u/nibupraju

44 male AR, getting an On-X valve

just three weeks back i was running carefree and then I found out that my valve needs to change. Took 3 surgen opinion and they all said the same thing. All my doc said, now there is no symptoms but all the reading just very near the line where i need to get a surgery, So rather than waiting for symptoms to start better get operated.

so in the beginning all i know was i need to get mech or bio valve. I tought the answer was easy. Oh boy then i understood its not an easy decision. Then i stumbled upon this reddit group and i learned a lot of things which i want to put it here for new people who will be joining our party which no one wish to join

• For majority of us, There is no perfect solution. All we have is a two option, where we have to choose which price to pay.
• Option 1 we have a mech option where you open up once(apart from rare cases) and then we have the management mode of life long blood thinners. This come with its own burden of weekly or monthly blood checks, stroke and bleeding risk etc
• 2nd , We have the bio option which gives us freedom from blood thinners but in future we have the uncertain timeline of valve degeneration, calcification etc and then maybe a TAVR (if your valve allows) and then another OHS depending upon your age and luck (some valves run for 5 years some for 10, some for 15 etc) . Always remember if someone got X years doesn't means you will get the same. you may get more or less no one knows as each body is a marvellous machine which have its own unique way to work . Also some unfortunate ones end up taking warfin for other needs which make them get bad side of both worlds
• We do have ROSS but you need to be the right candidate and with right high volume ROSS surgen and hospital, It have its own unique burden for turning 1 valve problem to 2 , and some unlucky ones needs another set of OHS for one or maybe both valves.
• One thing i learned is don't take all the data eyes closed. For eg Resila data is more around 65-60 year age group ( so a young person cant take that data eye closed) where as ON-X 1.5 INR push has its own risk as well. also some of the studies are done by the firm itself which have its own bias ( at the end they need to sell their product)

So there is no right answer. the only answer is what you want for yourself. Do you want a mech valve and manage the know risk or you want a bio and manage an unknown timeline. Find answer to this and you will get the clarity you need. Remember this is your burden to carry. So take your time, do your research and then commit.

In the begnining i felt we the unlucky ones who need to make such tough decision. In one of my hospital visit i meet a young chap who has brain tumor. He can chose between couple of years of life where he dont do anything but the chances of paralysis grows as well or a surgry with a good chance of recovery but with its own risk of paralysis or even death. So we are not that unlucky

Just want to end this with a statement from my wife.

" You are getting extra time in this world via a new valve and there will be a price to pay. There is no free lunches "

I am a 44 year old guy. waiting for surgery on monday, I never wanted an Mech valve and wished and fought for a bio ( resila ) but a couple of points made me to go for On-X (almost decided)

1 : The initial strategy as to go for RESILIA , hope it run for 10-15 years and then a TAVR (hope for 5 - 8 years). By my 60s i will get another OHS and may go for the best one available that time . This was all based on a big IF i get X number of years, But at my age i think its a wishful thinking that i will get 20 years (maybe i am wrong)

2. I had a chat with a person who works in US especially in medical field . as per him don't take the data eyes closed . He said the data of bio-valves will always be skewed towards older people. even if they mention all age group, they make the study in such a way that they get good results. so always take the data with bag of salt. Also his wife who works in a cadac hospital said at your age (less than 50s) we don't even give the choice of bio only mech, unless the patient is adamant on it

3. my strategy of SAVR - TAVR and then a second OHS may look good on paper, but the reality of 15 years of valve - tavr and second OHS has its own high risk it's not easy for the surgeon to navigate the remnants of first surgery, remove the calcified valve and then remove almost struck TAVR and then do another valve fitting, this will scar the heart tissues which will give me problems onwards. Also with a TAVR i read its hard for any future stent or for some cardiac procedure that why they are option for 70+ as the life span is less than a 60s guy

also sometime in future TAVR maybe not feasible for me due to various reasons and i heard TAVR has a high chance of failure as well

4. I know going with On-x has its on set issues but what i understand is that most of them are manageable and can almost be worked up if we put heart to it. we may face issues in 70s but thats 25 years away and hope someone bring some new drugs which will help our INR. Also On-x is running in markt for almost 25 years and we have a fair idea of the product amongst all age groups.

5. All i am doing is to avoid warfarin but who knows in future i still need to get warfarin for maybe some other issues then i will be struck with worst of both worlds

I may be wrong but i tried my best to make bio work but at the end i am sure i need a second OHS by 60s or even worst 50s .

