Adam’s Heart Valve Surgery Blog

I just received an email from Julie that contains several, ongoing concerns specific to blood banks and heart valve surgery. If you are a patient or caregiver preparing for heart surgery, I encourage you to continue reading this post.

Julie writes to to me, “Adam - Jon, my husband, had mitral valve surgery on October 31st at the University of Chicago. Leading up to his surgery, Jon did not donate his own blood to the hospital blood bank. Guess what? Jon DID need blood. But, it was AFTER the surgery. His hemoglobin went way down. I was so upset that the doctors failed to give Jon the option of donating his own blood. Adam, please advise everybody to do this. I feel I made a big mistake as his wife….not thinking about doing that!”

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Two critical questions for patients needing heart valve replacement - due to aortic stenosis, mitral valve prolapse and/or regurgitation - are, “How long does a valve replacement last?” and “Will I need a reoperation?”

While there are many different answers to that question, here is some very interesting information specific to St. Jude Medical’s Biocor™ Stented Tissue Valve. According to St. Jude Medical, this pig valve replacement provided excellent long-term durability for the aortic valve in patients 65 years and older.

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A few weeks ago, I posted a blog about Angie’s aortic mechanical valve replacement options.

Becky has a follow-up question that reads, “Hi Adam - My mitral regurg has worsened to the point where I need surgery, according to my cardiologist. I’m 48 and don’t want to go though a second heart surgery so I’m opting for a mitral mechanical valve. What are my options? Thanks, Becky.”

It’s good to see that Becky is aware that she has options for her mechanical valve replacement. Patient awareness is definitely on the rise! Just a few years ago, most patients simply said, “Okay. Okay. I want a mechanical valve. Thanks Doc.”

Now, patients are coming to their surgeons saying, “I want to be in the On-X trial!” or “What can you tell me about the Medtronic replacement?” or “I hear St. Jude’s prosthesis valve is great…. Can I get one of those implanted?”

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Last month, Scott was diagnosed with aortic valve regurgitation. After his initial research, Scott was going to select a mechanical valve. However, the more Scott learned about the use of anticoagulation therapy (e.g. Coumadin) to prevent clotting on aortic mechanical valve replacements, the more concerned he became. Scott’s email to me reads:

“Hi Adam - I’m 52 and suffer from severe aortic regurgitation. I’m torn between my mechanical and bioprosthetic options. Can you help me better understand the risks of anticoagulants relative to valve function and patient lifestyle?”

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Jill writes to me, “Hi Adam - My world is upside down right now. My dad was just told that he has aortic valve regurg and needs a prosthesis valve (or at least I think that is what he said). Can you help me understand what all of this means? Plus, I’m a visual person. If you have any pictures of a valve prosthesis that would be great.”

From Jill’s description, it appears that her father is in definite need of a heart valve replacement. That said, Jill’s father will need a prosthetic valve transplant to enhance the flow of blood through his heart.

According to Heart Health Online, a prosthetic heart valve is a replacement for a diseased or dysfunctional heart valve. There are two types of artificial valves:

• Mechanical heart valve - A mechanical heart valve prosthesis is made of man-made materials. The advantage of mechanical valves is that they can usually last a lifetime. They do not wear out the way natural or biological valves do. Here is a picture of a Medtronic mechanical heart valve replacement.

• Biological heart valves - A biological heart valve prosthesis is made from tissue taken from animals or human cadavers. These bioprosthetic heart valve replacements are treated with preservatives and sterilized for human implantation. Here is a picture of a Edwards Lifesciences biological heart valve.

I know that is a very, very, very simple description of the two types of prosthetic heart valves. To further your inquiry into prosthetic heart valves, I have included several links to other blogs about valve prosthesis.

• Mechanical Aortic Valve Replacement Options
• Trade-offs Between Mechanical and Biological Valve Replacements
• Latest Technology In Aortic Valve Replacement Prosthesis
• Information about pig (porcine) valve replacements
• Information about cow (bovine) valve replacements

I hope that helps answer Jill’s question about valve prosthesis. Please let me know if you have any other questions.

Keep on tickin!

Adam Pick is a double, heart valve surgery patient and author of The Patient’s Guide To Heart Valve Surgery, a unique book which integrates the clinical facts of heart valve surgery with the personal experiences of an actual heart valve surgery patient. To learn more about Adam and his heart valve surgery book, click here.