Valve recommendations

[Steve Krizan]

I am 37 years old and scheduled to have surgery to replace my aortic valve and to fix a sub aortic stenosis.   My surgeon is recommending a Biological valve, but everything I read on the Internet says that young patients should get mechanical valves.
I have seen the posts on this site with the generic answers for valve choice, but I would like a little more information.  Are the new biological valves expected to last longer than in the past?  Is life on coumadin really that bad?  I don't really want to have heart surgery every 10-15 years, but I am leaning towards the biological because there is a 20% chance that the growth causing the stenosis may grow back, and if it does they will have to operate again anyway.  Do you know of any other websites where I can talk to other valve recipients?
Any help you can give me is greatly appreciated.
Thanks,
Steve Krizan

[CCF-M.D.-RCJ]

Steve Krizan,

Thanks for the post.

I'm assuming that you have aortic regurgitation, and not stenosis?  Usually the membranes lead to stenosis of the outflow tract and regurgitation of the aortic valve.

Q1:"Are the new biological valves expected to last longer than in the past?"

Yes, they are.  But the key word in your statement is "expected".  There are numerous examples of so-called technological advancements in medicine that have been a bust.  The older Bjork-Shiley single-tilting disk mechanical valve is one example.

Q2:"Is life on coumadin really that bad?"

Depends on who you talk to.  Being on coumadin requires that you have regular INR checks -- Blood draw from arm or finger stick.  Most people need to have once per month checks, but some need more frequent.  You also may need to curtail some of your activities, depending on what you like to do with your spare time.

Q3:"Do you know of any other websites where I can talk to other valve recipients?"

I'm sorry, but no.  Maybe some of our readers can help?

Lastly, a key issue is whether or not your aortic valve can be repaired (not replaced), thus obviating the need for your decision.  Make sure you discuss this with your doctor.  And consider having a second opinion at a large center.

Best of luck.

[DottyCece]

I am on coumadin and it is a gross incovenience.  I have had blood draws every two weeks or even more often because I ahve been difficult to regulate.  With a valve replacement,  I don't have a choice.  I must be on an anticoagulant.

[basw7]

http://www.valvereplacement.com/forums/forumdisplay.php?s=d20ba41d64919d8453614ea1252e9c31&forumid=5

Steve, I don't have a valve replacement but may need one in the future according to my cardiologist.  I think you will like this valvereplacement.com site.

[DanHill]

Hi Steve! Like you, I struggled with the valve options before deciding on which one to get. Read my post above on my decision. I sincerely hope that it helps you. Also, having just had the surgery a few days ago, I'll be happy to answer any questions about what to expect!

Sincerely,
Dan

[M L]

I am 51 years old and I was told by my cardiologist, the surgeon, and nearly all other health professionals that I was too “young” to receive a biological valve due to the fact that they only last 10 – 15 years.  My cardiologist’s theory was that the biological valve would most likely have to be replaced when I was in my 60s or 70s and I would presumably be less healthy and able to withstand a 2nd surgery.  On June 4th of this year I underwent surgery to have my aortic valve replaced with a St. Jude mechanical valve.  I also needed to have much of my aorta replaced because it had stretched to twice its normal diameter.  Anyway, the operation was a success; I’m on Coumadin and will be for the rest of my life.  Other than the mild inconvenience of regular blood checks, I have no problems with the Coumadin and I find the inconvenience of Coumadin to be more acceptable to me than the possibility of additional surgeries.
QUESTION:  One disadvantage of the mechanical valve is that it is noisy, especially at night when sleeping.  I am told that this will eventually subside.  Does anyone out there know if this is true, and if so, how long will it take for my St. Jude to settle down and be quiet?  

[Steve Krizan]

From what I've read I don't think they ever quiet down.  There is much discussion about this in the forums at valvereplacement.com.  Many people run fans, "white noise" machines, humidifiers and other noise makers at night to hide the clicking.
I have a Timex Expedition watch that my wife and I can hear clicking on my dresser at night if I forget to put it in a drawer.  I think the clicking would drive my wife and I crazy.
Good luck.
Steve