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AlanC

I am 41 years old and going in for a Aortic valve replacement in June. Prior to visiting the Cardiothoracic Surgeon scheduled to do my surgery i had only really been considering a mechanical valve due to my age and my pre conceived idea of the length tissue valves last. ( Around 7 years in the medical book i have ).

However whilst not advising me one way or the other he did suggest i didn't discount the tissue valve out of hand. He also advised me that his preferred choice of tissue valve is using Bovine Pericardal tissue rather than porcine.

I just wondered whether anyone can tell me more about the Bovine type valve and its longevity.

My other concern is if i go the mechanical route is the effect using Warfarin will have on my body over what i would hope will be another 40 plus years !!. Up till recently i had still been playing Football and running every week as well as the odd walking weekend. I hope to still keep up these activities following the surgery and wondered which if either had any effect on this ?
 
Hi Alan and welcome to VR

If you go with tissue, Bovine would be the choice as they last much longer then Porcine. 15 years or so. If you choose mechanical or for some reason or another end up with the mechanical, the Warfarin has been taken by some members here as long as 35 years and they've had no problems with it.

I just had my second surgery last July and had a St. Jude mechanical put in. I have no desire to go through this type of surgery anymore. Being the mechanical valve, I would hope that I wouldn't have to worry about it any longer. There is always that possibility though.

If you take Warfarin, Football would be one thing that you really wouldn't want to participate in anymore because of the risk of serious injury and bleeding. Mainly head-shots that could cause an intra-cranial bleed. Some people still play anyway, but you must realize the risks and decide if it's worth it to you. Don't stop living because of Coumadin!

You can check out Al Lodowick's site at www.warfarinfo.com and get most of your warfarin questions answered there. He is also a member here and helps in the Coumadin forum.

See Peter Easton's thread below for valve information.
http://www.valvereplacement.com/forums/showthread.php?s=&threadid=304
 
Hi and welcome so glad you found us. I had my surgery at age 49 and choose a homograph. Had serveral reasons to choose this kind of valve. It is true that in 10 year or longer I will have to have it replaced. By that time I'm sure there will be all sorts of new changes. One reason was that I wanted to do things that those on coumiden have to be careful about. I take a baby asperin a day that's it. Good luck with you decision. martha
 
Welcome to our world Alan !

The Bovine Pericardial Valve manufactured by Carpentier-Edwards *was* my first choice because of it's longevity and avoidance of Coumadin. Unfortunately, my surgeon elected to install a St. Jude Mechanical Valve (which is an EXCELLENT mechanical valve) due to other considerations once he 'opened me up'. There are times I still wish he had stayed with my request.

Data I have seen on the Bovine Pericardial valve is that longevity numbers are 90% at 15 years and counting which means that 90% of the valves installed 15 years ago are still working just fine. If I remember correctly, the first experimental Bovine Pericardial Valves came out about 20 years ago. The Bovine Pericardial Valve is highly regarded by Dr. Cosgrove at the Cleveland Clinic which is the #1 rated Heart Hospital.

I understand there have been some small percentage of 'early failures' that required replacement within a few years.

Coumadin patients are urged to refrain from 'contact sports' and other activities which could result in trauma to the body. One surgeon suggested there is a cumulative chance of bleeding events with Coumadin. I've not heard or seen that mentioned anywhere else. Perhaps the improvements in monitoring and the use of INR as the monitoring standard have reduced or nearly eliminated this risk factor.

I've been on Coumadin for 11 months now with no problems. I live in the country and get a LOT of bumps and scratches but never experienced any unusual bruising or bleeding.

'AL'
 
I just recently had my valve replaced with the Bovine. As others have said over 90% have lasted 15 plus years. Some think it my last well over 20 years, but who knows? I'm pretty active and still plan on playing basketball once I recover fully.

I also asked both of my doctors and they said they would go with the bovine, but their reasoning was that surgery is no big deal and they have it down to a fine art. Now remember, they have never had their chest cut opened. I had and still decided to go with the Bovine and know I will go under the knife a third time down the road.

What ever you decide in the end... will be the right choice, because what we all have in common no matter what valve....were all here talking about our valves.
 
Hi Alan-

Welcome to this great site. There is so much to learn here. My husband is the patient here, and he's had 3 valve surgeries and 2 lung surgeries, has a pacemaker and has a whole truckload of other very significant medical problems. But he's still here and "going and doing".

His valves are mechanical and he's been on Coumadin for 25 years. Football would probably have to be avoided with Coumadin because of the risk of serious internal and external injuries, but other than contact sports or other risk taking things, things are about normal when on Coumadin.

