What am I doing?

[PeterBBandy]

This is getting to be too much for me to digest! In 1991 I had a double bypass. While I did not have a heart attack, sudden angina got my attention and four days later two mammary were rerouted before I had opportunity or reason to consider options. Yes, I was told about angiographs but not encouraged to go that direction. It all went fine, so when, two years ago, I was told my aortic valve leaked both ways (yes there is medical terms for it but I can neither remember or spell them), I just accepted the fact that some day I would have my chest cracked again. Since then I have had several ultrasound tests with the thought that when the wall of my heart got too big (or whatever) I would have a valve replaced.
Well base on a test in November, that time has arrived. Or has it?
I am scheduled for surgery on Jan 9. That is in four days! I was told I should consider having a mechanical or tissue valve and told some of the pros and cons of each. Since it seems like I am going to have to participate in the selection, I decided I would hit the net to get educated, or better yet, to get the answer. Well by now you the reader are getting an understanding how nieve I am.
I was blown away by the information in this forum. It scared me. I realize just how uninformed (stupid) I am. Perhaps I trust the famous Mayo Clinic more than I should. I live in Rochester MN and consider the Clinic as a big family doctor. I simply ?do what the Dr. says?. But from the forum I can see things are not that simple and the mechanical vs. tissue question is not a binary one since there are variations of each. Moreover, there are serious implications for either or any choice. Life is not as simple as I would have it.
One message that really caught my eye was the one from Jennie talking about the new CryoValve that seemed to lay a lot of the concerns about Coumadin to rest. I sent her a PM and that wonderful gas responded with a long and informative response. Thank you Jennie! She had some great advice and I will be talking to my doctors on Monday a more informed patient. More informed, but under informed none the less.
So the intention of this long winded message is to solicit additional ideas and suggestions from what is obviously a very informed and caring group of folks. After I meeting with my cardiologist who has been following my case and the surgeon who is scheduled to make repairs, I will have to make a decision; some sort of mechanical valve, a tissue valve, the new CryoValve if it is available, or simply not to have the operation done until I am comfortable with all aspects of the plan. I will be watching the forum for any responses which will be appreciated.
Thank you for reading this very long message.
Pete

 

[hensylee]

Welcome, Pete. I can't answer because I had bypass but everybody else in here are valve replacement pts and before morning, bet you will have lots of answers, or at least by tomorrow night so you will have information before your Dr visit on Monday. God bless

 

[Nancy]

Hi Peter-

Welcome to the site. You'll love it here. Everyone here has either had open heart surgery or has a loved one who has had it. So we all "get it".

Your surgery is coming up quickly, doesn't leave you much time to think about it. That has its pros and cons.

My husband is the patient here and has had 3 open heart surgeries. The last one was on July 18 of this past year. He's 70 years old. He has 2 mechanical valves. The aortic was replaced in 1977 and his mitral in 1999. He just had a repair on the mitral valve. In addition to those surgeries, he's had 2 lung surgeries and has a pacemaker.

Joe's been on Coumadin for 25 years now. It's just another part of his life, no big deal really. He goes and gets tested and takes what they tell him and it's quite well regulated. So far he hasn't had any major bleeds or other bugaboos that people worry about. He can't go out and get in a prize fight or other heavy contact sports, but at 70 he's not interested anyway. He does get tested about every 2 weeks, and he is careful to take his Coumadin at the same time every day.

I can truthfully say that Coumadin never limited his life. After his surgery in 1977, he did all the exercise he was used to doing, being an old "jock". pro baseball (minors) and semipro football. He didn't play the sports after surgery, but did do the exercising.

So I guess I'm trying to say that if you are considering a mechanical valve for its longevity, don't let Coumadin scare you. It can be lived with, quite well indeed.

There are many different types of valves represented in this group of people. You'll get many different answers to the questions you posed. Also do a search on Peter Easton's posts regarding valve selection. He did very thorough research into the selection process. It's quite interesting.

Most of all I wish you well with your upcoming surgery. It's a life saver and the doctors who do it are a very, very dedicated group. You'll be in good hands and you'll be fine.

 

[sylviayasgur]

hi pete!
welcome to this site. it is a wonderful place with terrific and caring folks. they helped me through my husband, joey's surgery and i am so grateful to them all.
nancy has a strong point.... although my husband (49) wanted to avoid coumadin, my dad (68) who had a st. jude's valve
(mechanical) put in 2 1/2 yrs ago, has been on coumadin for years (for afib and the valve). he doesn't mind it one bit and leads a very active lifestyle. if you read through many of the older threads you will find that the people taking coumadin don;t sem to mind it at all; it's those who don't take it and try to avoid it who seem to have a negative image of it.
mara had a ross procedure (as did joey) and she has a cryolife sg in her pulmonary position. steve from florida also has a cryolife sg if i remember correctly. peter easton had posted a fantastic thread way back in aug., '01 (i think) entitled "making the choice". i think it was is small talk.
i hope i've helped... please keep visiting and let us know what happens.
good luck and be well,
sylvia

 

[aesarco]

RP

RP

Hi!

I know this is a very stressful time for you. As you will note in my closing, we just went through this one month ago. Today, we saw our surgeon for our one month check-up. He said everything was looking very good for Bobby's RP. We saw our internist last week he stated that Bobby's heart sounded like a "well oiled German machine". We chose the RP after as much research as we could do.

Coumadin doesn't seem to be a big problem from the postings here. I guess you just have to watch your diet (no Vit. K) and you have to adjust to the ticking of the valve. Many say that it can be heard. I knew that Bobby would be disturbed by this, so a mechanical valve was on the very far back burner for us.

The pig/cow valves were good options, but they would need to be replaced in 10-20 years - this was pretty much a fact. Bobby is 56 and that would have placed him back into surgery when we would prefer not to have planned that way.

The Ross Procedure with its 24 year history and 15% failure rate seemed to be a good option for us. Our surgeon explained that the 15% failure rate is larger than reality considering today's surgical standards and processing of the homograft. So, the RP could last a lifetime, and it won't tick.

Arnold Schwengager (sp) did have the Ross and it did fail, but I read that he did not follow drs orders and went back to his routine too soon. I asked our surgeon today about Arnold, he said that Arnold now has two homografts.

Here are some interesting sites:
http://www.vesalius.com/graphics/cf_procedures/ross_proc/cfpr_ross_proc1.asp
http://www.kenskollectibles.com/kenross/
http://members.home.net/myrossprocedure/
http://www.nmh.org/services/ct_surg.html

Keep reading, keep asking questions, you will find what seems right to you.

Best Regards,

Ann