G.I. Bill’s Heart Valve Replacement Selection – Three Weeks And Counting

Selecting the right heart valve replacement is not and should not be easy to do. There are many factors that need to be considered including your age, your lifestyle, your overall health, your like / dislike of ongoing drug monitoring.

G.I. Bill is getting ready for aortic valve replacement surgery due to aortic valve stenosis. While his surgery is three weeks away, he is still trying to determine the best valve replacement type (mechanical valve or tissue and biological valves) for him.

Bill Prepares For Aortic Valve Replacement Surgery

Email Received From G.I. Bill:

Hi Adam,

I think this is the greatest site and I have your heart valve book also, which is awesome! I am a 50 year old male in great health, but need an aortic valve replaced. My cardiologist used to think that I would need a mechanical valve. Now, however, my cardiologist thinks a tissue valve may be best for me as the long-term survivability is about the same (if you don’t mind another surgery “in the middle”).

I was wondering if other people around my age have any insight or if you may have any thoughts. I’m starting to get confused and the surgery is only 3 weeks away. Thanks for any insight! Bill

Adam’s Response To G.I. Bill:

Bill,

First off, you are going to do great with your aortic valve replacement!!!

Second, you raise a great point about which is the most appropriate heart valve replacement for you – the patient. The great thing about today is that the medical advancements specific to valve replacement technology has really improved since Lowell Edwards created the first mechanical heart valve replacement in the 1950’s.

While mechanical valves are always regarded for their durability, one of the major negatives about mechanical valves is the required use of blood-thinners to prevent clotting (e.g. Coumadin Therapy) throughout the patient’s life. So you know, I have spoken with many patients about Coumadin. Interestingly enough, the majority of them do not mind the drug therapy.

Now, as for the tissue valves, I think the pericardial tissue valves (cow valve replacements) are now showing some very encouraging results at 20+ years survivability. And, as you know, there is no need to use blood-thinners with a tissue heart valve replacement.

Pig Valve Transplant From Edwards Lifesciences

I could go and on about the pros and cons of both mechanical and tissue valves. But, at the end of the day, you will need to make a choice. I strongly encourage you to discuss this more with your surgeon, your cardiologist and your support group. Personally, I remember creating a list as to the advantages and disadvantages of each valve type.

In closing, your cardiologist referenced the possibility of potentially needing a re-operation “in the middle”. I have two thoughts about that.

One, open-heart surgery can be filled with many challenges and complications during the heart surgery and the recovery. (I can attest to that.) That said, I would not be excited about the possibility of another open-heart surgery.

Second, by the time you need a heart valve reoperation, my gut tells me that minimally invasive technologies will be common. So, let’s say you do need a re-operation, the year will 2028. Considering all the trials going on right now, minimally invasive aortic valve replacement will might make your next surgery less painful and less complicated.

I hope that helps you with your heart valve selection process. If you have any other thoughts for G.I. Bill, please leave a comment for him below.

Keep on tickin!

Adam Pick
Written by Adam Pick

Adam Pick is a patient, author of The Patient's Guide To Heart Valve Surgery and the founder of HeartValveSurgery.com.

To learn how Adam has helped millions of people with heart valve disease, watch Adam's video, subscribe to his free newsletter, or visit his Facebook, or Twitter pages.

  • Can an 80 year old male in good condition be a good candidate for the minimally invassive surgery procedure for replacement of his aortic heart valve?
    Mel Hewitt mshewitt@aol.com

  • mercy turan

    This note to Adam: I read every blog “issue” with great interest, both as a nurse and as a member of a patient’s support team.

    Adam, you are sooooo GOOD! Has anyone else noticed, other than your devoted patients/families/fans? I HOPE SO.

    There I go again, how about a NOBEL Peace Prize?!!!! You certainly bring PEACE with information, compassion and concern. God Bless YOU!

