Susan's Journal

Fidel Martínez Ruiz  Hey Susan: Welcome to this HW place where sharing experiences. I underwent a mitral valve replacement with a biological prosthese on october 2023 as a result of a previous endocarditis. I didn´t have the chance of repair the valve. The surgeon told me the biological valve lifetime would round about 12 years (range 10 to 15) and even more (20 years in some cases), depending on patient life style, by the way all on according to medical papers. I have no idea where this figure of 8-years for you comes from. By the other side, there are now a new generation of tissue valves anti-calcification which extend the valve lifespan and put it farther. If you have need of a new surgical intervention, it would be done as a "valve in valve". Besides, there is other possibility with a mechanical valve, as Alexander and Melinda suggests. Anyway, It´s not a major unsolvable problem, so hang in there! !

Susan Schaberg  Thank you.  I appreciate your comments.   Two CT surgeons have told me that percutaneous mitral procedures are not ideal at this time, should only be done if the patient cannot have surgery.  I  hope they improve over time.  Wash U/BJC staff absolutely insist that biological valves last 8-10 years.  I don't understand it either, other than the valves they use produce those numbers.  That's why I'm not going there.  I hope the new tissue valves do last longer.  

J Alexander Lassally  Hi ! It might be worth getting an extra point of view at either Mt Sinai or Cleveland. Mt Sinai is renowned for repeat repairs. 
I do sympathize with your situation. I am just two years into the first repair (now early 50s) and do not want to think about that potentiality. 
If you do end up with a replacement valve, maybe a mechanical to maximize the lifespan?... 8-10 years sounds really low on the bio valve they quoted you. Are you at Barnes? I'd check that, too!  Good luck. 

Rose Madura  Hi Susan.  I can feel your frustration in your post and I don't blame you for being upset.  I would definitely get a 2nd opinion as stated above and consider traveling for the next procedure if necessary. It's a tough pill to swallow. Please keep us posted on your journey. Godspeed.

Susan Schaberg  Thank you for your kind comments.   I am frustrated and upset with no one who really understands.  Wash U/BJC insists that bioprosthetic valves last 8-10 years.  That's the line from everyone I've talked to:  cardiologists, CT surgeons, nurses.  Perhaps it's the valves they use?   At 61, I'm not eligible for mechanical valve. No consensus on why the repaired valve is failing:  a few cardiologists have said separation from ring; a couple CT surgeons have said thickening of leaflets.  I believe leaflet thickening is not repairable.  I've sent all my info to Cleveland Clinic and am waiting to hear back.  I am working on sending info to Mt. Sinai.   Are more recent surgeries less awful?  Thinking about the ICU from 19 years ago still stresses me.  I was a "take back" to the OR for excessive bleeding 8 hours post-op.  After transfusions I did fine but found all the wires, catheters, shots, and needle sticks horrible and overwhelming.  Again, thank you for the information.

J Alexander Lassally  Susan - Glad you wrote. I know how alone and frustrated I felt in my initial days before getting sorted. 

Did you have a thoracotomy or sternotomy back then?  I am super curious if you were an early thoracotomy?
For what it worth - my ICU experience was about as good as it could be. I felt safe and comfortable. Granted, there were some bumpy moments but I won't elaborate. 
Technically, though, I would drill deeper on two fronts. The 8-10 sounds low once again. I would say 10 to 15 from what I heard. At least 10-12. 
Second - why cannot you select a mechanical? I think you are in the grey zone at 61 but it seems reasonable to consider in a healthy individual if the idea of fewer surgeries rises to the front. 
Happy to answer any questions / follow your string. 

Jennifer reynolds  I had a mitral valve replacement at 59 yrs old (almost 60) and my surgeon advised a mechanical valve replacement and I am thankful to not have to worry about having another surgery: surely at 61 yrs old you can insist on a mechanical valve replacement.i I hope you can get a second opinion 

Fidel Martínez Ruiz  Hey Susan: I am surprised you we're told that a biological valve will only last only 8 years. Current valves have an average lifespan of 20 years or more. Latest generation of biological valves have good results up to now. Ask your doctor about this. Best wishes for your mitral valve treatment.

Marie Myers  Fidel- Unfortunately,  mitral biological valves don’t last as long as aortic biological valves. That being said, Susan- is a re-repair of your valve possible?

Fidel Martínez Ruiz  I think that the new generation of  valves ( example, Resilia tissue of Edward) has a lifespan of 20 years or more. At least this is what the manufacturers claims and is aproved by FDA and CE.

Fidel Martínez Ruiz  Marie, it's true that, while in in vitro tests the new tissue lifespan is very long, the life of the valves implanted up to now is lower, but is, I think, because there hasn 't been yet time to check It. Anyway, whenever is possible, surgeons choose repair as the first indication. 

Susan Schaberg  The surgeon said it is not possible to repair the repaired mitral valve.  Have you had a repaired mitral valve fail?  

Fidel Martínez Ruiz  No, Susan. In my case I got a biological valve. I had a previous endocarditis and was imposible to repair. Anyway, up to now (surgery was in october 2023) I feel ok. Ask me any question you want.

Jennifer reynolds  Hi Susan, I am 60 and had my mitral valve replaced with a mechanical valve a year ago. I chose mechanical because I did not want another surgery. I have had no complications, other than some a fib after surgery that resolved on its own. Hope this helps