I'm in process of deciding whether to go with a mechanical valve or a tissue valve to replace my bicuspid aortic valve. I have severe aortic stenosis now. I'm in my late 50s and I've been recommended towards the mechanical valves, but there are so many things like Wafarin, ticking, etc that bothers me. On the other hand, the tissue valves have a shorter life time and there could be difficulties in replacing it later on, which I was told I most likely I will have to do so. I'm quite active in exercising (jogging, weights, cycling)...nothing too tough, but try to keep somewhat healthy. Just wondering if anyone has had the Inspiris Resilia valve? Any insights as to how it's working for you and what side effects, if any? If anyone knows of any websites that may shed more information, please let me know. This is such tough decision. Thanks.
Inspiris Resilia vs other aortic valves - British Heart Fou...
Inspiris Resilia vs other aortic valves
Yes i have the edwards inspiris resilia. May 2020.In making your decision you need to accept that doctors will act on experience and want six years of experience with these valves. But the valves are improving every year.
I am 73 so the limited lifespan should not affect me. Since my op, i believe that the newest valve now has a space to renew by TAVi.
I had a private op and suspect i got all the best options, and i had two surgeons discuss which valve to use.
I have had no problems with the valve and think i got the right option.
My attitude was to trust the guy who would be doing the op. But i was so close to death that i am not sure i was thinking straight.
I was bicuspid and extremely heavily stenosed. I have a very strong heart.
Good luck Monty
Colin
Hi Colin, thank you for comments. I really appreciate your thoughts and knowledge. Cheers, Monty.
Hi Colin. I am in a similar situation to you but slightly older. Are you able/willing to give some indication of the cost of going private? Good luck with everything anyway. M
Are you sitting down. Or a multimillionaire.The worst bit was not knowing the final costs.
The best bit was i got loads of discounts because the Cromwell hospital had lost its very very rich overseas customers. And my godchild has a senior position in BUPA.
I paid £43,000.
There are package deals, but they made no sense.
I was dieing and all the nhs was closing down..
i calculated that the extension to my life would make financial sense as my pension dies with me.
Brilliant surgeon. Brilliant. Lovely staff. I had the basic level room, which was luxury. Late april 2020 i was due to have Colchester. Closed. Basildon. Closed. West Brompton. Closed. Harefield. Closed.
Cromwell was the last chance.
Surreal experience, Covid was raging. I was in first class luxury.
A very bad thing was no rehab. The NHS promised i would get rehab when the hospitals opened up. Never materialized.
A very good thing was that the pre op tests were done on site and i stayed in the hospital.
Colin
Most helpful Colin. Thank you. M
Hey Monty. I had the Inspiris Resilia Dec 2018 at age 50 and currently all good. The only medication I take for it is low-dose dispersible aspirin each morning. I also take a low dose of candesartan for BP, though that's not technically for the valve I guess.
So personally I'm very happy so far with the decision as, like you, the whole pros and cons thing was one I wrestled with. Re exercise I'm probably fitter and doing more now than I have been for many years, even if still an overly sedentary fiftysomething with creaky knees! It is a very personal and difficult decision, and there are genuine pros and cons to each. So the key is not to 'what if?' whatever decision you do make.
For me, I was leaning towards tissue anyway but what swung it was my surgeon pointing out that, while going mechanical may/should mean just the one op, that never can be guaranteed anyway. So, for me, I'll take 15-20 years (hopefully more as it should last 20-25 and I've even heard 30 bandied about) Warfarin free, even though, yes, it'll mean another op, and then see where we are with advances in surgery, valves, tech and coagulents. But it is a very personal thing.
If I can help at all with any other questions, do ask away. And good luck! Discovering this stuff isn't fun and does your head in, so look after yourself.
Cheers Nic x
Hi Nic, thank you for your comments. I really appreciate it. I only had one session with my surgeon and he hasn't mentioned the Inspiris Resilia valve to me, just the tissue and mechanical valves. But I'm doing more research on it now. May I ask you when did you have to tell the surgeon the valve you wanted to go with - during the pre-operation session or earlier? Thanks. Cheers, Monty.
Hi Monty. Yes I only had one meeting with my surgeon too, even missed him on his post op round as I was stuck in X Ray, which was galling as I wanted to thank him! It was also when the consent forms and pre op tests were all done.
I brought up the Resilia, as it'd been flagged up to me on this forum in fact when I'd done pretty much your post. We also discussed TAVI and the Ross procedure, neither of which were applicable for me at that time.
And he basically said the Resilia was becoming the one they (Guy's and St Thomas's) now use as standard when going for tissue valves, depending obviously on each patient. So I indicated at the meeting that was what I reckoned I would probably go for, but the final decision only needed to be given the night before the actual op. So lots of time for me to dither!
Hope that helps! Cheers Nic x
Hi Nic, thank you for your reply and information. It's such a mentally challenging decision.