    Mercy, mother of John Turan (Ross Procedure 3/5/08)

  • Bill

    Adam, thanks for posting my question on your Blog Site. Pretty much what you said, is what has been echoing in my head for a while. I feel that minimally invasive surgery will soon be commonplace for Valve Surgery, and we will be here to see it. Your advice as usual is outstanding. Most of my support group is asking me to avoid a mechanical valve as they feel it will not fit my life style. I am still digesting all the , if not only “dynamic” sites I have found with good Blogs and Infomation. I will keep you informed as it goes. I am also a Medic and find it all fascinating from a medical viewpoint….
    G.I. Bill

  • Bill

    Hi Mel and that is a good question, for which Adam surely has a good answer. I feel that we are on the cusp of minimally invasive surgery for Aortic Valve Replacement. My understanding is that trials for Aortic Valve Replacement are about to start in Europe. Maybe a few years until we get it..
    I believe Mitral Valves are being replaced with Minimal Invasive Surgery here. The future holds great promise for sure. We will see it happen!!
    G.I. Bill

  • Maribel

    Bill: My husband is 54 and had a St. Jude Mechanical valve replacement, doctors recommended this one because of the age and told him that risks are bigger in the reoperation. Since the surgery was already stressfull we do not wanted to take the chance of a second one. The blod thinner therapy is not so difficult, once you manage the dose and know what you can eat or not it is a piece of cake. But each case is different maybe you want to read this:
    http://www.womensheartfoundation.org/content/heartsurgery/heart_valve_replacment.asp

    Whatever you choose you’re going to be fine, let us know the date of the surgery and our prayers will be with you so good luck in your choice.

  • Jim Hayden

    G.I. Bill: God Bless you with your decision. I had my aortic valve replaced on April 3, 2000. It was replaced with an Edwards Lifesciences periocardal valve. I had a good 7.5 years with that valve when it started to regurgitate and needed replacement. When my cardiologist told me that it would necessitate the same surgery as the previous surgery – I cried. But, over the course of three days I knew I had no choice. On Nov. 26, 2007 I had my aortic valve replaced again – same procedure – same type of valve. I am back on the tennis court since Feb 15, and usually play doubles but just played a set of singles on Monday. I am 71 years of age and very active. I chose the cow valve because I am active and do not want to use blood thinners if I fall or lose my balance.
    Adam is right there are new procedures on the horizon that will be less invasive by the time a cow valve would have to be replaced, should you choose that option. However, be aware that these valves do fail at some point. They talk about 20 year possible time of existence but be sure that is the right side of a bell curve. The bulk of them will fail within nine to thirteen years.
    Considering the alternative, whatever you decide, find out as much as you can about the procedure, and go for it. Chose your surgeon well – that is your most important choice. Discuss your options with him
    Good Health to you,
    Jim Hayden

  • Bill

    Maribel and Jim
    Thank you for your inspiration and information. It is all so helpful and appreciated. I am still in the decision mode, but leaning toward the tissue valve. The Surgery is scheduled for 12 May. Keep me in your thoughts and prayers for sure…I am sure it will be one “Wild Ride”….
    Jim…question for you if I may? &.5 years seems early for the valve to fail. Were there any circumstances that helped cause the failure. ?
    Maribel, how long has it been since your husbands surgery?..and do you feel that his life is pretty much back to normal now…activity wise and overall quality?

  • MYOLA hATFIELD

    I am a 78 y/o female who is facing Aortic Valve replacement. I had a quadruple graft 10 years ago and my heart has not deteriorated, until I aam now in Heart Failure and am suffering from exertional Angina most of the time. Just walking I have to tke Nitrobid for the paiin. One surgeon said he would not do the surgery beccause I would not survive the Recovery period. I am to see another surgeion on April 29, 2008. I still do not know what to do. I am not ready to committ suicide. but I can;t live like this either. Any suggestions?

