Did I make the wrong choice?

[JohnnyV_46]

I had a mild heart attack 3 weeks ago. I'm 46 years old, self employed. The next day they did a Cardiac catheterization and found 3 coronary arteries that had some pretty good blockage. The Doctor also pointed out that I had a bicuspid aortic valve that was showing signs of Calcification and Aortic Anneuryzm that was over 5 cm. I never left the hospital before my surgery. I knew very little about the procedure.
I know the doctor explained the mechanical and tissue valve and then brought up the whole Cumadin issue...The only thing I could rememeber was how much trouble my dad had with Cumadin after lung surgery. I decided on the tissue valve. I had a friend tell me about this site after my surgery. It looks like most here have Mechanical valves. I have a Cow valve. I know I'll have to have it replaced eventually.I'll definitely be more informed next time. So do most opt for the Mechanical?

[Mary]

I had a bovine valve implanted too. You're not the only one mooing around this place! :)

[Lynlw]

I don't think there really is a wrong choice. My son is 17 and has tissue, but I know alot of people around your age here seem to go Mechanical. because chances are it won't need replaced, others go tissue to avoid coumadin , I know it's not as bad as people think, but I'm glad Justin doesn't have to deal w/ any meds for 10-15 years. I know alot of the people that have tissue hope when they need the tissue replaced, there will be improvements
I'm glad you are doing well Lyn www.caringbridge.org/nj/justinw

[samiam]

Mooooo. I'm 55. Don't know about the valve you received, but mine is "supposed" to last 25 years. When it's time to replace your valve, imagine how much further along cardiac procedures will be. They will probably do it with a catheter or something we can't even imagine. Maybe Dr. McCoy from Star Trek will wave his hand over your chest. Who knows?

There was no way you could have been "better informed".

Welcome to the group.

[KristiinSD]

And my surgery is not until the 29th of this month...and I would go tissue. I'm your age with a insufficient mitral valve.

Kristi
mr

[JohnnyV_46]

Well it's nice to know I'm not the only one Mooo'in here. How long does it take for your Sternum to heal? I really didn't get a very good send off from my Cardiologist because it was the Infectious Disease doctor who dismissed me from the hospital the second time. My first visit to the Cardiologist is not until the 20th of this month. It just doesn't seem like it's been 3 weeks!..I'm so glad I found this Forum.

Thanks for your Replies!
JohnnyV :D

[CCRN]

You are alive and well......You made or had the right choice made for you. Having a mechanical valve does not mean you will never have to have another open heart procedure. I have a mechanical valve and wish I had a tissue! Don't give it another thought...for a while. :) Live your life and enjoy. You could be one of the many that prove tissue valves last WAY LONGER than some people like to project. Take good care of yourself and have great expectations. I envy you.

[geebee]

I don't think there are right or wrong choices for valves. There are so many different factors that result in deciding what valve we end up with. Some of us didn't even get to make the choice ourselves. Just enjoy being alive and the rest will take care of itself in time. As many folks say "who knows what will be happening in 15 or 20 years".

Glad to hear you are doing well. Enjoy your new lease on life.

[cocoalab]

I tried to post earlier but the computer had it's own ideas.;-D

Congratulations for making it this far! That is the most important thing. I am actually mom, not the patient so I have not been as brave as all you have here.

My son has had his valve replaced twice and had a mechanical the first time- chosen for us after the repair just wasn't good enough, and we opted for tissue this time. He has a Bovine as well.

My hope is that all our tissue valves will last a very long time and that each of us will have succesful surgeries (okay I don't really want to be in this part of the we.) Who knows what the future holds? so we live today with what we have and trust God to get us where we need to go in the future. TRy not to worry; it is a waste of energy. :-D

Hope you can just enjoy your life!

[rbl1999]

Hi, I also had a bovine tissue valve in July and feel that I made a good decision. Like everyone here says, it is an individual decision. My surgeon felt that is what I should go with, I am 59, he feels I should get about 20 maybe more years out of it.. And I liked the idea of not dealing with the coumadin. As for the sternum. it is going to take a while to heal, it is major surgery, I am 7 weeks post op and am doing good, but my doc says about 6 months for full recovery. All the best Rose

[Phyllis]

Welcome to the cow pasture and glad to see that you had successful surgery in the nick of time! :) You should do fine with the cow valve and as others have said, who knows what advances will be made in 15 or 20 years. In the meantime, have a speedy and uneventful recovery and enjoy.

[Ross]

I don't want to be the naysayer here, but don't bet the farm on future surgeries or techniques. There may be some advancements, but it's not likely to be much more then we already have. All I'm saying here is, if given a choice, do not base your decision on what "MAY" happen in the future. The future is uncertain and cannot be relied on.

Did you make the wrong choice? Absolutely not! Your alive and that's a choice anyone can live with. :)

[MarkU]

I don't want to be the naysayer here, but don't bet the farm on future surgeries or techniques. There may be some advancements, but it's not likely to be much more then we already have.