For people who opte RESILIA , I wish that this is the best product out there and hope and pray people who opted gets 20 years and they never had to look back

If you guys have any good points to add or criticize pls help me (I am shit worried of strokes and extremely anxious )

I am a 44 year old guy. waiting for surgery on monday, I never wanted an Mech valve and wished and fought for a bio ( resila ) but a couple of points made me to go for On-X (almost decided)

1 : The initial strategy as to go for RESILIA , hope it run for 10-15 years and then a TAVR (hope for 5 - 8 years). By my 60s i will get another OHS and may go for the best one available that time . This was all based on a big IF i get X number of years, But at my age i think its a wishful thinking that i will get 20 years (maybe i am wrong)

2. I had a chat with a person who works in US especially in medical field . as per him don't take the data eyes closed . He said the data of bio-valves will always be skewed towards older people. even if they mention all age group, they make the study in such a way that they get good results. so always take the data with bag of salt. Also his wife who works in a cadac hospital said at your age (less than 50s) we don't even give the choice of bio only mech, unless the patient is adamant on it

3. my strategy of SAVR - TAVR and then a second OHS may look good on paper, but the reality of 15 years of valve - tavr and second OHS has its own high risk it's not easy for the surgeon to navigate the remnants of first surgery, remove the calcified valve and then remove almost struck TAVR and then do another valve fitting, this will scar the heart tissues which will give me problems onwards. Also with a TAVR i read its hard for any future stent or for some cardiac procedure that why they are option for 70+ as the life span is less than a 60s guy

also sometime in future TAVR maybe not feasible for me due to various reasons and i heard TAVR has a high chance of failure as well

4. I know going with On-x has its on set issues but what i understand is that most of them are manageable and can almost be worked up if we put heart to it. we may face issues in 70s but thats 25 years away and hope someone bring some new drugs which will help our INR. Also On-x is running in markt for almost 25 years and we have a fair idea of the product amongst all age groups.

5. All i am doing is to avoid warfarin but who knows in future i still need to get warfarin for maybe some other issues then i will be struck with worst of both worlds

I may be wrong but i tried my best to make bio work but at the end i am sure i need a second OHS by 60s or even worst 50s .

For people who opte RESILIA , I wish that this is the best product out there and hope and pray people who opted gets 20 years and they never had to look back

If you guys have any good points to add or criticize pls help me (I am shit worried of strokes and extremely anxious )

I am 44 year old , Have a surgery on Monday ..We thought we will go with Resila first , But kind of confused now

I know Resila is a good product and looking at my age i expect it to last for say 15 years and hopefully i may get a TAVR with added 10 years . At that point if i am still alive I still needed another OHS at the age of 70.

But this is all based on the belief of the valve surviving 15 years (but thats a big IF) and if it goes wrong then i am looking an OHS at 65 or even before that of TAVR is not an option tht. Also i am reading some people may develop adamant AFiB which may need Life long WARFIAN

Also i dont trust studies with eyes closed as most of the time , studies represent a small population only . so truth is always in- between

My wife and me in now thinking about why not On-X . At Least i am almost sure about one surgery (unless some rare shit goes and i may need to open up again). But we need the INR and other follow ups which will be for life

Its true that we will have more bleeding and stroke risk ( if INR drops) but even with Resila we can get stroke maybe not by valve but for other reasons .

we may think we dont need warfin now but maybe we have some condition that can develop later like DVT etc which needs warfin for life

So People with On-X just need to understand some quries

1- Diet means we need to be consistent with Vit K intake. So all other food its fine unless you do some extreme herbal shiit etc .

2. So when to travel for vacation to new country how you manage your diet

3. If in future you develop any new issues ( Like god forbid shit like Cancers, Liver issues etc) how we will get treated as warfin react with most of the meds . Also if you have co morbidies how will we get meds ( cardio have alternative meds which can help)

4. Being in On-X or any mech valve can we live a normal life ( I have no plans for MMA and all) but a normal life

5. When we get aged late 70s doesnt this warfin makes us more to falls and clots

there are so many confusion, and i am sure that you also have/ had these. can you put a word about all those and the answers you found

44 year old. Going to get aortic valve replacement.

My doc is the best in the entire state or may the the top 5 in entire country,\

We went with the mind to put an On-X valve but looking at my history he said he feels i should go for  INSPIRIS RESILIA valve since in my family history my dad had 2 strokes and die and mom died of a heart attck as well.

I always was confused tissue vs bio . He said he expect this to last 15-20 years (hopfully) and worst case 10 years with the latest trials.

He said i may need a surgery again by mid 60's if i am lucky but 15 years is good period for new tech to emerge. he is an advocate of Quality of life (no hard feeling against mech folks) where we can live without INR and warfin headaces and even we if select a Mech On x he said go for 2-2.5 INR range if needed as he think 1.5 is a dangeous number with less chance to make error

Now we are totaly confused as He is known to be the gold standard Surgen and his view evey my cardio doc says take it

People who have undergone OHS, pls tell me what you did right and wrong in first few weeks which impacted your healing

Things like

diet

Dressing

Day to day activities

Getting in and out of bed (how to )

Personal care

Mental health etc

So M 44, I found out that I had an bicuspid aortic valve 3 years back with. Mild to moderate AR which has progressed in 3 years to moderate to severe. Have a heart MRI tommrow and have to meet doc after that

I am sure I need a valve replacement in future but have to find out when to get as I don't have any symptoms apart my occasion light headness. As per doc bicuspid is the culprit which creates my value leake and he said it's better to go with mechanical as it's good for me looking at my age

I am scarred to be honest but as doc said you found out this before it got worst and you can afford treatment which is not true for a lot of people

Looks like I will be part of this family for a long time

Anyone using crypto cards for purchase and withdrawal. How are you paying tax for it

I still remember in the past she posted about her surgery which she later deleted. Now she is not even talking about surgery but telling that she lost the weight because of diet and exercise.