I’ve just had my final session with surgical team prior to my operation tomorrow. After being told that they were leaving the valve, they’ve said they may need to change and hence need to make a decision on whether to have a mechanical v tissue valve.
I’m 48 and don’t like the idea of having another operation in 20 or so years time but also am being warned of the consequences of being on Warfarin with a mechanic valve for the rest of my life.
Does anyone have a view of the pros and cons of each?
Thanks
Written by
Red_Baron
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Hi, seems a while since your "fitness for surgery" but tomorrow is the day. For younger people who are physically active I tend to recommend tissue but approaching 50 it becomes mechanical unless you are planning seniors rugby or boxing! The issues with Warfarin are I believe overstated and once stabilised you can go for home monitoring. Best of luck for tomorrow!
Hi. My husband had an Aortic Valve Replacement last year, at the age of 55. He opted for a mechanical valve as he doesn’t want Open Heart Surgery again. Warfarin hasn’t really been much bother. He’s had a few ups and downs with his INR (the measurement of how fast the blood clots) but he’s stable, now has blood tests every couple of months. Warfarin is a very widely used drug and has been for decades so it has a great deal of history behind it. It’s a safe drug to take as the benefits and risks and interactions with other drugs (except new ones obviously) are well established. The main risk is from bleeding, which your medical team will explain to you. They’ll also take into consideration any other conditions you may have and the drugs those conditions require or may require in future.
All the best for your surgery tomorrow and the future.
Hey Red_Baron. Good luck. If you check out my posts you'll see this discussed a lot. I'm 50 and went tissue in December. I had the Edwards Inspiris which - they say as it is so new nobody really knows - could last 20-25 years. It's coated in a special anti-calcificant, apparently. My take was similar to yours. I initially assumed for my age I'd have no choice but to go mechanical and wasn't hugely keen on the Warfarin issue. But I was given the choice and what swung it for me was my surgeon admitting that, even with a mechanical valve, while the likelihood is you won't need another op, that can never of course be guaranteed. So I'm gambling on 10-20 years (hopefully more!) Warfarin-free, in which time who knows how tech around valves and anti-coagulents and surgery will have developed? I currently just take dissolvable aspirin for the valve, so all very manageable. The sum of it is there is no "right" decision - there are genuine pros and cons for each. It's a very personal decision. The main thing is to accept whatever decision you do make is "right" for you and make it your own; don't "what if" it whatever happens. For me I was very lucky with the op, had very few complications and am well on the mend. It is a big operation but very standard and straightforward these days and I certainly came home after a week in hospital much less of an invalid than I had feared I would be, and then onwards and upwards from there. So whatever happens I hope things go well for you and that you are on the mend quickly. Good luck and keep us posted on how you're doing! Nic x
I think what Nic says is absolutely spot-on! I have the same valve as he does - if us set up to have a TAVI in years to come - and think I made the right decision. However, nothing in life is guaranteed. With tissue you may end up on warfarin and with mechanical you may need a re-do! I was 58 when I got my Inspiris - if it lasts me 20 years (and nothing else gets me first) I’ll be 78 and get a TAVI or whatever new thing technology has by then!! Good luck - the waiting IS the worst! Keep us posted.
Hi even at your age I would opt for a tissue valve because by the time comes that you need a replacement the operation you will need will not be (I think) anywhere near as major as it is today. There will probably be valves that don't need warfarin or replacements go for tissue.
I had surgery 10 months ago at Harefield. I had a tear in my mitral valve I also needed a double bypass.
The bypass went according to plan, however, the repair to the valve ruptured when I was taken off of the heart-lung machine. The surgeon had no option other than valve replacement. A composite tissue valve was used.
I was not in a position to be offered a choice. I am pleased with the choice the team made.
I took Warfarin for three months after the op I had to have blood tests every week, I am 68 and had to be so careful not to cut myself, even the slightest of knocks caused severe bruising.
I was delighted when my cardiologist took me off Warfarin.
I take one Asprin a day along with my other prescribed drugs.
I have recently been signed off by Harefield and do not have to go back for 12 months.
I had a mechanical valve when I was 48 in 2005 best decision ever, who in there right mind would want to go through that again if they didn’t have to. So you have to have blood thinners not a problem easily managed even easier if you buy a home tester. I wish you all the luck in the world
There is no right answer so I based my comments on the experiences of those I know. Red_Baron was first on the list today. We should know his decision in a few days.
had tissue valve nov 2012 (aorta) after bug invasion. this year (feb?) more bugs got in and destroyed replacement valve as well as mitral valve - got 2 more tissue valves and starting to get back to active. mololosomething 2x1.2 tablets daily / 1 x small aspirin daily.
Hi, yes, through the procedure and out the other side. I keep meaning to type up my experience but I went back to work 4 weeks after the op and have been on the go ever since. Will type everything up tomorrow
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The issues with Warfarin are I believe overstated and once stabilised you can go for home monitoring. Best of luck for tomorrow!
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