aortic valve prosthetics pros / cons

  : 48 y/o white male with bicuspid aortic valve that is stenosed and has a cross sectional area of .75 cms.  pressure gradient of 80mmHg.
  : My question is where can I find information on what is the best option for valve replacement?  Mechanical, homgraf, porcine?
  : I am scheduled in 2 weeks for a procedure and will be meeting my surgeon in 1 week.  Would like to be knowledgable when I have my discussion with the Surgeon.
  : What are procedure options as well.  Are there any laser options coming down the pipe in the next few months?
  : Thanks
  I'm 33, and had an aortic aneurysm repair with my valve spared.  Before I found out that my valve could be spared, I too was looking at mechanical, porcine or homograft.  For the latest information, check out the Journal of Thoracic and Cardiovascular Surgery and the Annals of Thoracic Surgery at a medical library (at most universities).  Look at the titles and the abstracts, most laypeople can understand the main points.  There are also websites with statistics as well (heartsurgeons.com, ctsnet.org, nmh.org).I found that homografts in younger patients generally last 15-20 years, porcine 10-15.  My opinion for what is worth, is that the risks associated with blood thinners is often down played.  Coumadin must be taken carefully, monitored monthly and there are diet restriciotns and it seems to interact with nearly every other medication.  There is a small but real risk of having a major clotting or bleeeding event - I have read and been told by two surgeons that it is about 1 % per year.  There are also some lifestyle restrictions as well.  My second choice was the homograft.  Rightly or wrongly, I personnally preferred to face another surgery - not without its own small risk!  It's a difficult choice. I hope this helps - I was luckly that my own valve could be spared.  The surgery was not that bad - either option has its down side - pick one and don't look back - you'll be fine.
Dear Bob
With a severely stenosed bicuspid aortic valve, repair is less likely an option. As long as you go to an experienced surgeon at a high-volume medical center, you will be provided with the best options for your particular case.
I hope you find this information useful.  Information provided in the heart forum is for general purposes only.  Only your physician can provide specific diagnoses and therapies. Please feel free to write back with additional questions.
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