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Reminder: We've been replacing human heart VALVES with pig valves for a long time now. My grandmother lived for almost a decade after her replacement. https:/

Reminder: We've been replacing human heart VALVES with pig valves for a long time now. My grandmother lived for almost a decade after her replacement. https://www.heart-valve-surgery.com/learning/pig-valve-replacement/ https://www.heart-valve-surgery.com/learning/pig-valve-repla...

livinglist 5y ago
May I ask how much did it cost and did insurance cover it?
- OminousWeapons 5y ago
  A surgical aortic valve replacement (SAVR) for example will cost ~50K I believe? It will be covered by insurance if it is necessary. There are also less invasive forms of valve replacement (transcatheter / percutaneous) which involve collapsing a synthetic valve around a balloon at the end of a catheter, inserting the assembly into a femoral artery, guiding the valve into the heart and into the open damaged valve, and then inflating the balloon and deploying the new valve inside of the damaged old valve. In SAVR the old valve is removed and the new one is sewn in. In transcatheter aortic valve replacement (TAVR), the old valve is held open by the new valve.
  - sokoloff 5y ago
    Is anyone having an aortic valve replacement that isn’t necessary?!
    - MikeTheGreat 5y ago
      Er, no, although that was a funny way for the parent to phrase it. It might be more accurate to phrase it as "depending on your insurance, your insurance may pay for it if it's covered AND you _meet_the_criteria_ for the procedure." For example: You may run into a situation where your doctor says "You know, it would be good to replace this now" and the insurance company says "Thank you for your professional opinion; our table says that we're not replacing it until criteria X is also satisfied"
- frumper 5y ago
  Not OP, but my dad was offered either a mechanical or pig valve when he had a bypass surgery done. Both were covered by insurance, I don't know which cost more, but he hit his deductible either way.
- Ensorceled 5y ago
  My grandmother was Canadian, as am I ... so nary a clue about the cost.
dnautics 5y ago
I could be wrong but I believe those valves are harvested for their cartilagenous (non-alive) components, their cells stripped, the valves throughly cleaned, and implanted in place. This is not quite the same as implanting an organ with live cells autonomously producing potential antigens on a daily basis
- Ensorceled 5y ago
  Correct. I'm aiming my comment more at the people asking about the moral ramifications ...
- Blikkentrekker 5y ago
  Would artificial valves then not work as well or even better?
  - iancmceachern 5y ago
    Nope, the ball and disc valves were where they started and they had any issues including wear, blood clots and strokes. You could also hear many of them outside the patients body.
  - kashunstva 5y ago
    The tissue component of bioprosthetic valves is treated ex vivo in such a way as to greatly reduce the immune reactivity. It's practically not a consideration. Mechanical prosthetic heart values are generally favoured only in older patients where re-operation is not likely to be required. The reason being that bioprosthetic valves have a more limited long-term durability. So why not always use mechanical valves? Their clotting risk is considerably higher and so they require higher intensity anticoagulant therapy - along with all of the attendant complications of that...
    - tired_medicine 5y ago
      Mech valves are actually favored in younger patients, since they don't become calcified, like bioprosthetic valves. However, they do require life long anticoagulation with warfarin, which is dangerous to live with.
TulliusCicero 5y ago
According to another article, that was also true of this patient.
mattrighetti 5y ago
My father got a brand new cow valve a few months ago. He had to choose between that, a pig one and a mechanical one, each one is better for each specific case from what I understand. But yeah, crazy stuff.
- ummonk 5y ago
  I imagine Muslims, Jews, and Hindus would tend to have specific preferences as well.
  - deleted 5y ago
    [deleted]
  - mardifoufs 5y ago
    I'd argue that in islam pretty much all of these restrictions are not applicable when it's for medical reasons. Alcohol is explicitly allowed in such cases (I think it was used to relieve pain in surgeries) , and even pork is okay to eat if you can't find anything else. Another example would be Ramadan fasting, which is not necessary if you are ill or when you are travelin. Overall, almost any restriction in islam is very flexible when it's a matter of life or death, or if it's a medical necessity/recommendation. So, a pig valve is arguably not any different from a cow valve when it's so clearly not for regular consumption.
    - jhgb 5y ago
      You can rationalize all you want, but you can't reason religious people out of things they didn't reason themselves into. If these people can be convinced that they shouldn't be doing thing XYZ on the order of an omnipotent being that nobody has ever seen, chances seem to be even between them accepting exceptions from this order and them rejecting these exceptions. After all, you see other people rejecting/ignoring other parts of their own religion all the time.
      - fortran77 5y ago
        > reason religious people out of things they didn't reason themselves into. Please don't presume things about religious people, especially since you're not one yourself.
xwdv 5y ago
You can live indefinitely with animal valves though they may need to be replaced every 15 years or so. It’a a fairly straightforward minimally invasive procedure though.
- MikeTheGreat 5y ago
  Wait, what? Are you saying that replacing a valve in your heart is "a fairly straightforward minimally invasive procedure"?
  - W0lf 5y ago
    Pretty much standard procedure nowadays. The search term for this is TAVI (Transcatether Aortic Valve Implantation)
    - MikeTheGreat 5y ago
      Huh. This is pretty cool: https://www.mayoclinic.org/tests-procedures/transcatheter-aortic-valve-replacement/about/pac-20384698 https://www.mayoclinic.org/tests-procedures/transcatheter-ao... They say that you might stay a night in the ICU, or perhaps a couple, but that's way way better than the week+ and months of recovery. Well, I learn something new everyday - thanks!
  - xwdv 5y ago
    Yes, you can probably be in and out same day or maybe the next day.
    - MikeTheGreat 5y ago
      Reading between the lines, https://www.mayoclinic.org/tests-procedures/transcatheter-aortic-valve-replacement/about/pac-20384698 https://www.mayoclinic.org/tests-procedures/transcatheter-ao... says you'll probably be there overnight. I, for one, would be really really nervous about having a major operation on a critical-for-my-life organ and then going home. I would definitely want some close observation even if it's 'just' for 12-24 hours.

