I pulled the trigger on the valve purchase. The winner is the Carbometrics Top Hat, a fine piece of Italian equipment, made of titanium and carbon (not carbon fiber, but pyolitic carbon , which I gather is the same material as carbon fiber but in a sheet form). The product brochure really makes you want one, even if your existing valve works just fine (Supra-annular positioning for the Biggest Valve Possible! 40% greater flow!!!).
BTW, this is not something for which I would recommend DYI installation. Splitting your own sternum and slicing open your own heart is awkward at best. You might make a try if you have a friend who dresses his own deer and has a good bone saw, a wife who is good with a needle and thread, and an uncle who makes some whoop-ass moonshine. You might even be able to rig up a heart and lung machine using an air compressor and that old peristaltic pump in your junk box. However, this is a much more complex process than most of us are ready to tackle.
My installation process began on Tuesday, 2/16 with a little recon in the form of heart cathaterization. The cardiologist inserted a probe in the artery in my groin and ran it up to my heart. This was done under a local anasthetic, so I could observe some of the activitiy. I could not move my head much, and I really did not want to see them feeding objects into my artery, so I did not get a complete picture of what was happening. It appeared that the crew took x-ray photos of the probe in place and also used the probe to inject dye visible to x-rays and take more phtos of that. I could see some of this on the computer screen, but I could not interpret the shadowy images.
The cardiologist’s conclusion was that my arteries were clear and in good shape, so there would be no need for any additional procedures when they had me open. However, the cardiologist did not sound totally convinced that the valve was bad enough to replace.
This process left me feeling fine, but I was told not to move my right leg or lift my head until 8:00 that night, about 6 hours after the heart cath procedure, because those motions could cause bleeding from the insertion site. This made it a bit awkward when it came time to eat dinner.
When I could move again, I was carted (in a wheel chair) down to x-ray for some more shots of my chest. Over the course of the day, I must have absorbed my limit of x-radiation for the next several years.
After that, the groomers came in and I was treated to a neck-to-ankle hair clipping, except for my back and the part of my pubic hair left from the heart cath prep. I am moderately hairy, so this took a lot of effort on the part of the groomers. The clipping was followed by a shower, and what was possibly the blandest snack (saltless soup and saltless saltine crackers) of my life. Then it was time to go sleep so that I could get up fresh and rested for my 6 AM surgery prep.