2nd Heart Surgery

My mother had valve replacement surgery two years ago.  Because she has always had an issue with excessive bleeding, her cardiologist, surgeon, and hematologist all decided it would be best for her to go with a porcine valve, rather than a mechanical one, so she could forgo the daily blood thinners.  After her surgery, she developed VT, and was placed on a halter monitor twice.  Now, only two years after her initial surgery, the porcine valve is leaking, and she needs to have it replaced, again.  She is only 57 years old.  We are all worried about her undergoing a secondary surgery, and we're also concerned that if she has another porcine or bovine valve, she'll have to have surgery again in another two years.  Are the risks of a second surgery, so soon after the first, exponentially greater, and, would a mechanical valve be a better choice for her? And does VT make the procedure even more risky?

A lot of questions, I know, but, we are all at a bit of a loss.
Thank you!!

[Michael J. McWilliams, M.D.]

Needing a second valve replacement surgery only two years after the prior surgery is pretty rare, but it can happen.  One could typically expect a porcine valve to last at least 8-10 years.  I am not sure what happened in this circumstance.

Repeat surgery does carry a slightly higher risk than the first surgery.  The key is to have the surgery done by someone with lots of experience.

Whether or not to use a mechanical valve is a tough question.  If all three doctors thought it was best to use a bioprosthetic valve, they are probably right -- mechanical valves are just as easy to implant.

The VT two years ago after surgery probably does not affect her current risks.  Many people have non sustained VT after open heart surgery.  If the heart is otherwise structurally normal, it should not be a problem.  If you haven't talked to your cardiologist about these questions, it would probably be a good idea.  It would help you understand their logic for the decisions.

I hope this helps.