livinglist 5y ago

May I ask how much did it cost and did insurance cover it?

OminousWeapons 5y ago
A surgical aortic valve replacement (SAVR) for example will cost ~50K I believe? It will be covered by insurance if it is necessary. There are also less invasive forms of valve replacement (transcatheter / percutaneous) which involve collapsing a synthetic valve around a balloon at the end of a catheter, inserting the assembly into a femoral artery, guiding the valve into the heart and into the open damaged valve, and then inflating the balloon and deploying the new valve inside of the damaged old valve. In SAVR the old valve is removed and the new one is sewn in. In transcatheter aortic valve replacement (TAVR), the old valve is held open by the new valve.
- sokoloff 5y ago
  Is anyone having an aortic valve replacement that isn’t necessary?!
  - MikeTheGreat 5y ago
    Er, no, although that was a funny way for the parent to phrase it. It might be more accurate to phrase it as "depending on your insurance, your insurance may pay for it if it's covered AND you _meet_the_criteria_ for the procedure." For example: You may run into a situation where your doctor says "You know, it would be good to replace this now" and the insurance company says "Thank you for your professional opinion; our table says that we're not replacing it until criteria X is also satisfied"
frumper 5y ago
Not OP, but my dad was offered either a mechanical or pig valve when he had a bypass surgery done. Both were covered by insurance, I don't know which cost more, but he hit his deductible either way.
Ensorceled 5y ago
My grandmother was Canadian, as am I ... so nary a clue about the cost.

dnautics 5y ago

I could be wrong but I believe those valves are harvested for their cartilagenous (non-alive) components, their cells stripped, the valves throughly cleaned, and implanted in place. This is not quite the same as implanting an organ with live cells autonomously producing potential antigens on a daily basis

