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British Heart Foundation
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Mechanical or tissue valve replacement?

HI

I am new to this forum and would really appreciate advice from people who have had a mechanical or tissue valve replacement. I am only 48, female and have 2 children 12 and 14. I live an active life and exercise keeps me sane. Nothing too strenuous but I like swimming and hiking. I was born with a biscupid aortic valve which has been watched for the last 6 years. It has now tipped into the severe category and I have been told I need imminent aortic valve replacement therapy. I live in London and am lucky to have been able to get opinions from 2 surgeons who specialise in the field. One surgeon is definitely pushing me towards the mechanical valve option but I suffer health anxiety in general and feel that this may not work best for me due to the worry over warfarin, constantly checking blood and also the ticking you can hear/feel. The second surgeon said it was a personal decision and that a tissue valve might be better for me despite fact it may wear out quickly. I've been told it could be anywhere between 5 and 12 years and then I will need repeat surgery which becomes a bit riskier. My gut feeling is leaning towards the tissue valve despite the obvious disadvantages due to my age/ongoing surgery. But I also know what I am like. I like a drink (which I know you have to be careful about on warfarin) and every time I go for bloods etc I fear the worst.

Any personal experiences or opinions would be so gratefully received as I have to make this decision literally in the next couple of days and it is really not an easy one.

Fortunately, they have discovered this early so I have no other arterial or aorta problems and despite the calcified valve I am otherwise healthy.

Thank you heart community

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Hey,

Personally, I would choose the mechanical over the tissue valve, simply, to avoid further opening up or surgery several years down the road not sure how the Warfarin works with this procedure, but there may be alternatives!

I also have a moderate to severe leaky Aortic Valve and was told by the doctor at St Mary’s, Paddington, who did the recent deep ultrasound scan in Febuary, that it will need replacing but has said they’ll do another scan in six months; that doesn’t give me much confidence when you hear the words moderate/severe. So I don’t know how long you can go on for with a leaky valve? I also have type1 diabetes for 43yrs now, insulin injections daily.

I still get breathless with most types of physical exertion since having a mild heart attack last June and was fitted with a Pacemaker in August. Was not stented at all as the arteries were okay. My job as a TV Sports Cameraman has been on hold since the heart attack, but I’m aiming to return next week albeit more part time and to see how things go the job is very physically demanding with a lot of travelling too, with heavyvequipment to hump around and my camera being around 10.5kg hangs on the shoulder a lot so I’ll just have to see how it goes I’m 58.

Good luck with your decision.

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Well your story is inspiring actually. Sound like you manage everything well with your diabetes. If it helps you may just be monitored for many years to come. The 'severe" word is scary but they would have just continued to watch me as they had done before but a stress ecg showed positive ischaemic changes suggesting heart is beginning to show signs of stress. So surgery it is - much earlier than hoped - still can't quite decide. Obvious choice is mechanical but my heart is telling me, that for me personally, I might regret it!

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Haaah, follow your heart and not you head I think they say. The diabetes has been manageable over the 43 years with it, and considering the work I do. When I was younger, I covered conflict areas: war in Bosnia; Kosovo, civil war in Sudan, Libya, etc... as a news cameraman but these days I just stick to sport for the broadcasters in the UK and only travel in the UK now. Bit more difficult now though, with everything going on and lost my other half of 25yrs in January through long term battle with the ‘c’ word. So you just have to keep going on...

good luck with your health and decision.

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The cardiologists will manage any issues. I have been Type I since childhood and had a successful quadruple bypass last year at the age of 66. The issues that followed, electrolyte imbalance and anemia, are also experienced by non-disclosure. You will be fine.

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Hi Michael, when you say you had a quad bypass does that mean your arteries were really clogged up? I also suffer with Pernicious Anaemia and have a B12 bi-monthly; Chronic Tinitus with poor hearing, auditory nerve damage caused by being near a bomb as it went off in Kosovo in the mid-90’s when I was there filming the war!