I think it depends on the timeframe. If you're talking about the next five years or so, then you're most likely correct. If you're looking at 10-20 years out, then I would tend to believe that we will be seeing significant advancements in minimally-invasive procedures, robotic surgery, valve technology, etc.

Mark

[hensylee]

recovery:
don't lift anything above 5# for first few weeks, graduate to 10# and eventually to 25#

Walk a lot and do your breathing exercises

No driving for about 4-5 weeks

Don't expect your sternum to be healed for some time. My surgeon told me it takes a full year to recover from MAJOR surgery, which opening the sternum definitely is.

Others may have more on this subject.

[LLJ]

You had alot done with so little notice! The decision would'nt be any easier if you had more time. I still debate if I should have gone bovine or porcine (I'm oinking ) Mechanical was never an option I considered due to lifestyle. I know alot of people have strong opinions about it and that"s good, because debate often produces change as well as solidifies ideas. Truth be told, it doesn't matter now, you will be going forward with a healthier heart! Take care of it with exercise and diet and it will take care of you. I'm with Ann,sternums take awhile to heal. Let the people who care about you take care of you. It's your job to get better and work on positive attitude in the face of sudden change!
Laura

[Eric]

Johnny,

Surgery to replace my ascending aorta and maybe my BAV (the doc will make a game-day decision) is this coming Monday, September 12th. If he decides to replace the valve I'm going bovine. Here's why...

I'm 42 and, very active and I don't want to have to deal with the drugs for the rest of my life. Also, a mech may not last me the rest of my life. If there is significant improvement in technique or the quality of valves over the next 10-15 years, I'll be the beneficiary of that. If not, at least I'll have a better quality of life in the meantime. Maybe I'll have a mech put in at that time which should last me for the rest of my life.

So, although the decision is personal and there is a degree of subjectivity to it, I made the same decision you made but took longer to make it.

[tobagotwo]

There may be more here on the site who have mechanical valves, but I am not sure. If so, it might be partially due to continuing information and support for warfarin (Coumadin) use, rather than a preponderance of people receiving mechanical valves. It seems a pretty even split among preops visiting the site.

People who receive mechanical valves will often stick around a bit to learn how to manage their Coumadin in practical terms, whereas those with tissue have less impetus to remain after the first few months postop. And the longer you stay, the more you're apt to find friends, and thus the more likely you may be to poke your head in and out long-term.

The use of different types is more split by different age groups than by any other criterion. The use of tissue valves in younger age groups has expanded greatly in the last five years, due to improvements in their longevity. However, there is no clear edge for either type over time as far as the patients' overall health and length of life in the most common implantation age groups. The deciding factors are usually best tied to your individual heart issues, general health, and personal preferences.

Of the tissue valves, the bovine models (such as the Carpentier-Edwards Perimount Magna) have the longest proven lifecycle so far. As such, you've been given a fine valve, even if you didn't get to choose it yourself.

Relax and enjoy the benefits you derive from your valve. If you've read much of the posting here regarding tissue vs. mechanical, you realize that people in your age group wind up in a terrible quandary as to which is the better choice for them, as it really is a toss-up, in terms of safety and prognosis.

Don't go back. Move forward.

Best wishes,

[Karlynn]

Welcome to our family. Some of us click, some of us moo, some oink and some have props from The Dawn of the Dead movie. We all share the common that we had screwed up valves, we had them fixed (or are going to have them fixed) and we now have a greater appreciation for life.

Life is to be lived with as few regrets as possible. Live away!

[momshell7]

HI

I just wanted to give you my two cents worth. My husband had his aortic valve replace last October and he went with the porcine valve. He is very happy with his choice. Like a lot of people on this forum, he didn't really know much about the different valves when he was told of his need for surgery. He was lucky :rolleyes: in the fact that he had a few months to do research the valves.( although in the begining reading all the information was confusing.) His surgeon and cardiologist both recommended the porcine valve, but the decision was completly up to him. Like others have said, there really isn't a right or wrong choice. Any valve that saves your life is a good choice. Enjoy your new valve. There are a lot of oinking and ticking valvers to go along with your mooing valve! Glad you found the site. It is very helpful. Just ask anything you need to.

[lance]

JohnnyV 46

I think you made the right choice. Any choice would have been the right choice--you're still alive.

You're not on warfarin--now that's a good thing.

Cheers

[samiam]

Well it's nice to know I'm not the only one Mooo'in here. How long does it take for your Sternum to heal? JohnnyV :D

I'm at 9 weeks or so. I was minimally invasive, which I'll "assume" makes a difference. At 6 weeks, I was able to start sleeping on my side. Most of the pains and twinges disappeared around that time, too.

Every day is a day of improvement, with a few baby steps backward every now and then.

Good Luck!

