Michael's Journal

Michael Willmon  That’s what I’m afraid of. I guess the On-x is the quietest. I’m leaning towards taking a gamble on technology and get the Edwards inspiris tissue valve. I’ll  have to get another surgery or procedure sometime in the future.  You could get one put in if you really hate the mechanical but yeah another surgery.

susan harris  Tissue valves last longer in older patients but less in younger patients.  Even so,there are patients in their 20's and 30's that get tissue valves and sign up for future interventions - who knows what technology may exist when the time comes.  But some do not want to go through surgery again no matter what - ask doctors how many or % of mechanical valve patients actually do have to have another intervention just so you have the facts.  I'd urge you to ask doctors about growing old on coumadin - the long term, not just short term things so you can make a fully informed decision.  How to manage drug interactions w coumadin as you get older and take more meds?, How do you handle surgery if on coumadin?, What are outcomes when someone grows into 80's or so when on coumadin (what happens when elderly fall (but good news is that you're already on a blood thinner when most have to start this later in life)...just a few questions to give you examples.

Rita Savelis  I've had 2 mechanical valves for 10 yrs since age 53. I have had no problems with coumadin. But of course many times I wished this hadn't happened. I get jealous of those who didn't need heart surgery until their 70's or 80's. In a perfect world I would not have had to have 2 valves replaced or take any meds. But my chest was irradiated when I had cancer treatment at age 15 and radiation has many late effects, including messing with your heart and lungs and causing other cancers. Even one heart surgery was difficult. I trusted my surgeon. There are no perfect solutions or right choices. You just move forward. Whatever choice you make will be the right choice for you and your singular heart. You can't look back. I'm sorry that you have to go through this. Take care.

Jennifer reynolds  I have an Onx mechanical mitral valve and happy with my decision. Have had it nine months and I just turned 60. I can hear it when it is very quiet but I have gotten used to it . At night I use a white noise machine. No side effects on warfarin but getting the level right is a challenge. I do not ever want another surgery so that’s why I went with mechanical. 

Robert Miller  I have no experience with a mechanical valve but was in the same situation as you at about the same age. For the first OHS I chose to go with a mechanical valve but they fixed it instead. Second OHS I decided last minute to go with a tissue valve. But they just repaired it again. So my point is that you have a good chance that it can be repaired. If not, in my personal opinion, Coumadin isn't a big issue. For me it would be more the clicking but supposedly your brain will blend that out after a while. I think that's probably true. I have constant ringing in my ears but most of the time I don't hear it unless I listen to it or when it's unusually strong. I think the mechanical valve would have been the same. But as I said, I can't talk from experience. 

Marie Myers  I don’t believe there is any other anticoagulant option proven safe for mechanical valves other than Coumadin.

Christopher T  I think I would focus more on the long term outcomes of the different approaches (BIO valve, ROSS, mechanical. ) you can lookup or ask your surgeons about statistics on these approaches. If you are 49 and in relatively good health shouldn’t be an issue for a sternotomy.

Sue Maize  Hi Michael,, it’s a big decision and one you make once fully informed of all your options. I’m not sure what you meant in a previous response about a “mini”? You’re having your  valve replaced without a full sternotomy? 

Susan Lynn  Michael - Minimally-invasive replacements of the aortic valve are possible with surgeons who have mastered the procedure.   It's a side- entry mini-thoracotomy and doesn't require a cut of the sternum.   Be aware that surgeons who tell you it's not an option may actually be saying they just don't do them.   Get multiple opinions no matter how confident you are with your first surgeon.   Heart surgery is big business and surgeons have become sales people.  Make the choice that's right for you. 

Michael Willmon  Thank you for your responses.  My surgeon Dr. Doolabh does a mini through a 2” incision between the ribs. He says the only thing he can’t do is a bypass so I think he can do a Ross. I’m considering the Edwards inspires resilia valve if I do bio prosthetic. Supposedly it can last 20 years but there isn’t enough data because it just came out in 2017. I would be taking a gamble on technology.

susan harris  There are great videos on the learning center - and you can scan by Ross, type of valve, etc.  There were clinical trials with Eliquis and one other blood thinner, I believe, with mechanical valves and the trials failed.   Adam always says its about a lifetime plan -- at 49, I'd ask each surgeon you get an opinion from about what they see for your lifetime plan.  and then weigh the differences in approaches about whats best for you.