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Yes, four arteries over70% blocked with LAD at 85%. The issue was hereditary (all male side of family dieing prematurely but my concerns were not taken seriously until I developed angina. Diabetes caused blockages to calcify so stents were not an option. Also have PAD, arthritic hip and prolapsed discs - the latter two collateral from accidents. On a bad day I feel slightly old! :)

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Sounds like you’re keeping your spirits up Michael, good luck!

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It is a very personal decision, but it sounds as if you already know deep down what you want.

Ultimately the decision is between warfarin/ ticking or reoperation, and obviously people vary between which they most want to avoid. Whichever valve you choose will be better than the one you have!

If you choose tissue I would definitely recommend the new Edwards Inspiris Resilia valve, which is very likely to last a lot longer than other tissue valves, as it avoids one of the main causes of calcification. Quite a few people on this forum have had it; it's not available in all hospitals but is available in at least some of the London hospitals. I would personally push for this.

If you choose mechanical then weekly home testing helps to keep your INR in range, which reduces the risk.

There are no alternatives to warfarin for mechanical valves.

My husband had 14 years on warfarin, and though his INR was in general very stable I found the worry over hitting his head and the occasions when his INR was out of range very stressful. I also definitely didn't want to tick, so I knew I didn't want mechanical and chose a Ross (a more complex operation with a donor valve). I expect I'll need a reop sometime but have confidence in my surgeon and hospital and enjoy the normality of my life now. Others of course feel the reverse!

All the best

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Thank you, really grateful for your feedback. Its so helpful to talk to people in similar boat. My cardiologist did talk about Ross procedure but for me felt it wasn't quite appropriate although I could choose to go that way. Thank you also for the tip of the new Inspira valve. I think this was the one my surgeon talked about yesterday. He said its certainly no worse than the more traditional ones but the jury is out on whether it delivers what it promises as noone has had it long enough. Horrible decision but I guess I have to see the positive side in that they have identified the problem and can still give me a good quality of life!

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Yes, we can't tell how long it will last but it does look like an advance that it doesn't require glutaraldehyde. The Ross is a big op, but I chose it because it has the best haemodynamics and I have a small annulus at 21mm and love hill-walking ( my 'plan b' if my pulmonary valve wasn't suitable was a tissue valve with annulus enlargement to fit a bigger valve). It's a very niche choice though and certainly not for everyone!

I agree it's important to look at valve problems positively - it's not that long since these things weren't fixable at all. You feel exhausted at first but it's soon all in the rear-view mirror.

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Hi. Do you mind me asking how old you are! I love hill walking too. Just want to be able to continue it. What’s the benefit of not having glutaraldehyde? Don’t know about that. Have no idea of the size of my annulus!😂. I assume if it was small it would have been mentioned after echo. Is that right?

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I was 60 at AVR - almost too old for a Ross, which is generally for younger patients. Most tissue valves have to be stored in glutaraldehyde, which promotes calcification, the Inspiris doesn't, which is the main reason it will probably last longer.

The valve annulus varies from 19mm to 29mm. The smaller it is, the smaller the prosthetic valve that fits it, and the higher the gradient after AVR. An echo will tell the size but often doctors don't bother to inform the patient! Women tend to have small annuli, but if you want really good exercise capacity the prosthetic valve size and haemodynamics are important.

Unfortunately doctors often are used to doing AVR in patients in their late 70s and don't really think about exercise capacity, particularly for women. A 25mm prosthetic valve is also large enough for a future TAVR with decent blood flow.

