Gerard's Journal

Cathleen Weed  Hi Gerard :) I understand what you are saying and why it makes sense to you, however I do know ( and agree ) anytime they can spare your native valve through a repair that is the better option. I completely understand your concerns about a potential repair leading you down the same path later in life but a good way to look at it is that sparing your native valve through repair would mean "maybe" a future surgery but a tissue valve would mean "absolutely" another surgery/procedure (whether it's open heart or by catheter) and so on. If there is a chance to repair it I would do that because your "own parts" are always the best. If they replace your valve now then you are looking at another replacement valve later on and so on. If they can do another ring now it will be stronger and better than the first time. 18 1/2 years is a long time! I didn't see your age now but the risk of open heart surgery at an older age only goes up somewhat if you stay healthy. The real risk is always with co-morbidities no matter the age. Keep healthy and active so that you are prepared either way. Control your blood pressure and any A-Fib episodes, exercise and follow a heart healthy lifestyle. Basically, control the things you can control. I like to say "Stay ready so you don't have to get ready". No matter what, I would opt for a repair always over a replacement. My entire life would have been different if I could have had a repair. If they can do that then you are one of the lucky ones. Nobody knows what the future holds but I wouldn't drive yourself crazy with what ifs. I know this is a stressful time, and you are asking all the right questions, but your choices are pretty good in 2023 so it's a good time to be a heart patient. Tissue valves are amazing now so even if you need a replacement you'll do great for a long time. So I would let the surgeon use his expertise (and hopefully repair it) <3. 

Robert Miller  Surgeon's won't repair a valve if they think it won't last for good. Could it break again. Yes, I had severe leakage  within 6 months and now leakage again after the second surgery. However, unless there are some medical conditions that suggest a replacement, it is better to fix than to replace. As for the ring, it's my understanding that it will always be replaced. I had mine for just some 10 months and they replaced it. There was nothing wrong with it. 
Btw, you said "wouldn't it make more sense to have a tissue valve than a replacement" Maybe I misunderstood but a tissue valve is a replacement. The general consensus is that it lasts about 15 years. For some it's a lot less, for others a lot longer.
As for Afib, ask about the maze procedure. Maybe it's applicable to you. Also ask about having the 'appendix' removed. It's where blood clots form, especially if you have Afib as blood pools up in that area and can clot up. 

Gerard LoRusso  Thank you Cathleen!  your answer is very logical, and maybe the answer I would have given someone else..lol..  You made some interesting & good basic points.  especially " sparing your native valve through repair would mean "maybe" a future surgery but a tissue valve would mean "absolutely" another surgery/procedure (whether it's open heart or by catheter) and so on. If there is a chance to repair it I would do that because your "own parts" are always the best."    I'm nervous & its 9 days away.. I know i'm looking too deep into it.   My surgeon said if its repairable he will repair it, if not, he'll replace it.  I need to pray & relax.  Thank you !  Gerard

Thank you Robert!  First off you are correct, when I wrote  comparing the tissue vs repair, I used the word replacement instead of repair, I corrected it  TY!! 
You stated "Surgeon's won't repair a valve if they think it won't last for good."  I know this but yet I'm trying to control the situation, which I know is not good.   TY for the reminder. 
When you had your ring replaced the 2nd time I assume it was through your chest or ribs?   As for the afib he is addressing that while inside.. & he did say he would clip the appendage on the left atrium where clots were most likely to form.    I feel for you for what you went through, I'm mixed w different emotions day to day.  Thank you!  Gerard

Rita Savelis  This is definitely a question for your surgeon, but as Cathleen said most everyone  still prefers a repair over a replacement. I'm sorry that you have to go through this. Take care.

Klara Čičić  If successfull repair is doable, than it is the preferred option for many reasons. If repair will be suboptimal, then replacement is reasonable. I think there can be TMVR done in the future even after the repair! Definitely ask your surgeon. 

Robert Miller  @Gerard LoRusso I probably wasn't clear. My second surgery was also open heart surgery (OHS) so it wasn't through the rips/robotic surgery. Actually, I was told that once you had one OHS they will do OHS again (no minimal surgery but inserting a second replacement valve is ok). Basically, it was the same thing again with some additional fixes. During that process they replaced the ring. It was a Medtronic ring before but the new one was some other brand. Not that it matters, I think, but Medtronic is a very reputable company. 

Gerard LoRusso  Thank you everyone, & to those I didn't personally thank...Thank you!!! This board has helped me al lot, reading everyone's upcoming procedure & reading the opinions of those who have been through it or are knowledgeable on the subject. Mon 8/21 is my mitral surgery at Houston methodist debakey heart. I choose a sternotomy since my guy has done many, Transcatheter which he's also done many he felt was too risky. He going to remove the ring that's partially unattached, assess the situation & will do a repair or replacement. I trust him, I'm nervous, optimistic, a bag of mixed emotions depending on the day :)