Ensorceled 5y ago
Correct. I'm aiming my comment more at the people asking about the moral ramifications ...
Blikkentrekker 5y ago
Would artificial valves then not work as well or even better?
- iancmceachern 5y ago
  Nope, the ball and disc valves were where they started and they had any issues including wear, blood clots and strokes. You could also hear many of them outside the patients body.
- kashunstva 5y ago
  The tissue component of bioprosthetic valves is treated ex vivo in such a way as to greatly reduce the immune reactivity. It's practically not a consideration. Mechanical prosthetic heart values are generally favoured only in older patients where re-operation is not likely to be required. The reason being that bioprosthetic valves have a more limited long-term durability. So why not always use mechanical valves? Their clotting risk is considerably higher and so they require higher intensity anticoagulant therapy - along with all of the attendant complications of that...
  - tired_medicine 5y ago
    Mech valves are actually favored in younger patients, since they don't become calcified, like bioprosthetic valves. However, they do require life long anticoagulation with warfarin, which is dangerous to live with.

TulliusCicero 5y ago

According to another article, that was also true of this patient.

mattrighetti 5y ago

My father got a brand new cow valve a few months ago. He had to choose between that, a pig one and a mechanical one, each one is better for each specific case from what I understand. But yeah, crazy stuff.

ummonk 5y ago
I imagine Muslims, Jews, and Hindus would tend to have specific preferences as well.
- deleted 5y ago
  [deleted]
- mardifoufs 5y ago
  I'd argue that in islam pretty much all of these restrictions are not applicable when it's for medical reasons. Alcohol is explicitly allowed in such cases (I think it was used to relieve pain in surgeries) , and even pork is okay to eat if you can't find anything else. Another example would be Ramadan fasting, which is not necessary if you are ill or when you are travelin. Overall, almost any restriction in islam is very flexible when it's a matter of life or death, or if it's a medical necessity/recommendation. So, a pig valve is arguably not any different from a cow valve when it's so clearly not for regular consumption.
  - jhgb 5y ago
    You can rationalize all you want, but you can't reason religious people out of things they didn't reason themselves into. If these people can be convinced that they shouldn't be doing thing XYZ on the order of an omnipotent being that nobody has ever seen, chances seem to be even between them accepting exceptions from this order and them rejecting these exceptions. After all, you see other people rejecting/ignoring other parts of their own religion all the time.
    - fortran77 5y ago
      > reason religious people out of things they didn't reason themselves into. Please don't presume things about religious people, especially since you're not one yourself.

xwdv 5y ago

You can live indefinitely with animal valves though they may need to be replaced every 15 years or so. It’a a fairly straightforward minimally invasive procedure though.

MikeTheGreat 5y ago
Wait, what? Are you saying that replacing a valve in your heart is "a fairly straightforward minimally invasive procedure"?
- W0lf 5y ago
  Pretty much standard procedure nowadays. The search term for this is TAVI (Transcatether Aortic Valve Implantation)
  - MikeTheGreat 5y ago
    Huh. This is pretty cool: https://www.mayoclinic.org/tests-procedures/transcatheter-aortic-valve-replacement/about/pac-20384698 https://www.mayoclinic.org/tests-procedures/transcatheter-ao... They say that you might stay a night in the ICU, or perhaps a couple, but that's way way better than the week+ and months of recovery. Well, I learn something new everyday - thanks!
- xwdv 5y ago
  Yes, you can probably be in and out same day or maybe the next day.
  - MikeTheGreat 5y ago
    Reading between the lines, https://www.mayoclinic.org/tests-procedures/transcatheter-aortic-valve-replacement/about/pac-20384698 https://www.mayoclinic.org/tests-procedures/transcatheter-ao... says you'll probably be there overnight. I, for one, would be really really nervous about having a major operation on a critical-for-my-life organ and then going home. I would definitely want some close observation even if it's 'just' for 12-24 hours.