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Hiya,

Not going to try to sway you either way, just going to give you my story.....I had aortic valve replacement 5 weeks ago (bicuspid valve) and chose tissue valve, even though I'm relatively young at 38, and so reoperation/s futher down line a certainty (assuming I live to decent age!) Decision was based on active lifestyle (competitive triathlete) and nature of job (risk of cuts etc.), and I felt that being on lifelong anticoagulation would act as a restriction to leading the life that I want. All I can say is that if you do decide on tissue valve then have a serious look at the Inspiris Resilia aortic valve manufactured by Edwards (this is the valve that I went with, apparently the first patient at Blackpool to request it), consensus is that it will have enhanced longevity due to anti-calcification properties, and also designed to enable valve-in-valve procedure (TAVR) in the future to eliminate requirement for full OHS. A few hospitals in London using this valve so you should be OK. However, no empirical data regarding valve performance yet due to how new the valve is (first human implanted with valve in 2017).

All the very best, make your choice and stick by it!

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Thank you, so grateful for your response and thanks for the Inspiris tip. My cardiologist def suggesting mechanical and I don't necessarily have an increased risk of cuts nor do I do triathlons etc. But for some reason the tissue valve sits more comfortably with me. I'm worried it will make me feel less human! I'm bad at making the most simple of decisions - this one is the hardest of all!

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My recommendation would be for tissue at this time but mechanical when it is replaced as by the time you go for a second replacement you will be in your seventies.

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Thanks Michael. I'm 48 and at worst I've been told tissue valve will last 5 years. at best 15! That will put me at 63 at best!!! Unless this new valve (Edwards Inspiria) really is as good as the marketing.

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Hia I had a mechanical valve fitted 2 years ago, I was 30. I went for the mechanical valve because of my age, I was also advised that this may be a better choice because I want children (because being pregnant can put a strain on your heart so might make a valve wear out quicker). I'd been on warfarin before so I wasn't too concerned about that.

There is a very faint clicking noise but 99% of the time I don't notice it, it only tends to be when it is very quite and/or when I am listening for it (e.g. if I'm doing one of those mindfulness exercises when you have to focus your mind within your body).

The warfarin is ok. I didn't drink a hell of a lot beforehand anyway so I have essentially gone t-total (I might have 1 or 2 drinks with a friend every few months), I do miss getting drunk and going dancing though! I self-test at home and e-mail in my results so that is not much hassle, the machine is not cheap but it's worth it as I'm probably going to be using it for the rest of my life. I do find I'm getting more nose bleeds (I've always been a bit prone to them), and my periods are sometimes heavier.

I have been told I may have to have it replaced at some point but that is someway down the road.

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Lucybird, thank you so much for your feedback., I was told mechanical valves last for life (unless something goes wrong)! I'm interested why you think you may have to have it replaced!

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I can't exactly remember when they said, but I think it might be my age. Most people will have it fitted later so it will last for life but if I reach old age mine may wear out.

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Just approaching my first 12 months with a bioprosthetic valve installed when I was 65. I wanted to avoid the warfarin dependency, dietary restrictions and ticking and happy to accept another surgery further down the line. Longevity is indeterminate but 10 good years is a reasonable expectation but theres evidence of some study groups approaching high 'teens. My echo cardiologist reports she has reviewed patients with 20+ year old valves so fingers crossed.

I'm now much improved under exercise following my gradual decline in exercise tollerance because of my pseudo bicusped aortic valve. It's been a life enriching surgery for which I'm eternally grateful. And I'm happy to report a 25mm annulus!

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Thanks so much. This annulus thing (which no doctor has talked to me about) seems very important. But I'm not wrote sure what it all means? If I was 65 I would 100% go for the tissue valve from what I know. What would you have done if you were 48? Don't worry. My decision is my own. I'm just interested to know!

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My cardiologist recommendation carried a lot of weight, but I had reservations about the reliability of my local GP practice although getting Warfarin doseage wrong would be inconvenient rather than fatal. Additionally, advancing surgical techniques including TAVI, minimally invasive surgery and robotics will probably offer less traumatic options than the standard sternotomy.

So 10 years down the line,optimistically, I'm hoping that I've not only maintained my healthy and active lifestyle (cycling, hillwalking, snowboarding, tennis) but any inevitable increase in age associated risk is offset by advances in cardiac surgery.

