Heart valve replacement, mechanical or biological

[Cowboy72]

Heart valve replacement

Mechanical or biologoical?

[080311]

Hi, have a tissue replacement AVR, went with what my surgeon thought was best for me.

[MichaelJH Heart Star]

Hello and welcome to the forum! It would be easier for people to give you their opinion if you could give some more details about yourself. These could include age (approximate would be fine), how active you are, sports, occupation, etc...

[Hanibil]

Hi I had a mechanical aortic valve in 2005 has been brilliant, tissue valves tend to only last around ten years , and have heard of them failing before that . Yes you will have to take warfarin but nothing too it and easily manageable with a home tester.

[road2ruin in reply to Hanibil]

Hi Hanibil,

Can I just ask how long it took your INR to settle down, or do you still struggle now?

Mine has been up and down a lot 3.5 one week 1.8 the next etc...

Many thanks

[Hanibil in reply to road2ruin]

They had a job at the hospital getting the right dose of warfarin dyer my operation but sorted it . Still goes up and down but I find it’s all down to diet. But it really doesn’t affect me when I use my home monitor I simply adjust the amount of warfarin I take .

[road2ruin in reply to Hanibil]

That's good to hear. I was considering the home monitor myself and I think you have now convinced me.

Thanks for your reply.

Peter

[road2ruin]

Hi,

You will get a variety of opinions depending on people's personal circumstances and preferences.

Generally speaking though, if you are under 50 the advice is to go for a mechanical valve, as in theory they can last a lifetime and certainly a lot lot longer than a tissue valve. If you are over 60 a tissue valve may be suitable. There is less maintenance with a tissue valve but they WILL deteriorate over a period of time and are unlikely to last more than 10 years, often less. There are ongoing developments in the valve world and one company in particular, Edwards Science, claim to have developed a tissue valve that will last 25ish years or so. These are unproven and some have failed after just a few years. Between 50 and 60 is the tricky stage and no 'right' or 'wrong' choice. You also need to consider the pros and cons of each.

A tissue valve WILL need replacing at some point, so if you are happy to go through the Op again then that's a consideration. Some times they can be replaced via an artery in your groin called a TAVR or TAVI, much less invasive, but not always. With tissue valves though there is no long term dependence on warfarin so you can almost forget about it.

A mechanical valve, certainly modern ones, are very highly machined and so the old risks associated with them, like blood clots for example, are greatly reduced. You will have to be on warfarin for the rest of your life, but this is no different than taking any other tablets daily. There is also the need for ongoing INR blood tests to check you are on the right dose, often weekly. It is only a finger prick test however and takes a few minutes. Like diabetes there are even home monitors available now quite cheaply (approx £300). One last things is that they tick...and some people don't like it.

For me, I was 49, so I went for a mechanical valve. Yes I take warfarin and it has been difficult to get the dose right, and yes it ticks and sometimes I don't like it. I am early days though just over 7 months now. and glad it is all behind me. Would I want the Op again, most definitely not, so I think I made the right choice for me.

All I can finish with is good luck. Most of us have been there and always happy to help.