Rob's Journal

Rose Madura  Hi Rob, it is a tough decision and a very personal one. Do your research; come to a conclusion and they go with it. The choice you make will be the right one. God bless you.

Marie Myers  Valve choice was the hardest decision I ever made. I remember going back and forth for months, changing my mind several times. I am glad you are sleeping well!  God bless you in making your decision.

Robert Miller  From all the articles I read the general consensus is <50 get a mechanical valve and >65 get an organic valve. But a lot also depends on the lifestyle.

I am just at the very low end of that 50-65 range so that pointed more towards a mechanical valve. In addition, if a first organic valve via open heart surgery lasts 15 years and then another replacement via a blood vessel lasts another 10 years it would bring me to 75 years. So if I get that old I might need a 3rd open heart surgery (I already had one before I had to make that decision). I kind of wanted to avoid this. Hence, I was pretty much set on a mechanical valve. That's despite my lifestyle which involves skiing, climbing ladders, working with jigsaws, circular saws, etc. I also didn't mind watching my INR, watch my diet, and I was going to get a home kit to measure the INR myself. 

Then on surgery day, while the nurse prepared me, she was asking about the valve. She was surprised I said a mechanical valve and said most people these days chose the biological valve, even at my age. I then talked to the surgeon. We ended up leaving the decision to him. He said he will look at the scares from my previous surgery and based on this will decide what valve to use (if the scares were bad then a third surgery is more likely to lead to complications). It turned out the scares looked pretty good so he would have used a biological valve. Luckily, he was able to repair the valve so it became a moot point. 

Rob Riley  Yeah I’m there I’m only 51 so that is the same scenario I find myself in. Thanks for your story and your decision making process it helps.

Rita Savelis  I hear you Rob. I think most everyone has reservations about both options. Whatever you choose will be right for you and you'll see that life goes on and one gets used to any valve. I've had mechanical valves (aortic and mitral) for 8 years and have a high dose of anticoagulants and a high target INR. After an initial period where I worried a lot about anticoagulants, now I don't think much about them. I test whenever I want - about once a month - I decide my own doses, I eat everything I want to, I do everything I did before surgery. I didn't have much choice because with double valve surgery for radiation induced heart disease, it was better for me to have only one surgery if possible.  So I did that. But deciding what kind of valve to pick seems to be the number one anguish of everyone on this site. Don't know if your surgeon has any personal recommendation for you , or how old you are. But whatever you decide will be right. In fact there is no right choice, just the choice you make. Take care. I'm sorry you have to go through this.

Greg Lewis  Hi Rob! I have come to the understanding that as Rita says, the only right choice is the one for you. Every valve can go for years. Or, not. They all can have problems. They tell you mechanical will go forever, but, not always the case. They tell you tissue valves will go for 10 to 15, but, not always the case. You work with machines, as did I, so you know that anything man made, can fail. So where does that leave us? I wrestled with, do I want to worry about bleeding the rest of my life? Do I want to come back for another surgery in 12 years? TAVR is a good possibility later on? 
My surgeon ultimately helped me make a decision. And I am very happy with it. For me, I chose tissue valve because of his recommendation.
Since my surgery was less than ideal, I wound up on blood thinners for a few months. Not for me..I worry too much, about bleeding. Type A personality.  Lol . It's not the taking Coumadin, and the INR that's the issue, for me. That was easy. It's the body leakage that I don't like. 😁  Not thrilled about the possibility of having to go through this again, but had to pick something. 


So. The choice was right for me. 
Whatever you decide..never think about it again. Can't  be changed. It just is. 
Hope I didn't add anymore confusion.  Good luck!!

Rob Riley  Hey Greg, thanks for the insight . I’m with you as I’m not real worried about the Warfrin per say but the leakage from cuts and scrapes mainly on my hands and bald head. I seem to bump it often. … lol… it’s a toss up still for me at this point. Surgeon recommended the On-x valve due to the lower INR and my age. But said I could go with the Inspiris tissue valve as well and it would do a good job and be large enough for TAVR down the road. 

Marie Myers  Valve choice was the hardest decision for me. I went back and forth for months, since there are advantages /disadvantages to each choice. Wishing you peace during your preop time.

Rose Madura  Rob, you are doing great and thinking everything out methodically.  I agree with Marie. The valve decision was definitely the hardest. My advice is to do research; make a decision and then go with it and don't second guess. Whatever you decide, it's the right decision.  Godspeed.

Rose Madura  I got a second opinion immediately after being told I needed surgery. I didn't like the new cardiologist who replaced the one that retired so went with the new one whose diagnosis was the same.  Your choice for a second opinion is a great choice.  I'm not a doctor, of course, but I'm thinking TAVR at age 51 is too young.  Just my thoughts.. each person's situation is different.  If I were you, I'd get the second opinion before the heart catheterization.

Terry Tannenbaum  Do it when you are comfortable, it's your body and mind so you need to be at peace with the professional opinions and diagnosis. I interviewed four surgeons and consulted with three cardiologists before making my decision. 

Rob Riley  Thanks Terry… today I felt rushed a little. I know that was not the intention at all from them. I am still just  a bit overwhelmed. I do have a second opinion lined up. 

Ana Brusso  Second or third opinions or more. Rose and Terry are right. You need to be comfortable with the surgeon that will do your surgery. Hope you find the right one. God bless you 

Rose Madura  Rob, I'm no expert but I think each person progresses differently.  Please let us know how your appointment goes tomorrow...

Susan Lynn  I'm not an expert, either, but I think your doctor will also look at your ejection fraction and ask if you're having any symptoms. You may want to ask about TAVR. It used to be reserved for high-risk patients, but is now a widely accepted approach to address stenosis. A quick out-patient procedure beats the trauma and recovery of OHS. Please keep us posted on your appointment. Good luck.

Patsy Stewart  Your doctor can usually predict a timeline for you by gathering all of this information, and watching your echoes along the way. My cardiologist was present the day of my TEE. He told me I wasn’t a candidate for a TAVR, but after my unsuccessful OHS, they scheduled me for a TAVR because that was the only option available to fix me. I am forever thankful for that second chance! I pray that you get hopeful news tomorrow, and they get a plan in place for you. ~❤️

Adam Pick  Hey Rob, Take it step-by-step and everything will work out fine.

As many patients might share with you... The time leading up to surgery can be the worst part of this entire process. Just know that you are not alone. Let us know how we can help!

Rose Madura  Rob, do your research and no matter which valve you choose, it will be the right one for you. There are pros and cons of each.  We are here for you so if you have any questions, ask away.  Godspeed.