Advice/opinions please? So just got back from first meeting with surgeon re aortic valve replacement. After meeting with cardiologist I though decision re valve type was taken, I’m almost 67, otherwise quite fit, and she therefore said metal valve would be best option. I was happy to take her advice. However surgeon has said I must choose and seemed to be steering me towards tissue. I mentioned Edwards Inspiris Resilia as I have read about it here, she said yes, they could use that but said there is not enough evidence to prove that it lasts longer than other tissue valves.
I would still have to have ohs as they are going to check the ascending aorta once in as it is dilated and may need fixing. I know advantage of not having warfarin with tissue, but then they don’t last as long….arghhhhh. Too hard a decision, wondered if anyone else had same choice to make?
Thanks
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Hythe123
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Hi I had a mechanical valve fitted in 2005 latest tests show it’s Working fine, tissue valves i understand last around ten years, so by now I would be looking at having at the least my second replacement. Who wants to go through that again. Then there’s the age thing as we get older it’s a lot for the body to have to endure. You may have to be on Warfarin it hasn’t presented me with any problems whatsoever, get a home tester it will cut your hospital visits down to around twice a year. As for life with a mechanical valve don’t even know I have it .
what about option of Edwards Resillia then TAVi through groin if it needs replacing? I had OHS to electively repair a 5.2 cm TAA and if bi cuspid valve was to be changed, that’s what I was going to have. The TAA was repaired but intra operatively the ToE showed good opening of bicuspid valve above 3 cm so wasn’t changed. I was 63 at time
I’m currently on the list for valve replacement and spoke to my surgeon about a month ago about options . I’m 69 and have a few mild AF episodes after 2 ablations , the last was about 20 months ago . My surgeon recommended a tissue valve and said the latest types have a lifespan of around 20 years so should see me out .
Thank you, it’s so useful to hear others views. I am at the moment completely on the fence f valveas can see advantages and disadvantages of both types of valves. Anyone else had to choose?
I am a bit younger then you, but I had the choice when I was fifty, five years ago. For me, it was easy, a mechanical valve. I went for this as there was the least possibility of having another OHS, something I am glad about after the event.
The general rule of thumb used to be, over 65, tissue valve, under 65, mechanical valve. Tissue valves do tend to last longer, as you get older. Don't ask me why, probably down the the lower acitivity levels or similar. I certainly would expect a tissue valve to last in excess of 15 years for you, possibly more. The Edwards Resillia, often quoted on here, as your surgeon says, do not have the long term proven track record yet, and I would't rely on them because of it.
Of course, as we get older, surgeons, where possible, will replave a valve using TAVI/R, which is much less invasive and has a much reduced recovery time.
I am warafarin, and is it a problem, no. Don't let that put you off. The decision is yours and I can see why you are undecided, stuck right in the middle. I don't think, for you, there will be any wrong answer.
hi, I had replacement valve and root 3 weeks ago along with repair to ascending aorta. I am 57 and was also presented with both options but decided the mechanical valve would give me a greater level of comfort as I am sure it would have been in the back of my mind that I’d need to be opened up again in 10-15 years time for a further valve . I have started on warfarin and am going to buy a machine so I can self test from home which will mean eventually that I only need a 6 monthly visit to the clinic. I wish you all the best for your upcoming surgery.
Thank you, congrats on having your surgery. Every time I read someone’s positive experience I decide that’s the road I’ll take, I wish the surgeon had advised but she just said it’s my decision not hers although she did seem to point me towards tissue. Thanks again for reply, good luck with recovery.
That’s no problem, I understand it’s a very personal decision and certainly one to consider very carefully. All the best and please keep us updated on your journey
I’m 71, had a bovine valve (Edward’s Resilia) 11 months ago. I was told 20 years or so life for it. It’s been fantastic since, I really feel rejuvenated.
I have always had tissue valves, my first one went from birth until I was twenty four. The second one ten years and I have just had another replacement in February.
They have said another ten they are aiming for but it could be less, all depending on my body, on my last echocardiogram it highlighted mild leaking all ready.
I had a tissue fitted in 2022 because I couldn’t have a metal as I couldn’t take warfrin , so the choice was made for me . My neighbour too has a tissue and had her fitted 18 years ago and she’s going strong ! I understand they don’t know the longevity of them because they are still working !
Mines doing great and although a life long vegetarian made me conflicted I’m forever grateful . Be guided by the surgeons etc and good luck with the op whatever one you go with they are a game changer and you will feel so much better !
I had a mitral valve replaced in September 2020; I had been prescribed warfarin about 18 months previously having been diagnosed with severe arrhythmia as well as a leaky valve. I assumed that as my cardiologist continued to prescribe warfarin that I’d had a metallic valve but it turns out to have been tissue and the reason I must take warfarin is because of the arrhythmia. He said he has patients living with tissue valves that are still working well way beyond 10 years.
Hello. If you go on my profile and press replies you will find many of them are to questions like yours, being the recipient of a mechanical mitral valve many years ago. At your age a tissue valve is usually recommended though.
I had my AVR almost 2 years ago, at age 69. Two separate consultant surgeons independently recommended the Edwards Resilia tissue valve, so my dilemma re choice was made far easier! I am now completely Med-free & the lifestyle advantages of not having to be on warfarin for life has been a 'plus'. The surgeons said that the Resilia valve is a perfect substrate for a future TAVI if/when a replacement is needed. The lifespan for the Resilia valve is still uncertain, but hopefully 15+ years. Current data shows very high performance up to the (latest) 7 year medical trials.
Conversely, many of those who have opted for a mechanical valve say that being on warfarin is not a big problem & they have the reassurance of probably not having to face a further AVR.
Just to put mechanical valve life in perspective, my mechanical aortic valve celebrated its 36th birthday recently and I have been taking Warfarin for the same length of time without having any problems with it.
I can give a bit of both as each of my parents had to have an aortic valve replacement as have I just this January. Dad had a pig valve and mom had the metal one. Dad last 21 years after his and only died because he got idiotic and began refusing the diuretic he needed because he was tiring of peeing all the time, the valve was still working just fine, he was 83 at age of death. Mom is still alive 30+ years after her mechanical valve and she had emphysema at the time of her surgery and is now oxygen dependent 24/7, she is age 88. Mine doesn't matter as it hasn't been more than a couple of months.
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