Worried about my Mechanic AVR's status

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cmlhrtrk

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Hello, I had my Aortic valve replaced with a 21mm stJudes valve when i was 12 years old at 2006 and now im 25. I have been getting my echocardiogram every year and i had no problems and no complaints until last year. Last year they said there was a minor/trace insufficiency and it is because as i am getting older the valve is remaining small for my age/body and I might need a revisional surgery for a larger valve in the future. I am an average sized guy, had few extra kilograms recently because of work routine but live and eat as healthy as i can. Let me come to the point, recently ı feel like I am having some palpitations, but while inactive, sitting etc, my physical capacity is still good, no pain or breathlessnes after even climbing 7-8 floors. But I am worried and scared that what if when I have my echo done and they say I need a replacement? I was aged 12 when I had it first done so it was a little traumatic for me psychologically. I am really worried that i may need to go through the same things. I need some advice on how to cope with this and what to do. Thank you in advance.
 
Leave it alone. "Insufficiency" on mechanical valves is normal as they all "leak". The size of the valve (21mm) is a different parameter (ability to flow) than leakage (insufficiency). Valve size is not necessarily indicative of valve performance. A 21mm SJM mechanical valve could have the same performance (pressure drop or EOA - EOA, look it up) as a 23 or 25mm tissue valve, so just because you put a bigger size in doesn't mean you will increase "performance".

JK
 
Even if you did need another surgery, it would be OK and you would manage.

Here's some advice on health anxiety that I just read today, from Dr. Andrea Bonior at the Washington Post's site:

"Your basic goal should be to label your anxious health-related thoughts as unhelpful (at least past a certain basic point of boosting your ability to be prepared) and start to see them as separate from yourself and from truth. It's the difference between 'I bet there's something wrong! I bet I have XYZ disease!' and 'I'm having the thought that I have XYZ disease. Hi, Anxious Thought. I see you there. But you are a heckler right now, because we have no evidence for that. I am on the path to finding out answers, and I will be prepared for whatever comes. But for now, I am going to see you as the dark cloud that you are, breathe more deeply to help you leave my chest, and watch you dissipate in my mind.'"
 
Hello and welcome

Hello, I had my Aortic valve replaced with a 21mm stJudes valve when i was 12 years old at 2006 and now im 25. I have been getting my echocardiogram every year and i had no problems and no complaints until last year. Last year they said there was a minor/trace insufficiency and it is because as i am getting older the valve is remaining small for my age/body a

the valves don't "age" like you may be thinking. I would say "minor" is ... well ... minor ... so don't give it more thought till you have something to think about.

Seneca:
04a2d5f81692986d17d303724714bf4b.jpg


Think about reading some of the Stoic philosophy :)

You'll be fine
 
Hello and welcome



the valves don't "age" like you may be thinking. I would say "minor" is ... well ... minor ... so don't give it more thought till you have something to think about.

Seneca:
04a2d5f81692986d17d303724714bf4b.jpg


Think about reading some of the Stoic philosophy :)

You'll be fine
Pliny the Elder expressed similar thoughts. My version is, it will or it won’t, nothing to be done either way.
 
Hello, I had my Aortic valve replaced with a 21mm stJudes valve when i was 12 years old at 2006 and now im 25. I have been getting my echocardiogram every year and i had no problems and no complaints until last year. Last year they said there was a minor/trace insufficiency and it is because as i am getting older the valve is remaining small for my age/body and I might need a revisional surgery for a larger valve in the future. I am an average sized guy, had few extra kilograms recently because of work routine but live and eat as healthy as i can. Let me come to the point, recently ı feel like I am having some palpitations, but while inactive, sitting etc, my physical capacity is still good, no pain or breathlessnes after even climbing 7-8 floors. But I am worried and scared that what if when I have my echo done and they say I need a replacement? I was aged 12 when I had it first done so it was a little traumatic for me psychologically. I am really worried that i may need to go through the same things. I need some advice on how to cope with this and what to do. Thank you in advance.
I love hearing from you. My 14 year old son had his AVR replaced 2 1/2 years ago with a St Jude. I don’t recall the size, but I’m curious now. I’m imaging him now as a 25 year old man. :)
 
Even if you did need another surgery, it would be OK and you would manage.

Here's some advice on health anxiety that I just read today, from Dr. Andrea Bonior at the Washington Post's site:

"Your basic goal should be to label your anxious health-related thoughts as unhelpful (at least past a certain basic point of boosting your ability to be prepared) and start to see them as separate from yourself and from truth. It's the difference between 'I bet there's something wrong! I bet I have XYZ disease!' and 'I'm having the thought that I have XYZ disease. Hi, Anxious Thought. I see you there. But you are a heckler right now, because we have no evidence for that. I am on the path to finding out answers, and I will be prepared for whatever comes. But for now, I am going to see you as the dark cloud that you are, breathe more deeply to help you leave my chest, and watch you dissipate in my mind.'"
Zoltania, this is beautiful advice! I love it for many aspects in life. He’s away this week at Young Life sleep away camp in Oregon. One of the busses (not his) veered off the road (going slowly) and tipped over! No kids were hurt but I can’t not think about “what if” it were my son’s bus and being on coumadin, etc. that’s my only challenge with this whole mechanical valve adventure. We can handle INR, but being at risk for bleeds does stress me out deep down.
 
