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Aortic Valve ..which one? metal? pig?
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Amateur posted:
I need an aortic valve replacement (not urgent,but better done soon), already confirmed by an angiogram. done thorugh my wirst artery.
I need also a stent too (not critical) and may have an old stent in bad shape (Taxus Express 2, paciltaxel eluting coronary stent system, from Boston Scientific) from 2004.
I still haven't had a meeting with my dr. to discuss the new valve. He mentioned a valve places through the femoral artery, that may last +- 7 years. He also mentioned a valve replacement through open heart surgery. I have PPO/Medicare and use one of the best hospitals, Cedars Sinai Medical Center.
My questions to this respectable group:
Any experiences with metal/femoral artery placed valves?
How bad is open chest surgery and it's recovery? (I am 73, and so far of sound mind)
Thanks to all!!
Reply
 
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billh99 responded:
I believe at the present time the Transcatheter Aortic-Valve Implantation (TAVI) valve is only approved for use in people that are at too high a risk for surgery.

However, I there might be clinical trails to try in on other patients.

I had heart surgery at 66 (bypass) and later rotator cuff surgery. As did one of my neighbors. We both agree that we would rather have a another bypass than shoulder surgery.

With open heart surgery the worse problems are in the first 2-3 weeks and is mostly from the cutting of the sternum.

Some valve surgeries are now being done with robotics, keyhole and other less invasive methods. You might ask about those.
 
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cardiostarusa1 responded:
Hi:

"He mentioned a valve places through the femoral artery, that may last - 7 years."

As applicable, some individuals who are deemed high-risk, or even inoperable, may be considered (by some doctors) a candidate for a non-surgical procedure that replaces the aortic heart valve (ReValving) without removing the native valve. Percutaneous (transcatheter) aortic valve replacement (PAVR), implanting a new aortic bioprosthesis right over the diseased heart valve.

Outcomes in general can not be predicted though, and pre-existing medical conditions (cardiac or otherwise), negative factors, and especially comorbidities (medical conditions known to increase the risk of death in addition to the most significant condition that causes an individual's stay in the hospital), as well one's general overall health and age are taken into consideration.

L@@K back in the Media

Nov. 2, 2011

FDA approves first artificial aortic heart valve placed without open-heart surgery

The U.S. Food and Drug Administration today approved the first artificial heart valve that can replace an aortic heart valve damaged by senile aortic valve stenosis without open-heart surgery. Senile aortic valve stenosis is a progressive, age-related disease caused by calcium deposits on the aortic valve that cause the valve to narrow......

http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm278348.htm
Aortic Valve ..which one? metal? pig?

Mechanical valves

There are advantages and drawbacks to mechanical valves.

Advantages: Mechanical valves are very durable. They are designed to last a lifetime.

Disadvantages: Due to the artificial material involved, patients who receive these valves require lifelong treatment with a blood-thinning (anticoagulant) medication. Blood-thinners are medications (such as warfarin or Coumadin) that delay the clotting action of the blood. They help prevent clots from forming on the mechanical valve, which can cause a heart attack or stroke.

Tissue (bioprosthetic)

There are advantages and drawbacks to biologic valves.

Advantages: Most patients do not need to be on lifelong blood-thinner medication, unless they have other conditions (such as atrial fibrillation) which warrant it.

Drawbacks: Biologic valves, traditionally, were not considered as durable as mechanical valves, especially in younger people. Previously available biologic valves usually needed to be replaced after about 10 years. However , recent studies on the PERIMOUNT aortic valve, show that these valves may last at least 17 years without decline in function. This represents a new milestone in durability of biologic valves.

- Source Cleveland Clinic

Be sure to check out this informational/support site for heart valve replacement patients, and for those who may/will require this type of major surgery soon.

SEE: FORUMS

http://www.valvereplacement.org/forums/forum.php

Coronary stents (bare-metal or drug-eluting) are only a Band-aid or spot-treatment, as it doesn't address the disease process and what drives the progression.

Coronary artery disease (CAD) is a lifelong unpredictable (may/can exhibit periods of stabilization, acceleration and even some regression) condition requiring a continuum of care.

Take care,

CardioStar*

WebMD member (since 8/99)



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James Beckerman, MD, FACC responded:
The newer, less invasive TAVI (trans catheter aortic valve implantation) procedure is a very exciting advance in how we treat valve disease. It is certainly worth looking into as to whether you might be a candidate, whether as part of a research protocol or not. In the right patient, I think it's definitely something to consider.


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