Akki's Journal

W. Carter  Your nerves will have to grow back together. It might take as long as 6 mo. or longer to get all your feeling back. Half of my hand was numb for about 9 mo. so it takes time.

Sophia Ridley  I don't know much about aortic valve surgery and the chance of repair as mine was mitral repair - I've a ring and goretex to support mine. I do wish you the very best for your surgery and a smooth recovery.

Emily Rowley  Good choice. I'm choosing a Tissue (most likely pig) Valve as my back up plan. Do you know what sort of Biological Valve you are having, such as cow or pig or horse or your own tissue or from a human donor?

Cathy Slipski  I too was told I should get a mechanical valve. I don't like the idea of a life long commitment to coumadin

Doran Herritt  I haven't seen that short a lifespan (5 years) on tissue valves in anything I read. Normal in a young person is 8-12 years, but there are those who have had theirs closing in on 20 years.

Valve choice is personal so do your research. You will hear all kinds of opinions as there is not one correct answer. Just a correct answer for you.

Once you do your research, decide and have a plan you will find peace.

And don't forget....even if the tissue doesn't last 25 years like a mechanical. Technology is getting better every year, there may be something permanent in 10 years that does not require open heart surgery. Time is your friend in this case. Tissue valves allow you to stay clear of Coumadin and the restrictions that come with it.

Take care, drn

W. Carter  How many times do you want to be on an operating table getting valves replaced? How many years do you want to spend recovering? I hear about all these future improvements for valve replacements but at the present the death rate has been so high they have halted all experiments. Even a mechanical valve is not a sure bet due to possible infection (endocarditis), thrombosis or a hemorrhage caused by warfarin. But even at the age that I was at the time of replacement (57) mechanical valve was the only logical choice for me. These are the questions only you can answer for yourself. I can tell you this, this has been a whole year of recovery for me that I don't want to do again, ever.

Enrique K  Akki, read all our journals everyone has different opinions on valve replacement and which valve to choose. I didn't get a mechanical valve because of my research of Coumadin and lengthy discussions with my cardiac surgeon and cardiologist team. The lifetime of a tissue porcine valve can be from 8-15 years or more. Wish you good luck in your decision on choosing a valve. 7 weeks post op and have never felt this great since I for diagnosed 3 years ago! Life is good.

Kenny Knox  Many folks have varying opinions. I had a valve replacement at 15 years of age and my most recent at 33 years of age (by Svensson as well). First round, I went tissue. Second round, I went mechanical. How young are you? Dr. Lars is a cardiac stud.. you're in great hands!

Emily Rowley  There are advantages & disadvantages of both, for me I'm choosing tissue after a talk with my Cardiologist+Surgeon and after extensive research on complications associated with choosing mechanical valve.
Carter, what is there a high death rate in? :S

  I had AVR this week after lots of research and personal experiences with valves. You are at Cleveland Clinic which is one of the best places to get good information! My father passed away from a brain bleed related to coumadin from his mechanical valve. My aunt had a pig valve and it lasted 17 years (she was low activity). My aunt did not have to take coumadin with her tissue valve. For me, I worry about pharmacogenetics and if my family is more vulnerable to the effects of blood thinners compared to other people (there is some research on this). The three surgeons I spoke with didn't argue with me when I told them my preferences and said they understood my rationale for my choice. Find what works best for you and as Enrique said above, read what other people have had experience with. Good luck!! This is a tough decision. Wish I had a magic wand instead!

Akki Patel  Thank You to all for your valuable suggestion. It has been a great help from all of you. I have now decided to go with th tissue valve but Dr. Svensson told me that there are 70% chances to repair it so if it is repaired then it will be great of god and thank you all again for supporting and giving your valuable feedback.

Akki Patel  Hi kenny I am 24 years old and I dont want to be on blood thinner for rest of my life so I am planning to do tissue valve and after that I will do mechanical.

Emily Rowley  Good on you for finding the right decision for yourself. I'm planning to go tissue (pig) valve then next time there might be a better alternative or mechanical or longer lasting tissue valve to choose from. All the very best :)

Emily Rowley 
I too ponder the same question to choose tissue or mechanical? I'm 21 yrs old and going for a tissue-Pig's Valve. My Surgeon uses Pig (closest to human), ask your Surgeon what tissue they use cause cow's are meant to last longer even upto 20 yrs, although young people place alot of stress on their heart so it wears out faster. 2% per yr increased risked of major complication (such as stroke) on Anticoagulants.