He's never had a bleeding incident that has been attributed to Coumadin. It is kept under good control, and he is strict with how he takes it,

Valve choices are quite personal in nature, but when you are thinking about your decision, please weigh the added stress on the body of additional heart surgeries. Each one takes its toll and you don't bounce back as easily with the additional ones, as you do with the first. They are significant and difficult surgeries. Also there is no guarantee on the longevity of any particular valve, only track record standards. The mechanicals do have the longest lifetime, maybe for the rest of your life.

Joe's aortic is 25 years old and still doing OK.
 
Hi Alan,

Like you, I was not interested in being on Coumadin for the rest of my life. I chose to go with the Bovine valve. My surgeon told me there is evidence coming in that these valves may last as long as 20+ years.

I'm 43 yrs old so I know I'll need at least one more surgery, but I think by then (as does my surgeon) the procedure will be much, much more common than it already is and much more simplified and pain free.

Good luck. Tim
 
Aortic stenosis

Aortic stenosis

Hi, I'm new here. My wife has A/S. Other than valve replacement is there anything "natural" which we can do??????

When does the fear and crying stop?
 
Hi mar-kadam-

Welcome, this is a wonderful site for those in the situation you both are finding yourselves.

There is nothing natural that one can do if surgery is needed. Aortic stenosis does not get better. The only way to take care of it is with surgery. There might be some medications that the doctor could prescribe to help with some of the symptoms, but eventually, in most cases, surgery is needed.

It is the most natural thing in the world to be frightened and worried when first getting this kind of diagnosis. It has happened to almost everyone here on the board, or like me, their loved ones.

The first thing to know is that surgery is done to save your life. Years ago when people had this condition, they didn't survive. But today the surgery is highly perfected, has a low mortality rate and the outcome gives you back your life.

The surgeons who do this are very dedicated and extremely well trained and skilled. They operate on hearts almost every day and sometimes more than once. Everything that is in there, they have seen before, and know how to fix.

The surgery is about what you would expect from major surgery, as far as the pain and recovery. But the pain medications used are very good, and hospitals strive to have it be as painless as possible, because they want you up and walking about the second day after surgery. Believe it or not, most people go home in 5-7 days. Pretty impressive, I'd say.

The very best thing you both can do right now is to read, read, read as many posts here as you can. It's hard at first because it's scary, but as you continue on, you will gain much knowledge and the fears will start to fade away.

You both will also have all the support and cyber hand-holding that you wish. This is a most supportive board and you will feel very comfortable here. We all understand what you are feeling and facing. It's a place you can come to vent, express your fears, and ask lots of questions. After things get straightened out for you, you will be in a position to help other scared newbies. This is a positive place, a good feeling place.

I wish you all the best. Please come in often and post often, but most of all start reading about the nature of the surgery.

I can relate to your position, because I am the wife of a three time heart valve surgery patient.
 
Listen to Nancy

Listen to Nancy

She's incredibly knowledgeable and supportive. Check other threads and topics. I think you'll be amazed at the breadth and depth of knowledge here.

As I related in other threads, this is my second major health crisis - I had cancer 13 years ago. And it wasn't a great prognosis, so the first milestone was 5 YEARS, then 10 YEARS, before I could honestly feel that the original tumor wouldn't recur. I had three surgeries, 6 weeks of radiation, and 3 months of chemo. Although none of those treatments was as strenuous as open heart surgery, if I had to do it over, I'd take OHS any day.

At least you know if the problem can be solved and how and when. It's not dragged out. So you need to be as positive as possible for your wife; print out some of the information on this site and leave it around for her to find. She'll start checking it out when she's ready.

If she needs to communicate with someone directly for reassurance, she can sure start with me or Nancy; or look on the personal stories for someone with AS.

Good luck and keep visiting.
 
Hi Alan, I just had my aortic valve replaced with a mechanical valve on 4-21-03. I am 52 and did not want to have this done anytime soon. I am on coumadin and so far have had no bad results. I am a firefighter and my doctor tells me I will be able to go back to work. The valve I have is a St. judes. Thanks Dave
 
Thank you for all the advice & Support. It certainly makes me feel happier about the forthcoming Surgery and also the effect this Surgery will have on my life in the years to come. Until I found this site I didn't appreciate quite how common it was, and it has cetainly lifted me reading about the many successes.

After looking at both types of valve I agree that both appear to offer a good way forward and I could be happy with either. However for myself i have opted for the Bovine Tissue choice, for much the same reasoning mentioned previously by Tim.W

I'll let you know once I am out . Not long too go !! . Had my
Pre-op meeting today and the Surgery is due to take place next Wednesday, 4th June.

Cheers for now

Alan
 
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