implanting homografts 10 years ago becasue of high failure rate. I am very upset about this reop but have chosen the On-X mechanical valve which I hope will last the rest of my life. I am part of a clinical trial which will be using aspirin and another drug, rather than coumidin. I would think carefully about the tissue valve route.

Hi Dale,
Whatever decision you make will be the one that feels the very best in your gut. However, I just wanted to chime in that a homograft is not the same type of tissue valve that many of us have chosen as of late. A homograft is harvested from a cadaver but most of today's tissue valves are created from the tissue of a pig, or cow, or in a few cases a horse. I have a bovine valve and since there are few study papers around that are relevant to this generation of bovine valve I am happy with the valve and comfortable with the knowledge that I may or may not have to have another OHS. So read, ask questions of us and your doctors then step into whatever decision you make and don't look back cause whatever valve you get will give you more life to live as opposed to the alternative of doing nothing and eventually dying. Best wishes to you on your surgery day.
 
Hi Dale and welcome to the family.

My surgery to replace a very stenotic bicuspid aortic valve was 10 days ago. More importantly, the surgery was very successful and I feel great. I’m 52 and I chose a mechanical valve because I don't want to go in for another OHS in 8-10+ years. But as everyone else has commented, the choice between mechanical and tissue is purely personal.

One thing that really amazed me during my surgery and recovery was I met two people in their 80's who were in the hospital for OHS - one was replacing an aortic valve (with tissue) and the other was a quadruple bypass. They both made it through with flying colors and are feeling like new again. It just goes to show that advancements in science and technology continue to expand the possibilities and redefine what can be done.

You'll be in our prayers on the 27th. Please keep us posted on how things go so we can join the celebration.
 
Difficult choice.....

My initial choice was for tissue valve and just felt it was what I had to go with. I was told possibly 20 years with new generation valves. I figured it would give maybe 8-10 good years and thought that would be worth it as it could mean 8-10 years of trouble free living. Now 8 months later I already had my 2nd OHS and have a mechanical valve. Off course I am bummed out about it but still don’t regret my choice. There are no guarantees anyway. Some tissue valvers need to be on warfarin anyway and some mechanical valvers need re-ops as well.

I was on warfarin the first 3 months with the tissue valve, when the tissue valve was found to be failing and now again with the mechanical. It is not necessarily a big deal to be on warfarin but my hobbies were boxing and motocross. I rather had continued to do them but then again there are so many other things that I want give a try as well.

Good Luck...
 
Hi,

I had a tissue valve put in 10 years ago (next week) and it's giving up the ghost. I'm hoping to have an On X valve replacement later this year (hopefully sooner rather than later). At the time of sugery it was suggested I'd get 15 -20 years, but has not been the case. From what I have gleamed 8-10 seems to be the lifespan. I'm not particularly upset about the shorter time. I'm grateful for the 10 years I got and am very much looking forward to having the replacement surgery and reclaiming my life (as I certainly feel symptomatic now).

All the best.

Phil.
 
Hi Dale,

My step son (12yo) had his aortic valve (and mitral), and Ascending Aorta replaced last November. It was all done with On-X (well, maybe not the ascending aorta), and the Aortic root was left intact. Do some research on this. Some people feel strongly about having the aortic root replaced in the whole scheme depending on your measurements, but other people (and surgeons) don't like replacing the aortic root unless absolutely necessary. We went with mechanical (On-X) because it seemed the best, and the surgeon only will use On-X in young patients - he feels re-surgery is way more risky than warfarin, especially with the chance of lower doses possible after the study is finished. All this to say that after all my tremendous research, mechanical with warfarin definitely seemed like the best option. Again, it depends on your lifestyle and choices most of all, so you need to make that choice for yourself. Best of luck, and WELCOME!
 
It sounds like you have already made up your mind on a valve (good choice by the way). As far as the coumadin goes, I have zero problems with it. The doctor may tell you that you can't eat anything green like spinach or Brocolli because it offsets the medication. It has been my experience that as long as I eat the same amount of green stuff everyday then I am fine. The doctor just put me on a higher dose (7.5mg) of coumadin/Warfarin.

You raise a good point though........ what about the effects of blood thinners when we get older? Chances are Coumadin will be replaced with something else by then and you have a hell of a long ways to go my friend before you have to worry about that. Also, my very simple non-medical understanding is that blood thinners are used to treat many other issues besides just heart valve issues, so you may be on them anyways.
 
Seems as if I'm chiming in pretty late to this post, but it's nice to finally come across someone who is in a very similar situation as myself.

Dale, I am 24 and I found out August 2011 about my BAV and have the exact same concern as you. I have not been told I need surgery just yet, but I will be finding out more information on my next appointment in just a couple of days.

I was told the a mechanical would be best since I am young, but I too was concerned about the effect coumadin would have on my lifestyle.

Best of luck to you and I look forward to hearing about any upcoming news and information you will have.
 
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