Mike's Journal

Andrew Dial  Mike, Thanks for sharing your story. Although I am not in the same situation as you.. I am curious as to what others have to say. Great question..

Sue Lee  Hi Mike. I’m keen to hear about your experience w a mechanical valve in young years as we are in a similar boat choosing for my young son (18). At 49, hard choice to make. The OnX is said to be quieter and less warfarin issue than prior mechanical valves. The new inspiris resilia sounds really promising and I think the next one could be an easier procedure as you mentioned. 

Rita Savelis  I'm sorry you had to have a replacement valve so young and that you now need another operation. I wish there were better options. But I'm not sure any option is the "right" one, which is why both doctors and patients make individual choices. Whatever you decide will be the right decision for you. I've had 2 mechanical valves for 8 years. Any info on why your mechanical valve needs replacing? Unfortunately at your age you would probably need several tissue and/or several TAVR valves, as you know. Heavy sigh. Take care Mike. 

Mike Ciembronowicz  The replacement is being driven by scar tissue formation underneath the valve.  Over my last few echocardiograms the pressure at the valve has been increasing to stenosis-like levels, and the left ventricle is showing  some thickening of its wall as well. 

Allen Carkner  My surgeon I believe sometimes will do Ross procedure on people whith a previous aortic valve replacement. May be an option. 

Rose Madura  That's a tough situation you are in and stinks.  I would have hoped the mechanical valve would have lasted longer.  Rita says it best when she said whatever choice you make will be the right one for you.  God bless you. Please keep us updated on your situation. 

Mary Jane Breinholt  Hard choices. I'm 59 (older than you but still on the younger side of valve replacement), with a (formerly!) bicuspid aortic valve and severe stenosis, and I had SAVR surgery 8 weeks ago. I faced the same biologic/mechanical choice. I can only tell you my thought process and what felt right for me. Everyone needs to make their own decisions guided by the expert advice of their doctors. My surgeon at Johns Hopkins in Baltimore laid out the pros and cons and it came down to the mechanical (OnX) being longer-lasting (he said I would likely never need a replacement of the mechanical) but required a lifetime a Warfarin (though a lower level with the OnX) which isn't ideal. But, he said, the bovine valve lasts 8-12 years and on the shorter side of that range for younger active people, and that 100% I'd need another surgery to replace the biologic in that time range. For a 2nd AVR, TAVR would/could be an option but by then I'd be 10 years older and more prone to complications. When it came down to it, I was really freaked out by the whole idea of OHS--terrified actually--and really didn't want to set myself up to have to do it again in 8-12 years so I opted for the mechanical. Of course there will be technological improvements in the coming years that will change the outlook of these things, but for me, I wanted to be one and done. I know nothing is ever a sure thing, as you know, and my mechanical valve may fail at some point too, but this is what felt right for my situation and is what both my cardiologist and surgeon were encouraging. Surgery and recovery certainly has been an ordeal and I still have a ways to go, but I started cardiac rehab this week (and walked 3 miles this morning) and I'm feeling pretty great all things considered. All the best to you as you make your decision and godspeed with your surgery and recovery!