[HSF] elective replacement of tissue valve

[rwmfglycar at aol.com]

There is in fact no way for you to know what the right answer is.
?In one 19 year old of mine?her course was:
19 years old?? mechanical valve? (lasted 9 yrs)
28 years old?? tissue valve?????????? (lasted 14 yrs)
42 years old???tissue valve???????????(lasted 8 yrs)
50 years old???mechanical valve?? (lasted? I think about 13 years andshe is by now on her 5th valve and not doing well, but I am sure you get the picture)
You are not dealing with a predictable issue. In my experience with the Hancock I,?average age +/-50, only25% calcified in the first 10 years
One thing you can do is inspect the valve very carefully (and gently) in situ?with magnification. If you see calcium deposits or thinning of the belly of the leaflet or a tear at a commissure you could take those as a signal that this is not going to be one that goes 20 years.
Obviously the decisionis also depend on patient factors that we are not discussing, your personal reoperative mortality rate etc etc

Best of luck
Bob
-----Original Message-----
From: yadav del <yadavluck at yahoo.com>
To: OpenHeart-L at lists.hsforum.com
Sent: Fri, 11 Apr 2008 12:42 am
Subject: [HSF] elective replacement of tissue valve 



We have a 26 years old lady  who had aortic  valve replacement with tissue valve  
and mitral valve repair  6 yrs back coming back now with mitral stenosis . we 
are planning for prosthetic  mitral valve replacement.
   
Should we replace the aortic valve now? It is normal by echo.
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