And both important and relevant, it actually felt like the right option for me and if the clock could be turned back, I believe my decision would be the same. Surgery and recovery was no where near as painful or difficult as I had imagined although going in as healthy as possible undeniably helps as does a focused and pragmatic approach to rehab. It's an opportunity to restore near normal life expectancy, all other things being equal and for me, continues to be life enriching.

Good luck with whatever decision you come to headorheart

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I was 47 when I had my heart op, I was born with a bicuspid aortic valve as well, and I was always told by the time I reached my 40's I'd need to have surgery.

I have two children, I made the decision to go with the mechanical valve, that was done 7 years ago now, and apart from the minor ticking, I've had no issues.

I've been on warfarin from the day the op was done, and I can honestly say I've not changed how/what I eat or drink, my INR nurse always told me consistency is the key to keep your inr levels right X

I still drink, maybe a glass or two of an evening, some evenings it might be a bottle, but that has never changed X

I have 3 labs and so they keep me active, I do a manual/physical job and have cut myself frequently but it's never been an issue, my bleeding always stops easily X I do gundog stuff for fun, I have tried to never let my heart issues dictate my life, I try and do whatever I want to do X

Whatever you decide I wish you all the best x

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Hi there. Thanks so much for replying. You were a very similar age to me when you had your op so your story is very relevant and really inspiring. I too have 2 kids (12 and 14) and love walking my dog (a hyperactive standard dachshund who can happily walk 10k with me- don't worry I am aware that I have to be careful with his little legs, I often carry him). I also love a glass of wine and love to hear that sometimes you have no ill effects on a bottle. I can do a bottle too sometimes and I don't really want to stop that at 48. I'm generally very pragmatic and don't really know why the idea of the mechanical valve freaks me out so much. I think it maybe will make me feel less "natural" but then that doesn't logically make much sense with a pig/cow valve either. Also I do really suffer health anxiety. When I was pregnant with my second child if I didn't feel him kick, I assumed the worst. I was literally sectioned in the maternity ward at the end of the final trimester because St Thomas's, London felt I could not keep coming in for dopplers every day/night anymore. Might I feel the same about the ticking? Likewise, every time I have to have a blood test I get crazy anxious, expecting the worst. It's just me, and I'm not proud of it, but I'm old enough to know now that this is unlikely to change. Noone knows how they'll react to warfarin until they're on it. I do not want my heart issues to dictate my life so what you say really hits the mark. I certainly want the best quality of life over the next 5-10 years to get my kids out of school and independent. My main fear is that if I go for the mechanical, which all my doctors recommend clinically (maybe not based on me), then I may seriously regret it. At least with tissue, whilst noone wants resurgery, I have another realistic chance that I can survive the next op and go for the mechanical route or TAVI. Everyone says trust your gut. My gut says tissue. But my head says mechanical

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Inr checks for warfarin are only a finger prick test, so no actual blood taking x

And as someone else said, it's not an op I would willingly want to go through again x

I find the ticking reassuring ☺️

Ultimately we can only tell you our story.

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Thanks so much. Ultimately I have to make my decision and stick to it. But these stories are all so helpful so cheers

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There's a lot of myths about warfarin. You a fine to have a couple of drinks (any more is bad for you generally, not just about the warfarin) and there's really no diet restrictions. Everything in moderation. I'm 37 and have mechanical aortic and mitral valves. Having gone through the surgery I found it horrendous, and would not willingly put myself through it again so I'm very glad I didn't chose tissue. This is life changing surgery, witj risks, so do consider whether needing to do it more than once is the right choice

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Hi, I had my aortic valve replaced at 32 in 2011 and went for the mechanical option. Mine was a bit of a rush job as I was scheduled to have it replaced later in the year but I ended up with an aortic dissection so when they said which valve to you want it was a case of choose now. I would make the same decision again as I had very little trouble with the so called clicking and knowing it would not need replacing was a bonus. As I later found out a tissue valve does not guarantee being warfarin free as it is sometimes needed anyway. With the warfarin checks, it can now be done at home with a little machine that only needs a drop of blood and is very simple. I personally would never look back, good luck in the difficult decision but considering your age I think mechanical would be my choice, well it was but you know what I mean, good luck.

