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jmorganky

Member
Joined
Aug 18, 2011
Messages
5
Location
Florence, KY
Hello All, my name is Jeff and I am scheduled for an AVR and aortic arch repair/replacement on September 2nd. I am sure that it has been covered in here a good bit, but I am scambling to get my life rescheduled and wanted to get as many opinions consolidated in one place as I could. I think that due to my age (44) and activity level, I will opt for the mechanical. I was hoping to get opinions on the different brands and options. Pre-surgical consultation on Thursday and I want to be prepared.

Thanks,
 
ONX is my valve of choice, Do the research and you will see why. In my openion it is superior in every thing , just search this forum and I think you will find it is the number one choice here ! good luck.
 
Have you checked the threads, in the valve selections forums? http://www.valvereplacement.org/forums/forumdisplay.php?16-Valve-Selection There is alot of pretty good info, links to studies etc. Valve choice is pretty personal and not everyone agrees which is the "best' choice, type or Brand. Plus remember for the most part everyone /majority of members here are not in the medical field and so there is ALOT that can go into it we don't consider. BUT it is a very good place to learn about the different choices available and why people like them. For the most part after surgery, everyone thinks theirs is the best for them. Its pretty rare that people wished they had a different type.
 
Hi and Sorry you are anticipating having OHS soon but you've found a great site.

I just want to comment that if you want someone to tell you which valve you should choose, your surgeon would be the best one to do that perhaps in combination with a trusted cardiologist.

Their advice would be more personal to you than from anyone here.
HOWEVER, there is fabulous and extensive information here from those of us who have been where you sit right now. I, personally, have had two OHS and know the only way I could choose for myself which valve was the best choice for me was to do all the reading for myself and then consult with my surgeon.

As has been said, most of us know that once the surgery is over, there is no good in looking 'back'. There, almost always, is not a bad valve choice except to not choose one at all and not do the surgery.

Start reading. It's one of the best things you can do for yourself right now.
And not just about valves........ read about how successful this surgery is and how most of us have such better quality of life after. How the anticipation of this surgery is almost always the worst part. For the majority of us, the surgery is not as bad as we anticipate.

ALL Best wishes.
 
Welcome to a fellow Kentuckian. You will find this forum to be a valuable resource for info and support. At your age, my choice would also be mechanical since this is a surgery that I prefer to have a minimum of times......hopefully, one time. Can't help with valve brands, but mechanical valves have a design life well beyond human life expectancy. My Starr-Edwards valve was finally taken out of production in 2007(?), after nearly fifty years of use.

My life with an "artificial valve" has been near normal. Very little impact on life style or activity. Warfarin(coumadin) is not a problem, but does require maintaining a simple protocol of taking the pill as prescribed and testing routinely. Warfarin, for me, has been a very predictable drug.....but it can bite you:eek2: if you screw around with it.
 
While everyone here advocates that patients should be actively involved in these types of decisions, I submit there are major limitations to patient involvement in the selection of the replacement valve. In my experience, it became evident that the surgeon would make the final choice based on factors far beyond my control.

He said he would not make a final decision until he had the old valve out, sized a new one, looked at different elements related to fitting and sewing procedures, and considered any other newly discovered factors which could affect his decision. I got the impression, there would be at least a half dozen different valves, ready for implantation in the operating room or nearby.

We did discuss mechanical vs tissue valves because of the obvious ACT issues. We agreed that a tissue valve would be best for me. My second concern was that whatever valve was selected, that it not inhibit the possible use of a trans-catheter re-valve technique for a future second valve replacement. He said he always tries to up size the valve so a second valve-in-valve replacement would have as large an opening as possible. One of the ways he does this is through a sewing technique he uses which allows for a thinner sewing ring marginal and larger valve ring.

After the aforementioned discussions, I felt comfortable in letting him make the final decisions on brand, model, sizes, etc.

PS. I would also like to add that I am now two weeks post surgery, and there have been no major complications or setbacks. As many before have said, it was not nearly as severe a process as I was prepared to endure. So if your anxiety level has gotten the best of you, please know that many of us have not had any problems with this procedure. gordo
 
Hey jmorganky! Welcome aboard. I've recently had surgery about 3 1/2 weeks ago. Thing are going well just slower than I thought and want. If your and "extreme" sports and excursion kind of person I would consider tissue. Not that you cant do extreme things with mechanical while on coumadim but there is greater risk. I personaly have never been very athletic or had the urge to sleep in the jungle for a month so I chose mechanical.

