Leaky St. Jude aortic valve?

Had a St Jude 23 aortic valve and ascending aorta replaced in 2004.  During surgery had complications and was in drug induced coma for 45 days while I recovered from kidney failure, stroke, respiratory failure and H.I.T..

Have been complaining of fatigue for five years and it come and goes.  Lately it has been dramatic and I just "poop out" and sleep for a day or more.  Cardiologist suspects a leak in the St. Jude valve and we are doing more testing.  Hve had two right heart catheritizationsin 18 months to measure pressues due to secondary pulmonary hypertension.  Now I am being told I have congestive heart failure.

I weight 220lbs and am approx 6'2" tall; relatively sedentary due to low energy.  I also still have active dissections going off the aortic arch.

Questions:

1.  Do the St. Jude 23 aortic valves hav a history of leakage?

2.  Could there be any alternatives to surgery?

3.  I live within driving distance to Johns Hopkins, Georgetown, etc  My original surgery was done at Washington Hospital Center.  Is there a heart center you could recommnd?

Thank you,

JCW


This discussion is related to 11 Year-Old St. Jude Valve Leaking.

[cardiobill]

Ok, well just to be clear I am not a physician, I have worked in cardiac imaging for a decade and manage a laboratory, so Ive seen alot along the way.

St. jude is a very reliable valve and that is why you pretty much see that valve as the valve of choice among surgeons.

St Jude valve does have cleaning jets, meaning there will always be leaks in it to help clean it to prevent embolus. Part of the engineering that makes it so good.
So yeah, always can see a leak.
BUT, the question should be, where is it leaking from? Is it dehiscing from its position, meaning is tearing out of its sewed in position? I cant remember the last ime I saw that, I have, but not for a long time.
But it can happen if what it sounds like you have some sort of connective tissue disorder like Marfans if you had an ascending aortic aneurysm to get the aortic conduit. But you could just have had uncontrolled preventable high blood pressure.
But active dissections going on? They typically dissect and with every beat of the heart it tears the inimal layer cm by cm until it dissects all the way down unless surgically done. I have seen that happen to the illiacs in a 24 hour period and into the renal arteries.
This is a bit puzzling based on the information you provided and that you are still alive. No doubt, I believe you, but I think things are not being fully explained to you, perhaps its b/c they your physician is just terribly pressed for tiem or already assume you think you know whats going on.

In any event, your next appointment, make a list of questions to get affirmative answers to whats going on? Active dissections are generally incompatible with life over a rather short period of time.

As far as surgical centers, the doctors I know with heart disease all went to Mayo Clinic in Rochester Minnesota. Cleveland Clinic would be a closer option seeing as how you are on the east coast I assume.
I am on the west coast so people go to Mayo for the complicated stuff. We refer to Oregon Health Sciences Univ. In portland Or with Slater or Song Mds for routine stuff. When I was in Cali, we sent the pediatric and strange stuff to Standford Univ.

But for the odder stuff, like recently a tough case was Mayo, he didnt survive dammit. But everyone else wouldnt even try

[ed34]

I seem to remember that a judge ordered a recall of some st. jude valves a few years ago? were they made of silver or something and consistantly leaking?
I'm sure however that the recall happened before you had your valve installed.