Tissue v mechanical valve?

[Fredders]

I am having to have another AVR some time in the next few months as my first replacement valve now has severe regurgitation. My dilemma is whether to have another tissue valve or a mechanical one. I am 58 so know that if I have another tissue one there is a possibility I may need another op. However I had a splenectomy last year after it went rogue and started killing off my blood cells, cause unknown, so am at high risk of infections and have to take antibiotics daily. In addition I understand that warfarin can be affected by diet. I am not a 'meat and two veg' person and don't eat what could be considered a regular diet - I often have cereal for supper. Is anybody on warfarin who can tell me how they get on with it?

[skid112 Heart Star]

Hi there fredders, not from personal experience no, but a thread here gives a link to a very informative fact sheet which may be of some use healthunlocked.com/bhf/post....

Hopefully someone with personal experience will be along to give their own experiences good luck

[laura_dropstitch Heart Star]

I'm not an expert on warfarin, but did take it for a year when I was first diagnosed, just because I'd given birth at the same time so was at higher risk of blood clots. It's quite a commitment in terms of monitoring it, lots of outpatient appointments. I had some issues with it reacting with other medicines e.g. a seemingly harmless anti-fungal treatment, which made my blood dangerously thin. (I was just given a massive dose of vitamin K and sent home with instructions not to touch anything remotely sharp and that was me sorted, so not hugely serious, but it was an eye-opener in terms of how easily the warfarin could be affected.)

I'm not sure what it would have been like to be on it longer-term. Hopefully someone around here can help you with that. Sounds like you have a lot of factors to consider, must a tough decision. Best of luck with it all

[Hidden]

Hi there - you're right that warfarin can be affected by your diet, as it acts directly on vitamin K. The AF association has a really great factsheet you can look through: atrialfibrillationassociati...

Hope this helps, Chris

[Fredders]

Thanks for your replies. I'm seeing my surgeon on Monday along with my pre-op checks so I'm making a list of questions. I am particularly concerned with the antibiotics because if I get an infection there is a chance I have to be put on intravenous antibiotics. I'm going to ask if there is an alternative to warfarin I can have. I still haven't ruled out going for another tissue valve.

[FMW62]

Yes it is a drag taking Warfarin every day. I'm semi-retired and live within 5 miles of the health clinic. At the regular clinics you get to meet and chat with other warfarin takers, but more important, it is a comfort to get the chance to talk regularly with a nurse who knows a fair bit about you. My surgeon recommended the artificial MVR as the life expectancy of the pig valve was 20 years and at 66 at the time he thought I had a greater life expectancy than that with a new mechanical valve. Very comforting!

[Fredders]

Well I had my pre-op appointment today and am having the mechanical valve and warfarin. I discussed it with the cardiologist and we agreed that because of the splenectomy it would be safer to have the mechanical one as if I had another tissue valve I would likely need yet another op sometime down the road. Guess I will have to sort out my diet! 😸 Should know on Friday when my op is, but they said it will be within the next 6 weeks otherwise I have to go through all of today's checks again.

[skid112 Heart Star]

Good news. Hopefully sooner than six weeks

[Fredders in reply to skid112]

Four weeks would be good - after my birthday and gives work time to get a temp sorted out - they were really good to me last year when I was off sick for nearly eight months. 😺

[kefalonia1]

Good morning, bit late replying sorry! l have been on warfarin since Feb as l have a mechanical AVR. lt takes a long time to regulate your dosage and its only now l am pretty much stable. Lots of green cabbage, cranberries and grapefruit should be avoided as they lower your INR readings. The only side effect l get is bruising easily even with a small knock but that is manageable. l have cut myself a few times and did not bleed to death so don`t believe the old wives tales. l was delighted to be told a glass of wine will raise your reading if its low so happy days! My mechanical valve hopefully will last a long time and l have no problem with it, even the annoying ticking has subsided, the tissue ones l think are from pigs so don`t last as long. lt is completely your decision l am 61 and also had to have the wall of my heart rebuilt with medical mesh as Sepsis and infective endocarditis had destroyed it. l hope this is helpful. Take care mate.

[Fredders in reply to kefalonia1]

Thanks for your reply. I have decided to go ahead with the mechanical one as my surgeon said it was too risky to keep having tissue ones replaced due to my splenectomy. I think I will have to completely revise my diet as I can go all week without eating any vegetables! Been checking the good and bad things to eat so that I can try to get my vit K levels fairly constant. Thankfully the anticoagulant clinic run sessions at my GP surgery, which is about 15 minutes walk away.

[Marco_]

Hi

I also need an aortic valve replacement. I'm in my late forties so similar dilemma.

I ruled out mechanical valves mainly because of the audible clicking they make, but also didn't want warfarin for rest of my life.

I researched and found this new anti calcification tissue valve that should last >20years. However no live data to back that up.

Asked my surgeon about it and he said I am a suitable candidate for this valve.

Here's the product link:

edwards.com/devices/heart-v...

Also link with newspaper article:

dailymail.co.uk/health/arti...

Hope this helps and good luck.

[KRod1 in reply to Marco_]

Hi There, Prof Wendler is fitting me with the Inspiris Valve on Monday. Have you had yours yet? I’ll report back on how it was once op is done and I’m recuperating.

[Marco_ in reply to KRod1]

Hi. No not had my operation done yet. Trying to find out if a repair would be possible in my case – I have a bicuspid aortic valve, and a prolapsed mitral valve.

I’m considering changing to another cardiac centre so I think I will contact Prof Wendler via email as I think he might be a better option for my case.

Did you specify you wanted yours done by Prof Wendler or did another cardiac centre refer you to Kings?

Wishing you all the very best for tomorrow – look forward to hearing your progress once you are back home.

[Roamie in reply to KRod1]

Did you have the inspiris valve? It is now six months, was it a good choice? Do you need to take warfarin? And what is the life expectancy of the valve?

[verysmallnosies in reply to Marco_]

Marco, how are you getting on with your new tissue valve?

[Marco_ in reply to verysmallnosies]

Despite having two valves with severe regurgitation, I am still asymptomatic. I also got a second opinion and I was advised to delay surgery until I started to develop symptoms of breathlessness and have an echocardiogram every 12 months.

A few weeks prior to lockdown my echocardiogram results revealed that my heart has started to stretch so can’t delay surgery any longer. But currently due to the pandemic I have no idea when this surgery will take place.

[verysmallnosies in reply to Marco_]

Oh my, just reading your last note. Have you a surgery date yet? Mine is sometime in September...

[Marco_ in reply to verysmallnosies]

No. You’ve prompted me to chase up the hospital again.

[verysmallnosies in reply to Marco_]

Oh, I hope that's a good thing

[verysmallnosies in reply to Marco_]

Marco, is this valve the Inspiris Resilia? It's not clear which type of valve it is?

[Marco_ in reply to verysmallnosies]

As far as can recall, yes it is the Inspiris Resilia, but would need to double check when I next speak to my surgeon.

edwards.com/devices/heart-v...