  That is a personal decision you will need to make with your doctor. I am two days post op with a bioprosthetic valve (cow). I am 40 and did not want to be tied to blood thinners the rest of my life. My father chose mechanical and died from a brain hemorrhage from blood thinners. He was in his 60's and had damaged his heart prior to receiving his replacement. His sister, my aunt, chose a bioprosthetic valve and was not tied to blood thinners. The positive about a mechanical valve is that you likely won't need resurgery and if you do, it will be a while. Cleveland Clinic has some great web chats where you can submit your questions to surgeons. I found that the most validating. Good luck!

Michael Shaughnessy  I continue to comment on this. The tissue valves that have the shortest lifespan are bioprosthetic or stented valves. Still a better choice in my opinion than mechanical. If your hospital does it pure biologic or unstented valves have excellent longevity. Mine is 4 years old and still as perfect as day 1. My surgeon has several patients greater than 15 years out with unstented biologic valves. I had my surgery at 43. 4 year anniversary this Saturday! I use it hard; triathlons , etc. As Laura said above anticoagulants can be disastrous. I have a patient that bled out in his brainstem at 47 on coumadin and remains paralyzed on one side with many motor problems. Was a football coach prior to this stroke. Save lives and ends them. Tough call. Good luck.

Akki Patel  Thanks Michael but still I had a question that my Dr. told me that in young patient the biological valve stay for just around 5 years so its better to have mechanical valve

Elaine Cutri  I was 22 when I had my pigs valve implanted. It lasted almost 12 years. I really enjoyed that period and did some incredible activities. I'm 57 and have a mechanical valve. I've learned to deal with the Coumadin, but I'm so glad to have had the tissue for a decade! Best wishes on your decision.

Mary K  Dr. Svensson at Cleveland Clinic did mine. Fantastic outcome. The incision is three inches long. I have two chest tube wounds under the breast on the right side that are each an inch wide.

Akki Patel  Thanks for the reply and I am taking the appointment and hope it I will be approved for minimum invasive procedure.

David Augustus  I had my aortic valve and root replaced with a minimum invasive procedure by Dr. Castro at Sequoia Hospital. I have 3-4 inch scar.

Akki Patel  Thanks David its really nice of you to share. I have a question like after you do ur surgery can you continue with your routine life?

Enrique K  Akki, I just had aortic root and valve replacement with minimal invasive surgery at Mt.Sinai Miami Beach with Dr. Jospeh Lamelas. trauma is much less and my incision is 5cm long. He is well renowned to have done 15-20 a week. Celebrities come from around the world only for his procedure as he is the pioneer of the minimal invasive procedure uses his own tools not robotics. I will be posting my whole surgery experience from oct 9, when I feel better and have energy.

Jeff Lashins  Dr. Svensson at CC repaired my aortic valve in May. The incision was 5" - called a mini-sternotomy.
If you're looking for someone to go in thru the ribs or laparoscopically, I don't think you're going to find anyone. The outcomes aren't as good in laparoscopic surgery, so this technique is reserved for the elderly or others with health issues that make open heart surgery not feasible. As far as entering through the side, this is done for mitral valve surgery, not aortic valve. I'm not a doctor though, so I'll let the CC tell you about this stuff.
The CC is awesome. You'll be in the best hands there. Have faith in that.

Akki Patel  Jeff I had a question like mine is bicuspid valve so is it like if I do valve repair it will stay for the 10 years or its better to replace the valve?

David Augustus  Akki, yes!!! You can read my story or check Adam's blog 9/22, besides the ticking, I haven't slowed down. Also, I had what Jeff is talking about. Sorry for any confusion.

Michael Shaughnessy  Had my AVR and aneurysm at University Hospitals of Cleveland by Dr. Markowitz, not Cleveland Clnic. He is my hero! Both are good but I wanted Medtronic Freestyle valve, CCF wouldn't do it. 4 yrs and doing great. Compete in running and triathlons without trouble. 48 yrs old. I am a physician.