Hi jennifer, i am 38 and was also supposed to get my new valve on Nov 19th. I am getting it Nov 15th instead. I can with much embarrassment say i know nothing about coumadin which you say is the main reason for going with the tissue valve. I have decided to go with the mechanical valve because of the chance of never having surgery again. Of course I can still change my mind. Thank you in advance for any info if you have the time.
Just want to wish you well and say that I believe you made a good decision re: mechanical vs. tissue valve and I'll tell you why. By the time you may need a replacement valve again, the technology will be alot different and I think a new valve will be done via transcatherer method (non-surgical. They are doing this now on patients who are not candidates for regular surgery.
I had my aortic valve replace this past June and chose a tissue valve because I didn't want to have to take coumadin forever.
I had my surgery at NYPresbyterian Hospital and my surgeon was Dr. Allan Stewart. I had a good experience and a fast recovery (and I am 73 yrs. old) and was driving 3 weeks post op. I am now going for cardiac rehab 3x a week and I enjoy it. I highly recomment it.
Best of luck to you and if I can help just let me know.
Blessings to you,
Trust me when I say, this is the worst part of the whole ordeal, once you have the surgery, you will be so busy rehabing the time will fly. I'm 4 months post surgery, back at work, walking daily, and feeling blessed to be here... Keep you head up and don't worry, you'll find yourself forgetting you even had surgery in a few months..
Your feelings are so normal! We can all relate...but believe me..you will find your "calm". Just keep looking at those wonderful children and remember who you are doing this for...their smiles will keep you determined as you are wheeled into that OR as well as through the recovery process. I felt like I was having an "out of body experience"...but I kept telling myself that this was really just a "nano second" in this big ole wonderful thing called life! (and just keep reading these success stories.) Hang in there Jennifer....it does get better...and you will find your zone...I promise! :)
Anxious feeling creep up on you as you get closer to your surgery date. It happened to me and I'm sure it happened to everyone else that went through this. These feelings are normal, as is the crying.
I tried to emerse myself in work but I became high strung, almost manic. One thing that I did that really helped was to write a journal here. Spilled my guts to everyone. Many nice people, that really knew what they were talking about, wrote back.
Once you are on the other side of the looking glass please take time to help others that are on the track behind you.
Remember that you can:
The choice of surgery and valve type is very personal. I had AVR surgery on October 10, 2012. I have a tissue valve and the surgery was minimally invasive. I have written a lot about my surgery in my journal here. (Joe Gimbel).
The choices come down to trading five years without surgery for living with blood thinners for the rest of your life, with
Also, if they cut your sternum, the healing takes longer. It is harder to find a surgeon that can do this and you have to physically qualify.
I am also 39 with 3 small kids 6 and under. I was 38 when I had my surgery earlier this year. Picking the valve was the hardest thing for me. Feel free to read my journal. But in the end and even at my age I went with a Tissue valve. 1) Because it was less meds 2) because it felt right for me and knowing how far medicine will grow in the next 20 years when I need to replace it again. It's a very personal decision and I really don't think there is a wrong choice. Read Chuck Holmgreen’s journal as well. He is our age and went for a mechanical valve and it was the right choice for him and hasn't limited him from doing the things he wants to.
Again that was the hardest thing for me but I am at peace with my choice even know that I will have to have it replaced again but my kids will older and maybe then I will do a mechanical one and be done with it.
Let us know how we can help as you go through the journey. This site is amazing and if you ask it they will answer it.
Feel free to contact me directly also if you have any questions. JimmyJohnson26@gmail.com
Jimmy Johnson AVR 2/20/12 Bovine
When I had my mitral repair I had to choose my backup replacement valve in case the repair failed. I chose tissue for 3 main reasons: first was lifestyle - I did not want to have blood thinners because I do a lot of outdoor sports; second was safety - I did not want to be exposed to the stroke risk of a coumadin mishap; third was tissue valves have a better technology path toward catheter-based - non surgical - replacement. So by the time a replacement is needed it might not be such a big deal. I won't presuppose you are done having kids yet, so that might be a reason too.
There was a study published in 2001 called <i>Twenty-year comparison of tissue and mechanical valve replacement</i> which said in the abstract
Tissue and mechanical valve recipients have similar survival over 20 years of follow-up. The primary tradeoff is an increased risk of hemorrhage in patients receiving mechanical aortic valve replacements and an increased risk of late reoperation in all patients receiving tissue valve replacements. The risk of tissue valve reoperation increases progressively with time." You can Google the study title to read the whole abstract, but the paper itself is for-pay.
Another paper, published in 2007 titled <i>Very Long-Term Survival Implications of Heart Valve Replacement With Tissue Versus Mechanical Prostheses in Adults Less Than 60 Years of Age</i> (Googling the title will bring up the full paper), concludes, "In our experience, selecting a tissue prosthesis at initial operation in younger adults does not negatively impact survival into the third decade of follow-up, despite the risk of reoperation." If you look carefully at the data in that paper, long term survival is slightly better for tissue, but the authors do not claim it is significant. Looking at their figures, I'm not so sure. It looks to me like there is a slight, but notable edge. Finally, they looked at death due to stroke out to 20 years post-surgery and found that having a mechanical valve is a risk factor here.
Anyway, all these lead me to think that tissue valves are a slightly better choice for some people.
The down side is that tissue valves often enough need to be replaced. 10 years is a typical time. Heart surgery is no fun and itself is risky, so to sign up for a repeat performance is not happy. Also second operations have a higher mortality rate than first ones. What I would say here is that in 10 years the replacement technologies are likely to be very different and much safer. But that is not a certainty. I mention the reoperation risk to give you an important consideration to use when balancing the options.
OK, that was too long. But I hope it helped. In any case you have some topics to bring up when discussing with your surgeon.
I am 34 and got pulmonic valve tissue last July. The pulmonary valve is the only one that can't be mechanical otherwise I would choose mechanical. I would definitely rather be on Coumadin than do this again! But I also have had other heart surgeries so this was my 2nd ohs.
Tissue or mechanical???? Probably the hardest decision you have to make once you decide on a surgeon. It is one that we all struggle with, wish I could give you "advice". I will tell you that, even though I chose tissue, I was on Coumadin for many years prior for another defect and I did not really have issues with it. The only issue was if I had to come off of it for some other procedure, then it took a while to get regulated again. I chose tissue for my replacement because I am older now (63), more prone to falling, etc., BUT...I still wonder at times if I should have gone with the mechanical. Good luck with your decision.
Linda Dixon, AVR 3/13/12
Good for you. I know it's scary, but you are being smart. Once your aortic stenosis is graded as severe the odds are better if you have surgery soonest. Connie pointed to my journal. This topic is covered in the July 21, 2012 post.
Welcome to HVJ! You will find a wealth of info here. We are here to listen, answer questions, and share our experiences of OHS & recovery with you. Way to go on staying on top of your condition!. It is very important, as you know, to be your own advocate.
I had my bicuspid aorta valve replaced in July @ Cleveland Clinic. Although, it was no "walk in the park" it is certainly do-able! If you want some good questions to take to your surgeon....read DVB's journal....he has done an outstanding job documenting his research...and so willing to share & answer any questions you may have.
Good Luck with your journey...and your climb up the mountain.... I will be watching for your posts! :)