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Thanks Matt. Really appreciated. Making the decision terrifies me more than the surgery/recovery

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For other indications like AF the newer anticoagulants that don't need blood tests can be used, rather than warfarin.

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Sorry to disagree but the new anti coaggulants are not effective / strong enough for mechanical valves. Research was being carried out but has been abandoned as it did not work so it has to be warfarin for those of us with mechanical valves.

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Sorry I didn't make myself clear, I was responding to Matt saying a tissue valve is not necessarily warfarin free by pointing out the new anticoagulants can be used in that case for things like AF. I should have made it clear I was talking about tissue valves, so thankyou for getting me to clarify that - I said earlier in the thread that there are no alternatives to warfarin for mechanical valves . So we're not in disagreement!

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Hi there,

I am 55 and had the Edwards Valve fitted in Southampton in November, like you I found the decision daunting/confusing/stressful but in the end decided that I didn't want to be on warfarin for ever and I was told that the Edwards Valve can have TAVI done on it up to 3 times, so that sealed my decision. Whether the Edwards valve lives up to expectations remains to be seen but I will do everything I can to preserve its longevity! I had an active lifestyle enjoy my holidays and thought that warfarin would be a bit restricting but it is purely a personal choice. As I like to ski (not that anything I do resembles skiing!) my surgeon also said that the Edwards valve would be the best choice for me. However now post op I have to say the thought of further OHS really does fill me with dread if I think about it, but I just put that to the back of my mind as best I can and think that TAVI will be the way forward.

As a side note I had a coarctation of Aorta repair in 1984, full open back surgery in those days and now this is done keyhole.....so advances are being made all the time and again this gives me reassurance that I may not need to have full OHS again. So next Decembers ski holiday is booked as is a cruise from Singapore to Hong Kong :)

Always happy to answer any questions you may have no matter what as I know exactly where your head is right now having been there very recently.

Best wishes

Denise

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I know it’s a difficult choice but totally understand the dilemma. I had an Inspiris in London with a really great surgeon in October 2018 and feel I made the right decision - feel great and no regrets. Feel free to message me - this time last year so was where you are now!!!!!

Alison

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Thanks Alison. Do you mind me asking your age and what surgeon you used?

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I am 58 so older than you however the person who told me about the Inspiris originally was only 37 when he got his. Chris Young was my surgeon - he was great.

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Thanks Alison, Yes heard the name Chris Young. I think in London there are number of great surgeons. Maybe spoilt for choice!

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Yes - we are very lucky. But so may people don’t realise that we can choose where we go! Who are you thinking if going to?

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I have been recommended Mr Chandrasekaran and also Mr Chukwuemeka. Mr Young is a far easier name to say! I've been reassured by 2 cardiologists and 3 medical friends that both are excellent as are Mr Young, Prof Wendler, Mario Petrou, Rosendahl. Can't see them all. And too many opinions become confusing in the end. Only thing is Mr Chukwuemeka I think did not feel comfortable using the new Inspiria tissue valve as he would prefer to see more long-term data. I instinctively feel I want to go for that but my cardiologist also put me off that. Need to try and talk to them again on Monday.

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Hi there

I am now 18month post avr replacement for bicuspid valve. My story is different from some of those above . I was 56yrs old, fit , slim and healthy my surgery was done within 3 weeks from diagnosis and I was in hospital during all this time. I only met the surgeon the day before surgery and was given very limited information and was not well enough to do the research I would normally have done. I made the decision to go with a mechanical valve as did not fancy further surgery if it could be avoided. I have no regrets about my choice. The only time I hear the clicking as I am going to sleep at night and it is reassuringly rather than disturbing.

