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Heart Disease  (Expert Forum)
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aortic valve replacement
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MedHelp Member's Question

aortic valve replacement

by Paul, Sep 23, 2000 12:00AM
I'm a 46 y.o. who is asymptomatic. On a routine physical a few months ago, I was found to have a heart murmur. Echocardiogram and cardiac cath. results showed "severe" aortic valve regurgitation. Valve replacement with a mechanical valve was recommended. I am concerned with the risks of being on coumadin for the rest of my life. Would the Ross procedure or homograft valve replacement be better options?  Or are the risks of coumadin therapy rare? thank you for your advice.
Doctor's Answer

by CCF CARDIO MD - DLB, Sep 26, 2000 12:00AM
Assuming that you are a candidate for any of the three procedures you list, I generally favor a homograft. The major risk of coumadin is bleeding, though this is more a problem in older patients. However, coumadin therapy also can be inconvenient in terms of requiring periodic blood tests.
Member Comments (10)

by Rob, Sep 23, 2000 12:00AM
Hi Paul,



I had aortic valve replacement for reguritation 6 months ago at age 48.  I did a lot of research on this board and by reading medline and decided that a homograft was best for me.  I had the surgery done at the Cleveland Clinic because their numbers were so strong, both in terms of experience base and outcome statistics.  My local hospital also does the procedure, but in far fewer numbers of cases.  The surgery was excellent at CC, the aftercare was adequate, though not as good as many places.



If you would like to chat, leave youe e-mail address and I will be glad to help.  At 6 months I'm feelling great and am very active.



Rob

by Susan, Sep 23, 2000 12:00AM
Hi Paul!  I had aortic valve replacement 18 months ago due to a congenital bi-leaflet valve that had become stenosed over the years.  I was 51 at the time.  I have a St. Judes mechanical because I don't want to have the surgery again.  Any tissue valve bears the risk of repeat surgery which at "our age" could be at a later time in life when there may be other ailments that could make the heart surgery more risky.  I am of course on coumadin therapy, but have had no problems at all with it.  I eat as I please, just don't binge on the no-no's.  I work in a high pressure profession requiring lots of travel by plane, car, buggy,  you name it; and I have a daughter in college.  I can do circles around most of the younger ones who don't take nearly as good care of themselves as I do.  So, all in all, it is a personal choice, but I don't regret mine.  The surgery ws no big deal either.  Not a lot of pain and I was walking a mile at the end of the first week--4 miles a day by the time I went back to work full time 6 weeks later.  Good luck!    Susan

by Susan, Sep 23, 2000 12:00AM
Hi Paul!  I had aortic valve replacement 18 months ago due to a congenital bi-leaflet valve that had become stenosed over the years.  I was 51 at the time.  I have a St. Judes mechanical because I don't want to have the surgery again.  Any tissue valve bears the risk of repeat surgery which at "our age" could be at a later time in life when there may be other ailments that could make the heart surgery more risky.  I am of course on coumadin therapy, but have had no problems at all with it.  I eat as I please, just don't binge on the no-no's.  I work in a high pressure profession requiring lots of travel by plane, car, buggy,  you name it; and I have a daughter in college.  I can do circles around most of the younger ones who don't take nearly as good care of themselves as I do.  So, all in all, it is a personal choice, but I don't regret mine.  The surgery ws no big deal either.  Not a lot of pain and I was walking a mile at the end of the first week--4 miles a day by the time I went back to work full time 6 weeks later.  Good luck!    Susan

by Paul, Sep 24, 2000 12:00AM
thank you Rob and Susan for the info you gave me. How do I find out how many aortic valve replacement surgeries are done at my local hospital along with their outcomes? I am certainly not opposed to travel for the procedure if it means the outcomes are generally significantly better elsewhere. Rob, my email is ***@****

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by Cheap surgery, Sep 25, 2000 12:00AM
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by Sandy, Sep 26, 2000 12:00AM
sorry i don't have any answers. but i recently saw a blurb on tv about a dr. doudi in my city.  he had just operated on a professional bicyclist who could no longer compete due to similar heart problem.  he gave him surgery with a tissue valve replacement,  and the patient is now back competing in the bike races.  i am trying to find out more and trying to determine the right questions to ask.  i have only moderate damage, but the symptoms have been life altering.  i would like to find something that would give me back my normal life.  still i see many surguries that do not really change the "symptoms" and extreme fatigue, etc.  so it is hard to know what to do.

by sue, Sep 28, 2000 12:00AM
Paul, I too had the St Jude Valve. I had just turned 40 when the surgery was done. I was born with a defective aortic valve which became very bad very quickly. The surgery was a success! I am told my valve should last the rest of my life as opposed to the pigskin. The coumadin is a minor inconvenience compared to a repeat surgery! I chose my thoracic surgeon carefully. He has been doing this surgery for many years with excellent outcomes. All the best to you!

by Bob beasaint@jumo.com, Oct 10, 2000 12:00AM
I had my aortic valve replaced almost 20 years ago,April 1981 that was the 15th.The mechanical was used and I have lived with the tinner since then, a few changes in the dosage other than that I have not had any restrictions.

I have always known that it leaked from 7 days after I went home.Now I an on a close watch to have it replaced.

Burlington Vt.
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