Aortic Stenosis

My husband was born with severe aortic stenosis and had a tissue valve replacement when he was 17 (which was 16 yrs ago). He is now 33 and has been in good health since but we have absolutely no medical records on him and at the time, being a 17 year old boy, did not pay attention to anything that his mother was told about his surgery. (she passed 12 yrs ago) I have heard that tissue valves only last about 15 yrs until they need to be replaced again. Is this true? What are the chances he will have to have surgery again? Are there anymore complications with the secoond replacement than the first? What is the life expectancy of someone after their second replacement? Is there anything that I need to be watching for to make sure that we catch this before it is too late? If there is anymore information I should know I would love to hear it. Thank you so much for your time.

[skydnsr]

He needs to just make an appointment with a cardiologist to get checked out.  All valve replacement patients are "heart patients" for life.  Any artificial valve recipient should be established with, and be followed by, a cardiologist.  Those who are otherwise healthy may only need to see their cardiologist once a year or so, just for a routine check-up.  But anyone with an artificial heart valve does need to have a cardiologist.  For most artificial valve recipients, and especially for those with tissue valves, an echocardiogram is done about once a year, to see how the valve is holding up.

For a young person who is 16 years post-op with a tissue valve, to have gotten this many years out of it is fantastic.  Speaking very generally, tissue valves tend not to last so long in younger people, so he has done well.  But it would be very surprising if he were not getting close to needing his next valve replacement operation.  The doctor will run tests, mainly an echocardiogram, to check how well the current valve is functioning, and then you and he will have a better idea what to expect.  

With an expert surgeon, your husband should do well with this next operation.  The individual surgeon's skill is a huge determinant of outcome.  As a general rule, the better aortic surgeons tend to be found at major heart centers.  But without knowing where your husband's first operation was done, if the first surgeon is still practicing, I think he deserves at least a look-up.  As I say, your husband has done quite well.  

Assuming your husband has no other health problems, other than needing to get a new artificial heart valve, and assuming that this and any future surgeries go well, then his life expectancy should be normal.  As part of the pre-op workup, a CT or MRI of the entire aorta should be done, in order to rule out aneurysms.  If there is any other surgical problem in addition to the valve replacement, you will want everything to be taken care of in the same operation.

Your husband will need to decide whether he wants another tissue valve, with the expectation that he will need OHS#3 at some point, or whether he wants to get a mechanical valve this time.  The mechanical valves are longer-lasting; in fact, the expectation is that they will last a lifetime.  Every once in a while, somebody gets a problem with a mechanical valve that requires it to be replaced -- but as a rule, not.  The drawback to the mech valves is that they can promote blood clots, so mech valve recipients have to be on coumadin.  

A person on this forum asked within the last week or so about tissue vs. mechanical valves and got a lot of good feedback, so you might want to look for that post.  If you can't find it, post again to say so, and I will scrounge up a link for you.

Good luck.