My wife had a calcified mitral valve replaced with a bovine valve in 2010 at age 69. The problem was owing to a bout of rheumatic fever she'd suffered as a child. She too has been working out for about an hour and a half five early mornings a week since the mid 1970s – stretches, yoga, weights, machines, as well as regular walks during the day and lots of garden work. So she's long been in excellent shape.

We traveled 300 miles to retain the services of a world-renowned specialist at UC San Diego for the procedure, which at the time was expected to require opening the chest. However, the doctor received a recently developed robot the day before the scheduled surgery, which allowed him to replace the valve less invasively by going between the ribs to access it, obviating the need to open her chest. So she was among the earliest to experience robotic valve replacement.

All went well for about thirteen years, when the valve again began to fail, pretty much as predicted. Her local cardiologist, who is not a surgeon, had just added a new surgeon to his practice and recommended we use her to perform the replacement. The doctor initially planned to accomplish it through an artery accessed in the groin. During her diagnostics she discovered that the original replacement valve had some sort of wire in it that was no longer employed in more recently implanted valves, complicating her use of the arterial route. After obtaining a second opinion, we decided to revisit the UCSD surgeon, who subsequently affirmed that opening the chest was definitely necessary to accomplish the second bovine replacement.

The surgery went well in SD, and the doctor concluded our interaction by saying "I'll see you again when you're ninety-nine".

Tom