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Heart Disease (Expert Forum)
Aortic Valve Replacement
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Aortic Valve Replacement
by Hope Fisher, Dec 30, 1999 12:00AM
My father, 68 years old was diagnosed with a calcium deposit in his aortic valve and replacement surgery was recommended. I'm trying to do a little research on his behalf so any information, websites, etc you can provide would be very helpful.
He is interested in the pig tissue valve rather than mechanical and extremely interested in minimally invasive surgery as well.
He is very active (tennis daily at least 5 times per week), non smoker (but lives with a smoker). He lives in the Berkshire mountains of Massachusetts and has heard wonderful things about hospitals in both Boston and Worcester.
Thanks in advance for your help!
He is interested in the pig tissue valve rather than mechanical and extremely interested in minimally invasive surgery as well.
He is very active (tennis daily at least 5 times per week), non smoker (but lives with a smoker). He lives in the Berkshire mountains of Massachusetts and has heard wonderful things about hospitals in both Boston and Worcester.
Thanks in advance for your help!
Doctor's Answer
by CCF CARDIO MD - CRC, Jan 02, 2000 12:00AM
Thank you for your question. There are two main options for aortic valve replacement: mechanical and tissue. Examples of mechanical valves are St.Jude, Star-Edwards and Medtronic-Hall. The advantage of the mechanical valve is its long life (usually longer than the person receiving it). The disadvantage is the need for life-long coumadin. There are no long term complications from taking coumadin other than the bleeding risks.
Tissue valves are made from pig or cow hearts and last about 5- 10 years. The main advantage is not having to take coumadin. Aortic homografts are tissue valves from cadavers and also do not require anticoagulation and may last longer than other types of tissue valves. No one really knows how long but it is probably more than 10 - 15 years. The chief disadvantage of the homograft is availability.
The Ross procedure transplants the patients own pulmonic valve to the aortic position and places a tissue valve in the pulmonic position. We have stopped doing this procedure at the Cleveland Clinic due to poor long-term outcomes with the pulmonic valve.
As you can see each option has its pros and cons. Ultimately the choice is between you and your doctor.
Support group newsletter.
http://frontpage.inficad.com/~hanky/heart.htm
Tissue valves are made from pig or cow hearts and last about 5- 10 years. The main advantage is not having to take coumadin. Aortic homografts are tissue valves from cadavers and also do not require anticoagulation and may last longer than other types of tissue valves. No one really knows how long but it is probably more than 10 - 15 years. The chief disadvantage of the homograft is availability.
The Ross procedure transplants the patients own pulmonic valve to the aortic position and places a tissue valve in the pulmonic position. We have stopped doing this procedure at the Cleveland Clinic due to poor long-term outcomes with the pulmonic valve.
As you can see each option has its pros and cons. Ultimately the choice is between you and your doctor.
Support group newsletter.
http://frontpage.inficad.com/~hanky/heart.htm
and the four main valve types.
However, there seems to be little choice by the patient and family as to which valve will be used, once you pick your surgeon. He or she will choose the valve they are most comfortable with. e.g. Dr. Cosgrove at CCF, I have been told will not use the porcine valve but the baxter bovine pericardial valve, if he decides that the homograft (another choice) cadveric valve or repair of the AV are not options and his Minimally invasive approach should be an option for a 68 yr old with no other involvement. If you choose Dr. Tirone David in Toronto, he invented a porcine valve and uses it almost exclusively, if he is not going to do the Ross operation. (another choice, and which has an excellent web page: just type in "the ross procedure" in any search engine for access.
If you want more sites or specific addresses, let me know.
I realize it makes beautiful sense but has many problems...??
in which her rbc's are being damage. My question: Is reoperation
the only answer? Also how often does a artificial valve cause
damage to the RBC's? Can this reoccur with the second valve
if another one is placed?
Are their any other choices. Is there a artificial valve out
there that would resolve this
My 85 year old mother underwent an AVR (aortic valve replacement) surgery at a major hospital in New York City; the surgeon is a widely known cardiac surgeon.
She also had calcified material in her aortic valve; her only symptoms were 2 brief fainting episodes; the first at 84 (they decided to do a less-invasive valvuplasty at the time) and the second at 85, after she'd climbed several flights of stairs. She recovered quickly from the 'fainting', but the AVR was highly recommended by the hospital staff.
I would definitely be happy to give you any 'advice' I can, as I feel I now know quite a bit about this specific topic: aortic valve surgery and the elderly.
Please feel free to Email me at: ***@****
-What is the percentage of success for this surgery?
-What would be the activities for this person after the surgery and for the next years of his life, will he be as normal as before the operation or he has to follow certain restrictions and farther treatment?
-How long will the new Aortic Valve remain in good condition without farther complications?
-What kind of Aortic Valve is usually implanted in this case, a mechanic valve or something else?
-What causes the Aortic valve malfunction, and what should he do to avoid worsening his present condition, which according to Heart Catheterization results, is 60 mmHg.
-When the heart has an Aortic Valve malfunction, what are the signs and symptoms that appear to the patient for the first time?
-If there is one symptom of fainting and chess discomfort, is it still necessary to go immediately for operation (aortic valve replacement)?
-If one has the first symptoms of aortic valve malfunction, does it mean that he will continue to have them continuously in the future or there will be a chance to avoid the symptoms by using another treatment?
Please, reply to my email address ***@****
My surgery went well and I'm doing fine... but everyone I talk to now is "flabbergasted" that I did the Homograft. I'm wishing now that I'd had more time to process it all.
My question is this -- there's so much info on Coronary Artery Disease (I do NOT have CAD)... and so little info on post-op do's and don'ts for valve surgeries..
What can I do to get as many years as possible out of this Homograft Valve? Is it just the standard heart-healthy stuff or is there anything specific to help?
It's great to not be on coumadin, but I will welcome any feedback
or info on long-long-long-term maintenance.
Thanks.. Bill