You ran 2 miles 12 wks after "the" surgery, eh! Congratulatoins, Super...that gives me hope. I'm 7 wks post mitral valve repair and discouraged I'm still not able to run 5 K without it being a run/walk. Barry on the Mtn in New Mexico
Sorry to hear about your initial misery in the hospital. There are lot of little bumps in the road to recovery and all seem to be expected. Take me for example, I went back to work last Friday and Monday I had the flu. Everyone is different. Hang in there for time is the ultimate healer.
I'm surprised you had the interest and energy to write at all!! I had no interest in writing for the first 2 weeks...had family do it for me. You sound like you are doing just great--you'll be fine in a few days, you'll see!!
Continued progress and healing,
First things first, there is no wrong decision here and your surgeon should stand by your decision either way. In my case, I was skeptical to go with the mechanical because it requires the use of Coumadin. Since I'm only 23 years old (22 when I had the surgery), I did not want to think of taking Coumadin every day for the rest of my life. In your situation, I would just advise you to take in consideration your lifestyle, activity level, and age. My surgeon told me that the tissue valves do not last as long in young males (under 30) than they do in men of your age. All in all, there is no wrong decision. It took me a while to decide on the bovine tissue valve, so don't feel bad if you are indecisive! If you have any more questions, don't hesitate to contact me!
Hi Arthur,welcome to HVJ. I am a 3 X open heart 1 Atrial Septal Defect repair in 30's, Mitral Valve Repair in 40's, Mitral Valve Mechanical age 58 3 months ago. I did not have a choice due to the fact that surgeons do not want to ever do another stenotomy with so much scar tissue in chest and heart, so Coumadin is on the agenda for life. I was just started to get stablized on Coumadin when I had a bout with a collapsed lung due to a nerve block so my levels are all over the place. Most of the time I had Home Health Care testing levels 3 X wk. IF I had a choice I would still have chosen a mechanical as I really do not want to have another valve replacement. I intend to get bac to my very pre active life, including swimming laps. am sure whatever choice you make as long as you have done all of your research you will be good to go. We have a son that lives in Hollywood, I just noticed that is where you reside. You will benefit greatly from this site. Feel free to message me if I can help in anyway as I see we are close in age.
Susan VandenBussche NC
I think the choice comes down to something very personal for you and your lifestyle. In May of this year I had AVR surgey and chose a tissue valve at 49 years of age. My cardiologist was overwhelmingly recommending a mechanical valve. I alreday knew I was going to have my surgery at Cleveland Clinic and they are very pro tissue, as was my surgeon Dr. Gillinov.
Ultimately it was my choice, and as a very active person tissue was the right choice for my situation. I did not want to have to deal with Coumadin, but the tradeoff is a valve that will likely last 15+/- years. The positive about dealing with future AVR surgery is that the protocal in the next decade for AVR will likely be through a catherter via the femoral artery, so not quite the process I had in May.
That being said, even if I have to have another median sternotomy, I would still chose a tissue valve, no regrets. Like Laurie below, I just could not accept the possible trade offs in quality of life. At CC, the post surgery anti coagulant for tissue valves is baby aspirin so I never had to have a single dose of Coumadin.
It is a tough choice, and I do not beleive one answer is more right than the other; it is just deciding what is most important to you and what you can deal with medically for both short and long term.
The best thing you can do is educate yourself on everything about your surgery. Learn what it is going to be like, and what you think is best for you and it will work out fine for you.
(PS - Arnold Scwharzenneger's 1997 surgey was with human homograft valves and will have to be replaced)
I had a bovine mitral valve and a tricuspid repair done in March at the Cleveland Clinic. I have been in a-fib (irregular heart beat) for 15 years and have been on Coumadin all that time without a problem. I also had a MAZE (you can google that, if you want) at the time of my valve surgery. The goal was to stop the irregular beats, but it was not successful so I remain on Coumadin. There already is a new drug on the market with more to come. This drug does not require the regular blood testing that needs to be done now (sort of like Plavix). As far as "incidents" with Coumadin the problem occurs if one does not keep their INR above 2. As far as the "beating" of the mech valves I understand there are newer ones available that are a lot quieter. If you do go with a tissue valve when it comes time to replace it, it most likely will be done through a catheter in the blood vessel instead of through the sternum and chest. Well, hope I haven't given any more confusion, but as it was said, whatever choice you make will work for you and then don't second guess yourself. That can really be counterproductive. Good luck. Let us know what you decide.
The bovine (cow) valves are supposed to last 20 years, so that may be one of your options. Many surgeons, even if you have a tissue valve (pig, cow, horse) still want you on Coumadin for 3 months. I was on it for one month and had constant blood in my urine and got anemic, so I just told the doctor, "I'm not going to take this stuff anymore." He switched me to aspirin.
You DO have control over how long you're on it. My cardiologist (not the surgeon) doesn't believe people need Coumadin with tissue valves and says aspirin will do it, but as he said also, "If you go to a surgeon and expect him to pull you through, you have to follow his advice." So I took the Coumadin for that month and am now on a baby aspirin a day.
Modern medicine is advancing so rapidly. Who knows what fantastic solutions they will have in 15 or 20 years.
Best of luck whatever you choose.
Hi Arthur, I had a lot of trouble with this one, kept going back and forth. My docs tried to push for mechanical since I am so young, but the more I read about Coumadin the more I knew it was not for me. You live your life now...and the tissue valve is so much more worry free. I did do extensive reading about side effects of Coumadin, trying to convince myself that it would be OK, but never felt at peace with that way. Even tho there is news about a Coumadin replacement lately, it is still a ways out. I read that 30% if patients hav a major hemmorhagic event on Coumadin.. Don't know how accurate that is, but still too scary for me. Even now Cleveland Clinic does almost all tissue valves and a third of their surgeries are redos. I feel confident that when the time comes they can do a good job with that. Also hearing my valve click away when i am trying to go to sleep would drive me crazy. i guess I am opting for the best quality of life NOW. My surgery is Tuesday and feel at peace with my decision, everyone is different. good luck Laurie C
Welcome to the journal---sounds like you are where I was about 3 weeks ago. I have a severely stenotic aortic valve too. I'm 51...I have decided to go with a biological (tissue) valve instead of mechanical. I do not want to be on coumadin and have to have my blood tested every month, have the possibility of a bleeding incident, or have the clicking from the mechanical valve. My surgeon, Dr. Girardi at NY Presbyterian, was VERY supportive of my decision even considering my age. After this is all over, I just want to get on with my life and not have to think about this anymore, which I knew would not be the case with the mechanical valve. My cardiologist told me that if I take really good care of myself I could get close to 20 years from the new valve. Of course, God willing, I will live long enough to have to revisit the situation 10,15,20 years from now, but by then I'm assuming the science and technology surrounding the whole process will have evolved for the better. Even if it's stays the same, the surgery is supposed to be so routine now, that to have it repeated as is would be a small price to pay for the peace of mind of not being on coumadin and for total freedom for those years (no bloodwork etc.)
Now, that said, everyone is different!! It all depends on your view and your activities. Apparently, Arnold Schwarzenagger had the mechanical one put in because he didn't want any restrictions on his activities. But I was told I too would be free to do whatever I wanted when I was all rehabed; so not sure about that aspect. Read up all you can on this and make sure you read Adam's book. Ask lots of questions; hopefully you will receive lots of posts from the friends here which is a tremendous help.
Let us know when you get your surgery date.
Good luck with your decision!!