British Heart Foundation
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Mechanical or tissue valve

Hi all,

I'm a 22 year old male living with heart disease. I had the ross procedure in 2010 and now need more surgery this year. I now have the decision of a mechanical valve or tissue valve. Saying I'm scared/confused in an understatement but understand this needs to be done, but can anyone give some advise on which is the better option?

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Hi Alfie, nothing in this life is straightforward. I would like to ask a couple of questions before giving you my thoughts (not medically qualified but seriously interested in heart disease). I) Are or were you fairly physically fit and II) Do you play sports and which ones?

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Hi Michael, thanks for your reply.

I)I am fairy healthy, I'd say I do well considering, I keep up with the people I play sport with. II)I play 5 aside football once a week with a local pub team and try and go running most days, I'm not one for weights as the straining doesn't seem to do me any good.

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Hello Alfie, thanks for replying. The reason I asked the questions is that doctors/consultants should be treating a patient but many treat a condition. You are still young and many people would say that a mechanical valve could last a lifetime. However, the downside would be (currently) it means a lifetime of warfarin and related blood tests. With warfarin you would bruise easily and badly, and if you suffered a fracture there could be issues. If there are no other considerations you have not mentioned in your position I would go for a tissue valve. These have a lifetime of around 10 – 15 years. Whilst it may then need revision you will still be quite young and it might be possible by minimally invasive surgery. Also advances in medic al science means that future ones could last a lot longer – they are making advances particularly with bovine valves. Although I am awaiting a quadruple bypass I became familiar with valves issue when my best friend’s wife needed a replacement mitral valve and two more valves repaired. In her late sixties she chose a tissue valve as she has a degree of osteoporosis and did not want to risk complications if she suffered a fracture, particularly a hip where replacement is routine but quite invasive. Please let us know your decision and how you get on…

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Hi Michael, I'm more leaning towards the tissue at the moment with the hope that in 10-15 years time the science would have improved a lot. Thank you for sharing with me and will let you know once I know where I stand. Thanks again

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Hi Alfie, I’ve had two aortic valve replacement operations, my first was a tissue valve when I was 52 and my second was a mechanical one last year at 59.

Not knowing what sort of heart disease or any other health issues, I agree with. Ichael and would go for tissue. Mine didn’t last as long as the surgeon expected but they do usually last 10-15 years, although there are some new ones that are supposed to last longer than that. They are already doing some valve replacements by keyhole surgery (TAVI) and I expect these will become more the norm as things evolve.

I went with a mechanical one this time as I had to have my spleen removed last year and am therefore a high risk if I get an infection. Although this means I shouldn’t need another op, it does mean I’m now on warfarin for the rest of my life. Thankfully my INR levels have been stable so I only have to test once a month, and I have a home testing machine so don’t need to attend the clinic. The downside for someone your age is regulating your diet and little or no alcohol, as both can effect your blood clotting. Also you have to be very careful if you do sports, they don’t recommend any contact sports or ones where you could bang your head, because of the risk of internal bleeding.

If you have any questions about the surgery itself and recovery etc, ask away as there are plenty of us on here who have gone through various procedures and we’re more than willing to share our experiences.

Wendy

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Hi Wendy, thank you for your reply. For me right now sport is a big part of my life, not just to stay healthy but seems to take my mind off of everything else. I had surgery many years ago so it's a little bit of a blur of the recovery side, how long does it take get back to everyday life and like it was previously?

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The first few weeks are the worst but after that I started feeling a lot better. By week 6 I was driving again, albeit short distances. I went back to work after 12 weeks but felt I could have gone back a couple of weeks earlier but my GP said she thought 12 weeks was early enough. I’m a secretary so nothing strenuous so although work were willing to let me go back on ease back ( reduced hours) I actually went straight back full-time and felt fine. The only problem I had was breathlessness, which turned out to be my pacemaker maximum being set too low, now had it tweaked and feel much better.

Like most things after such invasive surgery it’s just a case of not rushing things, you know your body better than anyone and you’ll soon know what you can and can’t do during the early months. Your age and fitness levels will also make a difference - I’m and old couch potato 😜

Wendy

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You are just a year younger than my granddaughter who previously had a Ross. She then had a Fontan at 13. Since then she has been on Warfarin. She self tests and manages the Warfarin well.

You need to listen to your surgeons. It is true that there are great advances in heart surgery so a tissue valve could be right for you at this stage in your life, but mechanical will last longer and avoid more surgery.

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Thank you Nanny, hoping the science will advance as going through this every 10-15 years feels a bit much. Thank you for replying, is your granddaughter okay with the tests and warfarin or feel she is held back?

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I had a replacement valve made out of my dna so I guess it be a tissue valve. Been told it shouldn’t need repairing or replacing often. Should onli need a valve op every 10 to 15 years but cos of lifestyle factors it’s every 3 years.

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Hi Gal, sorry to hear that, what kind of lifestyle factors? if you don't mind me asking.

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The fact that someone 4gets to clean her teeth

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