Heart Valve Re-Operations: What Should Patients Know? (with Dr. Nimesh Desai)

www.Heart-Valv... - Patients who undergo heart valve repair or heart valve replacement operations may require a heart valve "re-operation" if their initial procedure fails. For patients, the process of going through a second (or third) operation can be confusing and frustrating.
To help educate patients about heart valve re-replacements and heart valve re-repairs using surgical and transcatheter techniques, we interviewed Dr. Nimesh Desai, a leading cardiac surgery and director of the Thoracic Aortic Surgery Research Program at Penn Medicine Heart & Vascular Institute in Philadelphia, Pennsylvania.
Important questions asked to Dr. Nimesh Desai during this video interview include:
1. Is it common that heart valve reoperations are performed at Penn Medicine? Is one type of reoperation more common than others? If so, please discuss.
2. Why might a patient need a heart valve reoperation?
3. What types of heart valve reoperations do you perform? Are any of those procedures minimally invasive using surgical or transcatheter techniques including TAVR, TMVR and valve-in-valve?
4. How are heart valve reoperations different than initial primary procedures (e.g. process, access, risks, etc.)?
5. What are the outcomes for your patients that have needed heart valve reoperations?
6. What is your #1 piece of advice for a patient who needs a heart valve reoperation?
To see patient reviews and a complete surgeon biography of Dr. Desai, please visit www.heart-valv....
To learn about Penn Medicine Heart and Vascular Institute, please visit www.heart-valv....

[@nas3426]

Such a great interview!!! Thank you so much!!! I have had a heart valve repair and had so many questions. This interview answered most of them. Thank you 🙏🏼

[@HeartValveSurgery]

So glad to hear you enjoyed this video with Dr. Nimesh Desai!

[@McCulloughFarms1]

Great video and thank you for making it happen. I'm 60 and I have a St. Judes Mechanical Aortic Valve that was installed 13 years ago in 2008. It was replacement of a 2002 bio prosthetic valve. My question is can a TAVR be done to replace my St Judes?

[@HeartValveSurgery]

Hi Patrick, Glad you enjoyed the educational video with Dr. Desai. Unfortunately, TAVR can not be used to replaced a mechanical valve. Sorry about that!!!

[@timp.9582]

Look into the bentall procedure using bioprosthetic valve. It does requires a sternotomy

[@Sunsheel]

Thanks a lot to both of you for your efforts ..from india

[@HeartValveSurgery]

Our pleasure! Thanks Sheela!

[@TheJoeyboots]

Heart surgeon saved my life. 😊

[@helenbucciarelli3459]

there my doctor!! I repaired my heart valve in 2014. And Dr Desai I need to make an appointment with you again

[@apurbapandey6346]

Hi everyone, my mother is about to undergo mitral valve replacement surgery after an initial failed mitral valve repair. However, the latest echo showed that she has now developed mild-moderate TR after the surgery. The surgeon has suggested that we may not need to repair the tricuspid valve as it is a secondary cause of MR. But I have read on the internet that it is better to repair it at the same time. I am really confused about what to do. Has anyone been through a similar situation? Can anyone provide any advice or guidance on the better way to proceed? Any help would be greatly appreciated. Thank you!

[@richt6353]

Thank you for this excellent video!

[@HeartValveSurgery]

Hey Rich! You're very welcome! Great to hear you enjoyed Dr. Desai's research and insights!

[@Rahul-fe8jx]

Thanks for the excellent video .But I have a question. I have recently undergone aortic valve replacement with 23 mm ONYX mechanical valve along with ascending aorta replacement. I am 30 years old. In future do I have to go for reoperation ? I have heard that mechanical valves are durable and long lasting .

[@HeartValveSurgery]

Hi Rahul, Great question. As you know, time will tell. The advantage of a mechanical valve, like the On-X valve, is that they are very durable. There is a chance you may never need a re-replacement. Have you seen this video yet - kzbin.info/www/bejne/iXm7XnSuirBrfq8. Allen's story might help you learn more.

[@Rahul-fe8jx]

@@shanithmuhammed1490 I am feeling better and refreshed from before. The surgery was done at Narayana Institute of Cardiac Sciences , Bangalore ,India from a very renowned surgeon Dr Devi Shetty and his team .If you need any guidance you can contact me regarding valve replacement

[@Rahul-fe8jx]

@@shanithmuhammed1490 yes since it's a mechanical valve ....so I need to take a blood thinner acitrom tablet .But if you do not want to take blood thinners you can go for Ross procedure instead of mechanical valves

[@reggebocobo7105]

.