[Emma]

Johnny,
Glad to hear you came through your surgery ok. I don't think you made the wrong decision at all - you made the best one you could based on the knowledge you had and you're alive and here with us now so you ovbiously decided something right!
We had no choice with our daughters mitral replacement - it was mechanical or nothing so we live with the warfarin and deal with the best way we can. We don't find it too much of a problem at all and don't really think about warfarin as too much of a big issue and hopefully we've avoided future surgeries this way, but I'm sure living with no anti-coag meds for more years would feel much the better option to some people.
Good luck with the rest of your recovery!
Love Emma
xxx

[JohnnyV_46]

Thanks so much to all of you for your Replies! Eric, I know your surgery will go just fine! I just remembered They gave me a Warranty card with my Valve and I pulled it out of my wallet...lol It's from Edwards Lifesciences LLC.. size 29mm Model 3000TX.

Originally after the Cardiac Catheterization I told my wife I wanted to go home and think about things for awhile. The doctor advised against of it because of the Coronary artery blockage. I'm glad I didn't now...I always sweat dentist appointments, I don't know what I'd have been like waiting for a OH surgery!

Lol, my first big surprise when I first got home, I went up the stairs to the second floor like I'd never had the surgery, just wasn't thinking. I thought my heart was going to blow right out of my chest! I do the stairs now 2 weeks later, but I take them a bit slower and usually only at Bed time.

Kind of tough around here right now, I own my own Carpet Cleaning biz (Job) and I've been having to pass on quite a bit of work/money. My regulars are understanding and said they will wait for me to get back on my feet. Normally my Son in law helps with the biz, but he's in New Orleans with his National Guard unit.

Well I'll try not to be a pest but I do enjoy internet Forums.

I almost forgot the best part! We've been worried about my wife having Mitro Valve Prolapse. She went to her Cardiologist the week after I had my surgery. He says "I should have been treating your Husband!"......lol

[Lynlw]

speaking of New Orleas, I was wonderring how many people there w/ mechanical valves are running out of their meds, or even mech or tissues, wading thru that water imagine how many cases of BE will come from that
it is such a shame. I don't know alot of adults w/ heart surgery, but I've been talking to a transplant coordinator in Texas and she said they got a few heart kids transferred from NO, one is a teen ager on biventricular assist device waiting for a new heart since Jan, I can't even imagine being his parents and everything they are going thru, Lyn www.caringbridge.org/nj/justinw

[McCln]

The choice for the mechanical valve are for many reasons. It is nice not have to worry about for many years, if possible. The regement for coumadin is easy, the foods are not. But, with care and consistacy, it can be managed well. IT takes time and accounting of meds, which can affect the INR. Mostly, it is usually the younger people, the mechanical valve is chosen, the guarentee is better for younger people. But, not all choose that route. It is a choice between patient and surgeon. That is all I have.

[MarkU]

JohnnyV 46

I think you made the right choice. Any choice would have been the right choice--you're still alive.

You're not on warfarin--now that's a good thing.

Cheers

No bad choices if you're still kickin'...

I'd prefer not to be on Coumadin, but it's better than having a stroke or heart attack, so in my case being on Coumadin is a good thing...

Overall, I just feel blessed that I am otherwise healthy and can still pursue an active lifestyle.

Mark

[Curtsmum]

My son is going to have his mitral valve replaced soon, we dont have a option like you did, been told we have to have mechanical, think its a age thing. Anyway its hard enough to deal with without making a choice, allthow i would want the best i could have for my son. Iam glad i dont have to make a choice i think that would wreck my head even more.

[Ambience]

Odd, I took the mechanical valve and I ask myself that same question. Originally I was going in for the Ross procedure, but right as they started shaving my chest and giving me my seditives the doctor mentioned that a tissue valve would not last as long as a mechanical one. My eyes lit up as I struggled to decide the tradeoffs and at the last minute I told them to put the clicker in me.

I can't say I regret the decision, when I'm in a small room or elevator it's a great conversation starter. People look around the room and then ask if I have a pocket watch. When I tell them it's my heart the first thing out of their mouth is "But you're so young!" To which, I haven't really thought of a great reply. I've thought about telling them it's a bomb attached to my chest, but post 9/11 I'd probably get arrested and smacked down.

I mirror everyone here when I say your choice was the best one...not much you can do about it now. :) Or to quote Morpheus, "What happened happened, and could not have happened any other way."

[Innercalm]

And my surgery is not until the 29th of this month...and I would go tissue. I'm your age with a insufficient mitral valve.

Kristi
mr
Kristi: how insufficient is your mitral valve? Who will your surgeon be? I wonder because I may go to California for evaluation.
Susan (innercalm)

[KristiinSD]

My mr is severe.

My surgeon is Walter Dembitsky, Sharp Memorial in San Diego

I am choosing tissue for a variety of reasons including my belief that by the time I need a replacement valve things will have changed significantly. I also forsee another sugery (not related to heart) in my near future.

Kristi