I have to take warfarin for life but really don't find it a problem. It did take a while to settle down but I now self test and phone in the result and have been on the same dose of warfarin for the last few months. Yes there are a few rules but nothing that I can't work around. And yes I manage a couple of glasses of wine at the weekend.

Hope this helps , it's a difficult choice to make and feel comfortable. Good luck and good health to you. Mary

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Hi,

I was in Bart's Nov '17 expecting a double bypass and a replacement tissue aortic valve, after the op I was told that they hadn't replaced the valve but had repaired it. This was somewhat of a surprise as the possibility of repair had never been mentioned or shown up in my pre op googling.

The repaired valve has gone from major regurgitation to minor, and of course being my own tissue requires no ongoing medication. The unknown is whether the repair will last and if so for how long. AV repair is so rarely done that there aren't any useful statistics. I'm having 6 monthly scans and so far the valve has not deteriorated at all.

Whether it's a possibility in your case I wouldn't know, but it might be worth asking.

For the record I was 66 at time of op and the surgeon was professor Uppal at Bart's.

All the best.

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Hi, October 2018 I was diagnosed with endocarditis which required open heart surgery to replace my Aortic Valve after 6 weeks of antibiotics. I was a healthy 39 year old with no other health problems or heart conditions. In fact when they done the angiogram all looked good for someone of my age. I was gutted to have to go through this with a young family ( 10, 14 and 19 ). I had a mechanical valve fitted in December 2018 and after a couple of post op complications I feel great and back to work. Before the operation I loved going out for a beer or 3 with my mates but now with the Warfarin I am pretty much teetotal, I have the odd pint here and there. I have found a good non alcoholic beer that my local now stocks so I can still go out and have a beer and watch the footy but can now drive home as well. Don't get me wrong sometimes I would love a drink but being alive and not drinking is far better. The tick is not always noticeable and I'm sure it will get less noticeable as time goes on, I'm only 3 months on and it certainly has quietened down since surgery. Also another plus is if everything goes well I won't have to go through surgery again! Hope this helps any questions just ask

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Very similar story to you, Stevo, I am 18months down the line and can confirm that the clicking gets quieter, I only hear it as I go to sleep and it really quite reassuring.

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That's great to hear. Did you get sore shoulders and arms at times and if so for how long?? Also when did the pain from the wound finally go away, I'm not too bad but sometimes feel it it the sore shouldet/arm is sore/ annoying at times

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Yes I did get shoulder pain and ended up getting physio to sort the problem out. A lot of folk on here describe shoulder pain I think it's due to poor posture post operation.

Sounds like you have done amazingly well being back at work . I think my wound was healed and generally pain free within 3-4months provided I was not too ambitious or stupid.

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Yes I'm feeling good, very rarely have to take painkillers but when I do it's because of the shoulder/ arm pain. I feel as though I can do more than what I can physically at times!!

May sound silly but does the click of your valve sound funny at times?? Mine does, Sometimes it sounds as though a load of air bubbles squeezing through!! Lol it doesnt worry me but just wondering if anyone else hears different clicks

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Don't think I have heard different sounds from the valve but have been aware of having the odd episode of arrhythmia,(I had AF post operation but this was corrected with drugs) Everything is still so new for you your head will be spinning. If you read my story you will my journey....it was a long but so worth while and thankfully I am so well now.

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Hi I had a mechanical aortic valve in 2005 aged 48 I love it, has transformed my life I drink mountain bike and as I write this am in Austria skiing. So what you have to take warfarin two minutes a day. Get yourself a home tester around 300 you won’t regret it.