One thing I wanted to start learning is martial arts and with coumadim and especially the surprise of a pacemaker after surgery I'm limited with this which is a little disappointing. If your a big alcohol drinker you must be much more careful with intake, the days of drinking and randomly getting drunk should be over, the days of casual controled social drinking sessions with limits are now the future.

For me the surgery was very tough mentally as well as recovery being tough mentally. I would not want my body to go through that much trauma again if I can avoid it. This is why I chose mechanical. I'm hoping at most I would have to do this one more time in my older age and by that time there should be some major advancements that will make my possible second surgery better.

BTW I'm 28 years old. I chose an On-X valve for the hope I will have more options with anti-coagulation drugs in the future as well as hope that the On-X valves prove to do less damage to blood cells and overall have more protection of stroke risk at lower drug levels. The less of any drug I take the better. That's why I chose On-X for the future chance and hope of more freedom of choice and risk.
 
interestingly enough, my cardio consultant advised me that I could play 5 a side football (soccer) after I get a mechanical valve and am on warfarin..
as long as i wear shin pads and avoid heading the ball (in small sided soccer the ball stays at ground level most of the time, so thats not so difficult).

My MRI scan confirmed the results of the Echo...I have a long wait until May '12 for my next appointment with the consultant...

I've been getting back to playing lots of soccer and tennis...and am fitter than i have been in a few years...
I'm even lifting small weights to keep some upper body strength (although with my aorta dilated to 4.9 cm heavy weights are a no no )

Things have got back to normal for me...for the time being...but I know I'm in the waiting room now, and in the next few years the opp will happen
 
Then there's those of us who wanted an On-X and had it put in, only to discover that my existing anatomy didn't fit correctly so a porcine valve was then put in, all in the same surgical event. When I awoke and was informed of the goings on, I can't say that I was the least bit disappointed since I was still MUCH better off than I was prior to surgery. Keep an open mind, discuss your preferences with your surgeon, yet realize that it's not always the choice of the patient when it's crunch time.
 
While everyone here advocates that patients should be actively involved in these types of decisions, I submit there are major limitations to patient involvement in the selection of the replacement valve. In my experience, it became evident that the surgeon would make the final choice based on factors far beyond my control.

He said he would not make a final decision until he had the old valve out, sized a new one, looked at different elements related to fitting and sewing procedures, and considered any other newly discovered factors which could affect his decision. I got the impression, there would be at least a half dozen different valves, ready for implantation in the operating room or nearby.

We did discuss mechanical vs tissue valves because of the obvious ACT issues. We agreed that a tissue valve would be best for me. My second concern was that whatever valve was selected, that it not inhibit the possible use of a trans-catheter re-valve technique for a future second valve replacement. He said he always tries to up size the valve so a second valve-in-valve replacement would have as large an opening as possible. One of the ways he does this is through a sewing technique he uses which allows for a thinner sewing ring marginal and larger valve ring.

After the aforementioned discussions, I felt comfortable in letting him make the final decisions on brand, model, sizes, etc.

PS. I would also like to add that I am now two weeks post surgery, and there have been no major complications or setbacks. As many before have said, it was not nearly as severe a process as I was prepared to endure. So if your anxiety level has gotten the best of you, please know that many of us have not had any problems with this procedure. gordo

My surgeon told me the same thing re. making allowances for a highly likely transcatheter replacement in future. I believe him because he participates regularly in percutaneous replacement trials in the US. I am 51 (relatively young for this type of procedure I am told) and I went with tissue because of the low maintenance requirements. Regardless, it is your personal choice and you should make it in consultation with your family and surgeon and based on your lifestyle. Hope you make an informed decision. Good luck.
 
My Mass General surgeon told me basically the same thing though I am little older than you.
He fully expects transcatheter replacement to become commonplace in the near future. They are already doing them for some patients.
 
I'm with Jkm7 and Enjaynj: had my surgery one week ago today, and, at 53, my surgeon also feels that there's every reason to expect percutaneous re-replacement. He fitted me with an Edwards bovine valve and managed to fit a slightly larger size to make percutaneous even easier. It was tricky, but they did multiple TEEs during the surgery to check the architecture of my heart, and apparently it's worked well. I would definitely encourage you to discuss your valve choice in light of future percutaneous approaches.

Good luck!
 
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