Picking a valve

When I was in the hospital in February, and there was serious consideration of doing surgery then and there, I was told that I had a choice to make. I could have a mechanical valve. I could have a tissue valve. The advantage of a mechanical valve is that it lasts forever. Its disdvantages are that I would have to be on lifelong Coumadin, an anti-coagulant, and that it makes noise. With a tissue valve, it would be silent and I would not need the anti-coagulant, although it may not hold up for the rest of my life. At 62 years of age, I am in a gray zone regarding whether I should go for the tissue valve, with its limited life expectancy, or the mechanical valve. There is one caveat, which pushes toward the tissue valve, and that is developing technology. There is a reseach project going on now, in which they are replacing heart valves through a catheter. If it is successful, and the doctors believe it will be, that technique would be available by the time I needed another operation. This would be like using a stent to treat a blockage in the coronary arteries instead of heart bypass surgery. If I had the surgery in February, my knowledge and choices would have been limited to the information I just gave.

With the operation in July, I have been given a larger number of things to think about. First, it is not completely clear that the surgeon can avoid using mechanical valves. I use the plural, valves, because he will not know whether he can fix my mitral valve until he sees it. If he can, that's one valve, the aortic, which will be replaced. He can use a tissue valve for that. If he has to replace the mitral valve, he is not willing to use a tissue valve for that (it does not last as long as an aortic tissue valve), so its a mechanical valve, with lifelong Coumadin. So as long as I'm taking the Coumadin, he would use mechanical valves for both.

My surgeon likes the St. Jude valve, a tried and true product, which has been on the market for years. There are some other valves, some he'll use, some he won't. Two valves he feels comfortable with are the On-X or ATS valve. He suggested I look them up.

For years, Maryka and I drove two cars, a Honda Accord and a Dodge Grand Caravan. The Accord, as I am sure you know, is a reliable sedan. The Grand Caravan is a family car, useful for transporting a caravan of young people, to school events, parties, and baseball games. More recently, I purchase a Hynundai Elantra, less flashy than the Honda, but clearly an econcomical, reliable car. With the children grown up, Maryka said she wanted a Mazda Miata. When she first said this, I did not exactly know what it was. But the name, Miata. Hm. Caravan? Miata? It speaks for itself. Sometimes, I drive her car, since she needs mine if she goes shopping, or has more than one passenger. Pretty neat, a 62 year old man, motoring around in a cool sports car.

So, I'm been thinking, am I going to settle for dowdy St. Jude's valve, or be hip this time: an ATS. Maybe, I should really get bold, and ask for the On-X.