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Aortic Valve Replacement

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Aortic Valve Replacement

Post by dibeatson on Tue Nov 17, 2015 1:04 am

I had my aortic valve replaced with an organic pig valve on March 24, 2014.  Everything went very well for the first 18 months.  My heart regained full strength and returned to normal size.  The refraction rate went from 35 to 55.  

Unfortunately, during my last check up in September, thickening of the valve leaflets was noted, although I had no symptoms.  Then in October, I had some major fatigue during several short runs.  It was as if I was in the last mile of a marathon after only 1 or 2 miles.  I have subsequently enjoyed several 3 mile runs without any problems.

Today, my cardiac surgeon told me that I will likely need to replace the valve with a new mechanical valve.  This is very disappointing after only 19 months. Apparently, I am one of only 400 patients who experience such problems. Warfarin may reverse this matter, but if not surgery will be required early next year.

Has anyone else experienced such challenges?  Please let me know.

Thanks,
David

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Re: Aortic Valve Replacement

Post by Dave Tuttle on Tue Nov 17, 2015 6:52 pm

I'm sorry to hear this David and hope you can avoid another surgery with the warfarin. I don't know of anyone currently posting on this forum who had a similar experience (members please correct me if I'm wrong) but you might want to contact our friend Mark, he may have some insight and information of interest to you. Please keep us posted and good luck!

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Re: Aortic Valve Replacement

Post by dibeatson on Tue Nov 17, 2015 7:04 pm

Thanks Dave. I have been in contact with Mark, but he has no experience with a situation like mine.

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Re: Aortic Valve Replacement

Post by RoadKillBill on Tue Nov 17, 2015 7:06 pm

Hi David

Sorry to hear about your situation. One of our members had an aortic valve failure after just a few years and had to get a mechanical. I am hoping she replies to offer her perspective. I don't think the underlying issues were the same as yours, but you should know that she tolerated the second surgery very well and continues to enjoy cycling, running and swimming. It's disappointing for sure but there is also reason for some optimism. Please keep us posted.

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Re: Aortic Valve Replacement

Post by ljoan on Tue Nov 17, 2015 9:53 pm

Yo Dave Tuttle -You forgot about me!!!
Hi David: This is Laura-I know what t feels like to be a member of an unenviable minority. As I neared my 5th year with  my porcine valve it literally blew out-most likely during a triathlon I had done earlier that day. It wasn't a mortal event (obviously) I found a remarkable surgeon. He too advised me to get a mechanical valve although he left the decision to me.  He believed the toll on the body is great with OHS and didn't believe advances in tissue valves  or the subsequent  method in which they are implanted would change greatly in the next 10 years.  I was not happy about a lifetime on coumadin-but even less than a fan of yet another OHS. Two OHS is plenty for me!!!  Post surgery, it was suggested that the original valve was too small and thus unable to tolerate the forces generated. The mechanical valve was several sizes larger. It sucks Dave. But the alternative is worse I guess.  Life on coumadin isn't bad-I have a home unit that measures my INR and don't worry too much bleeding.  I eat pretty much what I like-but keep my leafy greens and veggies to a moderate amount. No change in alcohol consumption-but also keep it in moderation. I have never felt better as far as exercise-a testament to the idea that the last one was too small-I feel SOOO much better since this one.  It's been 5 years since the mechanical.
Feel free to ask me anything
I still feel lucky to be alive and have survived a leaflet blowout (resulting in a high pitched whistling in my chest until it was replaced :0)
Laura
Why the heck would Warfarin change your leaflet thickening???


Last edited by ljoan on Tue Nov 17, 2015 10:44 pm; edited 1 time in total
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Re: Aortic Valve Replacement

Post by Tom price on Tue Nov 17, 2015 10:32 pm

Welcome! You certainly drew the short straw on this one! Laura is our expert on reops. I believe Laura went to a more experienced surgeon for her second surgery....Laura?......as they are more complicated. And I agree with Laura: how does warfarin stop leaflet thickening? I need to google that!
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Re: Aortic Valve Replacement

Post by LMRun on Wed Nov 18, 2015 7:28 am

Hi David,
Sorry to read you have to have a reop.  I do not have experience in what you are asking but when choosing a mechanical valve, you will face decisions that won't be any easier than when you chose your tissue valve.  Make your decision based on your own research and with your surgeon's guidance. You will want to make sure he/she has lots of experience with On-X valves. 

I have an On-X aortic valve, 8 years post op with no issues. The results of the clinical trials are in, the INR has been reduced for non-high risk aortic On-X valve patients, the new INR range is 1.5 - 2 with low dose daily aspirin.  My cardiologist reduced my INR to this new range last April, I have not had any problems, and I test at home monthly.  I like to stay close to 1.5, but I don't panic if I drift a little above 2 as my range prior to clinical trials was 2 - 3.  

Good luck with your decision, coumadin is not something to fear, managed appropriately, you will be fine.

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Re: Aortic Valve Replacement

Post by Sumorunner on Wed Nov 18, 2015 7:33 am

Nope. I went with a mechanical valve the first time because I was only 43. I was told the pig valves had a life span of 10-15 years max, so it was inevitable I'd have to have it replaced again and again. Did not want to go through that op twice. In fact, it's now going on 25 years and I never looked back.

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Re: Aortic Valve Replacement

Post by Rachel August on Thu Nov 19, 2015 1:27 pm

Wow David - so sorry to hear this!!! I'm always waiting for the shoe to drop (my OHS with Bovine was in 2011) - It'll happen for me too....it does suck that it happened for you this quickly.

As you see, Laura is the go-to gal on this one, she's also an all around amazing person!!!

Good luck to you!

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Aortic Valve Replacement (Edwards 3300TFX) and Ascending Aortic Aneurysm Repair
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Re: Aortic Valve Replacement

Post by ljoan on Fri Nov 20, 2015 11:01 pm

LM run: I wish I could have had the ON-X. Apparently I needed a valve size that was larger than ON-X supplied. I would love to be on aspirin only!
Laura
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Re: Aortic Valve Replacement

Post by LMRun on Sat Nov 21, 2015 1:59 pm

Hey Laura, I still take Coumadin, my dosage has been lowered so that instead of maintaining an INR of 2 -3, my range is now 1.5 - 2.0. I used to take 40 mg a week, now I take 32.5 mg a week. 81 mg aspirin a day in addition to coumadin.

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Re: Aortic Valve Replacement

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