[@anischorfi1027]

@@Rahul-fe8jx hello brother, have you taken the covid-19 vaccin , i heard that it could be bad for persons who had mechanical valve replacement

[@archiehendricks6093]

When doing a reoperation, can patient elect to have a mechanical aortic valve rather then a bio.

[@HeartValveSurgery]

Hi Archie, As each patient situation is unique, we would encourage you to ask this question to your medical team. That said, we are aware of patients who have selected a mechanical for their re-replacement. However, please note that a mechanical valve re-operation can not be done using a transcatheter approach. We hope that helps!

[@timp.9582]

Always opt for a homografts or bioprosthetic valve, if these are viable options of course. Mechanical valves require blood thinners which can be a crutch to one’s lifestyle

[@sreesai8340]

Lasting in maitrvalve

[@nasirfarooq99]

Hello Everyone I had a an open heart Mitral Valve replacement 4 months ago but now i have got sever Aortic Regurgitation. I am 29 Years old and Doctors are asking it to get replace in early possible means. In this instance, i would like to ask what sort of complications i may have to bear after going through Redo heart surgery just after 4-5 months.

[@ningarajh4203]

I sir Am Ningaraj from Bengalore.... My father was 58 years old admitted in Jayadeva hospital Bengalore so till taking treatment in hospitel.... Doctors they will told AVR Replacement.......so my Question is machenical valve Replacement better or Biothytic valve is better..... Plz give suggetion Sir

[@dhonydhin4980]

On reoperation , is it possible to have a mechanical valve after tissue valve? Presently I'm using tissue valve. My name is Dhondy thank you

[@merrymahray4568]

at 30 years old on 2018, i had mitral valve stenosis operation with biological valve 31mm so what do u think that for how long can be lasting,and does it needs to repair or reoperation and my second question is for the second reoperation what do you prefer biological or mechanical valve

[@garyjene9146]

Here is a question for you. Under the TAVR, it normally would be known as valve in valve. From what I have learned over the past couple of years, there are different sizes of valve replacements. If the valve has been sized at, say 23 mm, and a 2nd operation is needed 12 yrs later, can the next size down be used and inserted in the 1st replacement? Or does the 1st replacement have to be removed before the 2nd one is put in place? I was going to ask about the Ross procedure, but that is a whole different ball of wax.

[@HeartValveSurgery]

Hi Gary, Great question! If you are eligible for a valve-in-valve procedure, the transcatheter valve is fitted inside the initial, surgically placed valve. So, it really is a valve-in-valve procedure. The first valve is not removed. Here's another video about valve-in-valve procedures you might like to review - kzbin.info/www/bejne/h4KzoWyNi82qqJo. Regarding the Ross Procedure... Here's an hour-long webinar about the Ross Procedure that might help you - kzbin.info/www/bejne/sKvCgqCBgs2DetU. Hope this helps!!!

[@timp.9582]

Valve in valve will reduce the overall diameter of the valve aperture, which affects blood flow rate. Ask your surgeon about this. The Ross procedure is complex, and not always a sure thing, however the beauty is a native valve is implanted and offers long term results

[@Mrwinecontreras]

Hello I’m having a second aortic valve replacement done next month as first one failed, and really nervous as doctor told there’s a risk of not making it through and that part really got me very nervous, any advice ?

[@ogleperson]

How did it go man?

[@TheJoeyboots]

Inspiris Resilia by Edwards Life Science. 🫀👍

[@nrbrtbns]

Sounds promising, but there is no experience with this valve for more than 8 years. With many aortic valves, problems only appear after these 8 years. Additionally, it is not yet clear whether the valve-in-valve feature with TAVR will generally work on the Inspiris Resilia.

[@TheJoeyboots]

@@nrbrtbns In summary, this in vitro study shows that the Inspiris Resilia aortic valve performed well through 1 billion cycles of testing (the equivalent of approximately 25 years of use). Absent thrombosis or calcification. National Library of Medicine

[@nrbrtbns]

@@TheJoeyboots This study is only about simulation of mechanical wear (excluding calcification and other biological processes) From that study: "Other factors, such as leaflet thrombosis and calcification, may contribute to structural valve degeneration but are not studied here." I really hope the Inspiris Resilia lasts 15 years or more, but it still needs to prove that it's capable of doing so. I (60 years old) will have my first heart aortic valve replacement in three weeks, and despite all my doubts I will probably choose the Inspiris Resilia.