Hello, I had my Aortic valve replaced with a 21mm stJudes valve when i was 12 years old at 2006 and now im 25. I have been getting my echocardiogram every year and i had no problems and no complaints until last year. Last year they said there was a minor/trace insufficiency and it is because as i am getting older the valve is remaining small for my age/body and I might need a revisional surgery for a larger valve in the future. I am an average sized guy, had few extra kilograms recently because of work routine but live and eat as healthy as i can. Let me come to the point, recently ı feel like I am having some palpitations, but while inactive, sitting etc, my physical capacity is still good, no pain or breathlessnes after even climbing 7-8 floors. But I am worried and scared that what if when I have my echo done and they say I need a replacement? I was aged 12 when I had it first done so it was a little traumatic for me psychologically. I am really worried that i may need to go through the same things. I need some advice on how to cope with this and what to do. Thank you in advance.
Please relax, worrying right now will make you nuts. Just relax, keep up the exercise and active lifestyle and just watch a little bit for signs for trouble. When you worry too much, it will happen from stressing over it. You are still young. you keep it monitored every year, and keep being healthy. You are doing fine. Hugs for today.
 
Leave it alone. "Insufficiency" on mechanical valves is normal as they all "leak". The size of the valve (21mm) is a different parameter (ability to flow) than leakage (insufficiency). Valve size is not necessarily indicative of valve performance. A 21mm SJM mechanical valve could have the same performance (pressure drop or EOA - EOA, look it up) as a 23 or 25mm tissue valve, so just because you put a bigger size in doesn't mean you will increase "performance".

JK
Not all valves should be leaking at all. I don't have a leak at all and had mine(St. Jude's Valve) put in 2001. If there was a leak, I would be screaming. Do not scare people that all valves still leak after replacement.
 
Not all valves should be leaking at all. I don't have a leak at all and had mine(St. Jude's Valve) put in 2001. If there was a leak, I would be screaming. Do not scare people that all valves still leak after replacement.




Modern Mechanical valves do leak by design, your st Jude does, as does mine

the hinges have a degree of regurgitation built in to help stop clots from forming.
This occurs at the periphery gap &
b-datum gap

this backwash ( leak ) is a design feature

(y)
 
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Not all valves should be leaking at all. I don't have a leak at all and had mine(St. Jude's Valve) put in 2001. If there was a leak, I would be screaming. Do not scare people that all valves still leak after replacement.
What Leadville said - please don't let my low post # detract from my reply accuracy. I will try to stay in the background here but lets just say I have a number of decades in the field. I will only post when I think I can add something. Pellicle has most things covered so no need for my comments. It is indeed astonishing to see the leakage jets from a mechanical valve. Properly operating tissue valves do not leak. Do not confuse this normal leakage for a mechanical valve from a paravalular (leakage outside the cuff) leak which of course, is highly undesirable. JK
 
.......... Worry is like a rocking chair, it gives you something to do, but you don't get anywhere.

My biggest concern was the "little ball" would get stuck open........or closed........THAT would be one helluva problem! Never happened:p. What did happen was my OHS gave me the opportunity to live well past what my docs thought. In two weeks it'll be 52 years since they stuck this little "wine bottle stopper" in me and it continues to amaze my docs........and me(y)
 
Hey nobog. If you know stuff, PLEASE share. Don't keep in the background.
There are some legalities involved with my posting(s) as I am still working. You sign these non-disclosures and I need to be very careful what I say / do not say. If I can shed some light on a specific topic I will try to be concise and help where I can but as mentioned I will try to stay on the sideline. The leakage issue was a point that I thought I could help.

I will retire in a year or so so at that time I will be able to speak "more freely". The non-disclosure never really ends but it will be easier to speak in general terms.

On another note, the ball and cage valve does not leak as the silastic ball makes a positive seal.

JK
 
Interesting...
Lol I once told an echo tech during my test my mech ATS valve was NOT leaking when they said something - it was a newer tech and they spent an extra 20 min trying to figure out what they were seeing. I had my cardiologist appt right after that and told him what happened and boy did he laugh. Then I debated the issue with him, I had to finally bend. I've been a bit strong-willed in the past so he wasn't surprised! Am still sad he retired (not for him, for me) as he 'got' me - my new doc's sense of humor isn't quite as good :) I attribute the leaking to the leaflets being inflexible and not able to function as well as the exquisitely designed native valves.
 
On another note, the ball and cage valve does not leak as the silastic ball makes a positive seal

Never say never........mine has indicated a "mild leak" on my Echos since the early 2000s (when I started keeping copies of medical tests). Docs have always told me not to worry as a mild or minor leakage is normal for my prosthetic valve.......and it has never been serious enough to consider any kind of correction. My point is not to play what if games regarding past or future......real or imagined heart issues. Ya gotta eat the elephant one bite at a time.
 

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