mechanical vs tissue valve - experience in pregnancy?

[inca123]

Hi,

Im new to the forum and I am looking for some advice. I am 30yrs old, and have had aortic stenosis since I was born. Recently the stenosis worsened to severe and I have been advised to have surgery. My difficulty is in deciding on which valve - mechanical or tissue to have. I am planning on children in the next few years, and with this think a tissue valve would be much better, as I am normally very active (I am a vet by profession and run/cycle regularly).

However my surgeon seemed to feel this was a risk due to my young age, and potentially it may wear out quickly. Doesnt feel like there are any easy answers! Any advice/ experiences would be much appreciated!

[MichaelJH Heart Star]

My view as you are active and plan to have children is a tissue valve, preferably an Edwards Resilia valve that has a predicted life up to 25 years. I think it is not the time for warfarin. The valve will last better if you maintain a healthy lifestyle and near obcessive dental hygiene.

[inca123 in reply to MichaelJH]

Thank you for your reply Michael

[MichaelJH Heart Star in reply to inca123]

I should have added that as you did not mention anything there are no other medical issues that make future valve replacement high risk. Mechanical at 50 could be acceptable but tissue will have moved forward.

[werd]

If you wish to go through valve replacment again and again in your life go for the pigs valve.if not go for the macanical valve i had 1fitted when i was 26 i am now 71 and just had my yearly app with doc and the valve is as good as the day it was fitted

Yours werd

[Boblell in reply to werd]

Wow. 45 years and it's still like new. Having had my mechanical aortic valve last year I am obviously interested in how long they last. This is the longest I've heard of. Thank you.

[verysmallnosies in reply to werd]

That is brilliant, Werd!

[Suzy61Taylor]

Hi Inca123. I have a mechanical valve as I too was worried about wearing out a tissue valve. I’m on warfarin and I hate that more than anything. I’m also on medication for an under active thyroid and I was never told that warfarin and levothyroxine was a poor combination. My surgeon was quite clear that the choice was mine and so I chose mechanical. I am 66 but I still workout everyday, from running, cycling and weight lifting and compete regularly. My valve should never need replacing but I could kick myself for not researching the effects of warfarin. Even a small cut on my finger takes 2/3 times longer to heal so it’s not just the anticoagulant process that’s longer. Also, having severe osteoporosis in my left hip and thoracic spine is compromised by warfarin. All medication has it’s drawbacks and a tissue valve needs daily aspirin I believe. No easy answer. I do like hearing my valve tick and as I’m very slim, especially around my chest I’m very aware of it. I recovered from my op so quickly and I put that down to my high level of fitness. It’s a difficult decision to make. It’s weighing up the positives but also the negatives. All the best to you x

[inca123 in reply to Suzy61Taylor]

Hi Suzy61,

Thanks for your great reply, it's good to hear different experiences. It is frustrating in some ways that the choice is given to us, when I feel in some ways you cannot fully understand how that choice may affect you.

Really pleased you have had such a good recovery.

[werd]

Hi werd here again,there are worse things in life than warfarin as i said i have had my valve for 45 years and had no real probs with my i n r

For the last 5 years i have self tested and dosed. testing weekly the machine cost £300 and i get the testing stŕips on prescription if you are a vet testing should be no prob.

Ps i live in scotland

[Lynnca]

I have just had a mechanical valve fitted at 64. Likewise I didn’t like the idea of warfarin but am managing it ok. I was advised that the mechanical was better as I might not be as fit when a tissue one needed to be replaced

Recovery was good and I am back to walking daily and back to work

[JJL15]

Hi! So I had a tissue valve put in when I was 28 (6yrs ago) as I wanted a family . I’ve now had 2 kids on the new valve and it’s still going strong!! I didn’t want the mechanical as I always wanted a family! Have they said if you can have a mechanical and still manage a family? Because l didn’t think you could have both due to the warfarin. I think my valve will go for another few years my Youngest is 9months old so hoping I will have the next surgery done once both my kids are at school and more self efficient. It is a scary thought as it is big operation but it really isn’t as bad as you would think x good luck to u

[inca123 in reply to JJL15]

Hi JJL15, thanks for your reply, it is so helpful to see how others have managed.

So they have advised you can have children with a mechanical but it is higher risk to you and baby. during pregnancy you have to switch to heparin rather than warfarin which is much harder to control

Really pleased you have had a positive experience with the tissue valve.