  • Myola check with Cleveland!! You did not say where you live .I am 72 going to cleveland may 27 for possible too valve repacement. Keep looking for a surgeon to do it

    may god be withyou
    John

  • Bill

    Myola,
    I agree with John, to keep asking and find the right surgeon. Their views of recovery are often very different, and you probably know how well you will do after surgery based on your physical abilities. Never give up however, as it sounds like you are having such bad problems. You will find the right surgeon and the right answer…and be just fine…
    let me know how it goes…
    Bill
    fly-guy@comcast.net

  • Jim Hayden

    Bill: You asked a good question: were there any circumstances that caused the new valve to fail? We are trying to determine the answer. The failed valve was submitted to Edwards Life Sciences for analysis but we have not received any results. I have also asked if there is any way to preserve the new valve but have not received any answers. Adam Pick has not been able to get any answers and is still in line to receive an answer.
    I will be in California until May 17 and I hope to visit Edwards Life Sciences. I’ll let you know if I receive some answers.
    Good health to you, the procedure is bearable and worth the effort – you’ll live longer.
    Jim Hayden

  • Maribel

    Bill: My husband was fixed two months ago february 18th and he is better than before eventhough he was totally asympthomatic. His quality of life is better also he is more awake, he is driving, working the same number of hours than before and he is cycling again!!! Everybody says he looks better than before, so alive!!! Whatever valve you choose your life is going to change and for better. Only you and your doctor can make the decision but please don’t be afraid of blood thinners my husband is quite used to the controls and very few things he’s not eating. It is not such a sacrifice. If you decide for a mechanical please contact me and I can give you a lot of info on the blood thinners ( my mail maribelgarzon@yahoo.com) If you already decided it please let us know!!! See you and good luck in the 12th of may wild ride!!

  • mercy turan

    Bill: May 12 is already circled in my calendar (it is my best friend’s Sarah’s birthday!) but now it will also be your new birthday! Several days prior, I have a little star marking the day to remaind me to really concentrate on my prayers for you. I will pray for strength, both physical and spiritual, for you. I will pray for God’s hands to work through your surgeon’s and I will pray for the greatest possible outcome from your surgery! Our son had surgery (Ross procedure) on March 5, 2008. It was a very tough time until we found Adam, his book and his blog. I had prayed for peace in our minds for so many hours, then I sat down to once again search the websites, and the very first thing that appeared in front of me was Adam’s name. I truly belive that I prayed with all my heart and hopes for a light in the dark path we felt we were crossing, and there it was! Then again, it was a roller coaster of a time for the first 48 hours (including the day of surgery, which was about 8 1/2 hours) It is tough, but it is doable, through it all, our faith and hope sustained us and kept us full of strength until we began to see the light and the days passed little by little, with great improvement each day. God bless you. You’ll do fine. Mercy, mother of John Turan.

  • Bill

    John, Maribel, and Mercy
    Again, your insights and kind words are worth more than you can imagine. I enjoy hearing from each of you and you always give me incouragement and insight. As you said, I will be better and live longer after the procedure. It’s just hard to imagine when I am asympthomatic and know what lies ahead. I cannot imagine being “down” for that length of time.
    Mercy, you sound like an outstanding Mom…John is lucky to have such a loving and caring Mom and I am sure you and your family are a big part of his recovery. Indeed, I am sure the caring support of all your families and your personal determination brought you thru this…
    11 days and counting….
    Bill

  • Maribel

    Bill: Tomorrow’s the first day of the rest of your life, tomorrow I’m also having surgery they are taking my ovary off (big cyst) but believe me all my positive thoughts will be with you, you’re going to be just fine. I know it is hard to think you need such a big surgery if you’re probably feeling all right, my husband Sergio felt the same but it is better to do it now that you’re ok because your recovery is going to be better. As I told once to dear mom Mercy: it is going to be a blink of an eye!! you’ll be ok very soon. I will give you the same advice I gave Mercy: be carefull with the visits, everyone wants to be there with you (in the hospital and at home mostly) have mouth covers always were you are and make people wear them when they are with you, you don’t want to catch a cold, coughin and sneezing can be very painfull. Take care of yourself and good luck in the wild ride!!! Remember we will all be thinking about you!!!

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