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Me again you can drink if you think oh I’ve had one to many simply do a test that will give you a result and alter your dose as required you will get so used to doing it it will become second nature, as for a tissue valve my Surgeon said he didn’t want me to have one as I was only 48, I had already decided not to have a tissue valve who wants to go through that again in ten or so years

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Super helpful, thank you. The testing as you drink made me laugh! I’m pretty organised (well I am now at 48) so I’m not worried about home testing etc. Any other dude effects from warfarin about from fact if you have a bad fall it can be dangerous?

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You will bruise, but you would in any case if you fell right now, just be careful I have had many a fall skiing but been fine bruised but ok. The mechanical valve is designed to go on for years and years. As I have said who wants to go through all this again in ten or so years, best decision I have ever made

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Hiya. I am 50 years, female with 2 children aged 18 and 16 and was also born with bicuspid aortic valve which was only diagnosed 4 years ago. I had a tissue valve replacement in Nov 2018 and am very happy with my decision. Like yourself the idea of Warfarin was a no-no as I like my wine and also don't always get my breaks on shifts in hospital and as I can't even have a ticking clock in my bedroom ruled that out quickly!

The idea of going through it all again was a down side to the tissue valve but found out here on BHF website about an Edwards Inspiris Resilia valve which can last up to 25 years so I have got that and now back at work and so glad I don't need to worry about blood checking.

Everyone is different, when I asked my consultant what he would do in same position he said tissue valve. Also technology changing all the time so hopefully by the time it needs replaced can be done by some minimally invasive technique 😀

Hope this helps and wish you all the best and a speedy recovery. Take care and let us know how you get on -x-

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Hi, thats so helpful. My heart is saying tissue, my head is saying mechanical. I did ask my cardiologist about the Inspiria valve and he said since its only been used for 5 years, there's no guarantee it will last longer and he would prefer more data before using a new valve which they won't have for 10 or so years. But then other people swear by it. I kind of feel like I'd like to take a chance with it.

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And how bad was the recovery after surgery. Could you face it again in 5 years if you had to?

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My surgeon said this valve has been used in Poland (I think) since about 2009. As your surgeon says it's not been used long enough to give reliable statistics but as it is made by the same company that makes the tissue valves currently in use, even if it doesn't last 25 years but still longer than what's used just now I think it's worth it.

I had read a lot from this website about recovery so had prepared myself for the worst but I was washing and drying my hair 3 days after op, could raise my arms - had bought blouses and front fastening pyjamas as some people had said it would be difficult getting dressed but was fine. My family have all been really surprised how well I have recovered. Also I think because it was 6 weeks before Xmas I was out xmas shopping (no carrying bags though). I do think being positive helps and having supportive family and friends. I did get a small wound infection which is apparently quite common in women as when you lie on your side your boobs stick together and gets a bit sweaty 😂 but if I was doing it again would put a dressing over my wound at night to absorb sweat.

If I had to do it again in 5 years I really don't think it would be an issue. Also you sound very active and fit which also helps. I had started getting out of breath with chest tightness on exertion so had stopped going to gym/exercise classes. Really enjoying the cardio rehab classes just now which give you more confidence in pushing yourself.

Hope this helps and any questions just ask. Do you have a date yet for your op?

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Brilliant info. Thank you so much. Looks like next Sat😬

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All the best then for a speedy recovery and better weather to do it in! -x-

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Hi headorheart, I was admitted to A&E in 2014 with sudden breathlessness and no other symptoms. A few days later they found a bicuspid aortic valve which had severe stenosis. Apparently it was a congenital heart defect that I was never aware of. A week later I was recommended a mechanical AVR at the age of 45.

My valve doesn’t make any sound and I have no issues with warfarin. I have my own INR testing machine to check my reading and alter my warfarin dose accordingly. I travel a lot and take my machine with me for reassurance. 5 years down the line, I don’t think about being on warfarin too much as think it’s easier than managing diabetes and insulin.

I am so grateful to my bionic heart valve :) and I was told by my surgeon it will last a lifetime. Hope this helps and good luck with making your decision.

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