valve choice with ascending aorta replacement?

[lmazur]

I'm new to this forum. 62 year old female with Marfans that just found out I need my aortic valve and ascending aorta replaced. Do I have a choice between tissue or mechanical or since they will need to use the dacron on my ascending aorta, does it have to be mechanical?

 

[Lynlw]

I'm new to this forum. 62 year old female with Marfans that just found out I need my aortic valve and ascending aorta replaced. Do I have a choice between tissue or mechanical or since they will need to use the dacron on my ascending aorta, does it have to be mechanical?

Hi welcome, you should have a choice you can have either valve type witha graft

 

[Superbob]

Welcome to the forum! I was 63 at the time of my surgery, and had the aortic valve and root replacement using a porcine device, the Medtronic Freestyle. I believe you have options -- ask your doctor about them. All best to you!

 

[lmazur]

I haven't talked to the surgeon yet. I thought since they have to use dacron on the ascending aorta, that might dictate that they must use a mechanical valve. Thanks for the insight.

 

[Julian]

I haven't talked to the surgeon yet. I thought since they have to use dacron on the ascending aorta, that might dictate that they must use a mechanical valve. Thanks for the insight.

From my understanding you can choose tissue or mechanical with a dacron tube. In fact I know you can but talk to your surgeon for absolutes.

 

[Superman]

You can definately get a tissue valve and dacron graft as many posters on here have that and I also have a fried at home who has that same set up.

Can't speak for your surgeon and what they're willing to do or would prefer.

I also don't know if you can get a one piece valve/graft in tissue like you can with mechanical.

 

[bbuck]

I will be getting a tissue valve with the dacron ascending aorta graft in May. Its not a one piece, but they will sew the valve to the dacron tube first, at least thats what my doctor said he'd be doing anyway.

 

[Tom Berning]

lmazur,

The only difference is you can get a mechanical valve with the Dacron graft already attached, if you go tissue then the surgeon has to stitch the valve to the graft themselves. So it's a bit less work for the surgeon to install the combo unit, but I know my surgeon told me he was happy to do that if I wanted him to.

Tom

 

[lmazur]

Thanks to everyone for responding. This is all very new to me but from what I have read so far, I am leaning towards tissue valve. I would like to avoid the coumadin if at all possible. Is there no need for coumadin when you have the dacron graft and tissue valve? I followed a vegetarian diet for 20 years and the need to monitor my green vegetable intake is something I don't want to do. Seems silly considering the life altering surgery I face but when I'm on the road to recovery, I'd like my life to return to somewhat normal again. I'll talk to the surgeon at the CCF in March. Any recommendations on surgeons at the Cleveland Clinic from anyone?

 

[Sarah_Louise]

Welcome to the boards,
Here in the UK when we have a valve replacement, whether it was tissue or mechanical we are put on warfarin, (tissue valve 3 months, mechanical valve life)
Love Sarah xxx

 

[jklump]

I had the same surgery you are having 1 year ago next week. I didn't know about needing a graft until the surgeon saw something he didn't like on my echo. He ordered a cat scan and saw the problem with the aorta.I went the tissue route with the datascope graft. After the surgery I ask him about additional meds. His answer was "1 full strength asprin a day". No coumidin after surgery or anything else. I was on metrolpol for a short while but off of that after about 6 weeks. Everybody's different , but that's my story.

 

[sarahsunshine]

I understand the concerns of Warfarin and being vegetarian. However, in my experience (and many others on the forums here), that is very unlikely to be a problem. The best thing to do is to "dose the diet" as opposed to changing the diet to fit the dose.

A bigger concern for me would be if osteoporosis ran in your family or you already had signs of low bone density. Warfarin interacts with Vitamin K, which is linked to calcium uptake. Some studies suggest a link between increased risk of osteoporosis and warfarin use.

 

[ElectLive]

Is there no need for coumadin when you have the dacron graft and tissue valve?

No guarantee, but definitely most commonly the case. Short term, some surgical centers do still recommend Coumadin for 3 months with a tissue valve in the aortic position, but the majority of places in the US do not. I don't believe an aneurysm graft has any influence either short or long term, at least it hasn't in my experience (Aspirin 81 only from Day 1). My surgeon put it this way: "your blood won't even know the graft is there" after a while, it merges with native aorta fibers/tissue. Now, long term, some people with tissue valves do also end up on Coumadin but not because of the valve, because of other risk factors they might have such as A-Fib. You should discuss with your surgeon if you have any relevant risk factors. But again, big picture, the norm or majority of tissue valve/graft cases involve no Coumadin either short or long term.

By the way, you said aortic valve and ascending aorta, is it definitely all of the ascending aorta including the aortic root that is to be grafted? Some patients (such as me) only have a portion of the ascending aorta grafted. I may have missed it, so just wanted to confirm, since a few of the responses having to do with pre-sewn conduits would only apply if the aortic root is included.

 

[67walkon]

I have a dacro ascending aorta and a bovine valve. They had a pre-built unit, with a porcine valve already in place, but something about the placement or location of my arteries caused the surgeon to do the graft and valve without using the pre-built thing. Everything works fine and I'm not on coumadin.

Good luck!

 

[lmazur]

Met with the surgeon today at the CCF and my surgery is now scheduled for April 16. He will be using a bovine valve and a dacron tube for the ascending aorta. He said once he gets in there, he might be able to repair the ascending aorta and not need the dacron graft and he will be able to do the minimally invasive surgery. This was such good news, I was almost dancing in the halls! I'm ready to get it done and start the recovery process. Thanks to everyone here or all your wisdom.

 

[escargome]

Well good then. On to the next step on your road to recovery. April 16th is not to far away, so time to get your things together (see sticky on tips for getting ready for surgery) Take time to relax and put your mind in the correct frame. With knowledge comes power and with power comes strength so you will climb that mountain and be on the other side with a whole new lease on life before you know it. Best wishes to you.