Hi Monty,
Just for balance, I was 49 and like you had severe aortic stenosis. I went for the mechanical valve after much discussion with my wife an family. I agree, there are so many things to think about and it really is a personal thing. For me the though of definitely having another op, probably sooner rather than later, was the biggest factor in the decision process. My surgeon and I talked about the edwards tissue valve, but he was not convinced about the longevity and I believe there are cases of some failing after just a few years (I am sure you can probably find that about mechanical valves too).
With regards to the warfarin and ticking; the warfarin is just another tablet, or in my case three. I monitor my own bloods at home with a visit to the surgery about once every six weeks. This takes a max of five minutes and a finger prick. The ticking is there, although not everyone hears it, but mostly now I don't notice it unless I concentrate and think about it.
In summary, go with what you feel like. I hate to say it, but at your age there is going to be a good argument for and against either choice, so you must feel mentally content. It is never going to be perfect and it took me a while and some therapy to get my head around that.
Good luck with everything.
Peter
Hi Peter, thank you for your thoughts and feedback. I've only had one consultation with my surgeon and I am on a waiting list now for surgery. When did you have to give your surgeon your final decision? Was it before the pre-operation or during the pre-operation. I still have an angiogram to attend to now. Once again, any information is very much appreciated. Thanks. Monty.
Hi Monty,
I too only had one appointment with the surgeon and I confirmed my decision at that appointment, although he did say to me that I could change my mind as long as I gave them notice (no idea how long the notice would needed to have been though).
I had my angiogram before I saw the surgeon, but this may depend on each NHS region. My op was in Bristol and I live in Taunton, so the surgeon travels down on certain days making it less likely to be able to see them frequently.
I am sure they will give you all the time you need. I cannot praise the Bristol Heart Institute and the staff enough, from the Surgeons to the ladies and gents that cleaned and brought me my food, all of them real professionals. They certainly made me feel safe and looked after.
Please don't hesitate to ask if there is anything else you want to know. Many of us on here and all happy to help. It's a tough thing to go through alone.
All the best,
Peter
Hi Peter, thank you for your comments. I really appreciate them. Cheers, Monty.
My gut feeling would be to go mechanical. Whilst a 25 year lifespan has been predicted for the Inspiris Resilia there is no real life experience of this. Some actually only lasted a few years. As regards Warfarin once your INR is stabilised you should be ae to go to home monitoring. Also drugs are being developed thatshod eliminate this need. There's no real money in Warfarin but a modern day replacement 💰💰💰as it would be a lifetime drug.
Hi, I had a mechanical one 2 years ago. It was an emergency op with less than a week to get my head round the fact that I had a bicuspid valve & stenosis (had never heard these words before) requiring OHS! I went with the surgeon's recommendation which I am happy about, hopefully I won't have to go through similar surgery again, I was only 49.The warfarin & ticking is OK, I don't notice the ticking much and I'm fitter than pre op as my valve works properly.
Good luck.
Andy
Hi Andy.. There are forum members who have had a mechanical valve for over 40 years so you are good to go and maybe set a new record! Cheers, MichaelJH
Hi Andy, from what I am hearing, the longevity of the mechanical valve is really good, and hopefully it will last you a life time. Cheers, Monty.
Hi Andy, I was the same as you, 49 with a bicuspid valve, who knew eh! Whilst I wasn't an emergency like you, I was still quick, less than 6 months. A lot happier now it is all done and so glad I found this forum. Good luck to you.
Peter
Hi I had a mechanical valve fitted in December last year, I was 55.
There were many reasons for having the mechanical valve but the main reason was longevity, it won't need replacing. The thought of having a second operation and the complications that can bring certainly made up my mind for me.
As to warfarin, yes you have to take it for the rest of your life but that is a small price to pay in my view and it becomes the norm in your life.
My valve does tick and early on it became quite noticeable. It has quietened down as I've recovered and you do get used to it.
As to being active, after nearly 6months of recovering I'm playing golf again with a full swing, I'm returning to work in a few weeks, I work for a landscape gardener so physical work and I'm feeling quite fit and healthy.
It does take a time to recover, it certainly isn't easy at times but the nurses and doctors are superb and you will have your cardiology rehab team to help you.
You will have aches and pains which can be quite concerning and days when you just feel incredibly unwell, all of this is perfectly natural.
Walking is your main form.of exercise and.i would suggest keeping a walk diary. I logged how many 10 minute walks, 20 minute walks etc I did and.its a great way to see how your progressing. As an example, in February I was doing 2 10 minute walks a day, move on to March and I'm doing 3 20 minute walks a day increasing to 3 half hour walks to June where I'm playing 18 holes of golf. It really does help to see that you are progressing.
Good luck with your surgery and your recovery, I hope it all goes well for you.
Hi Peter, thank you for your thoughts. It's such a daunting process trying to figure out what to do. Cheers, Monty.
Hi There, I had an Edwards Inspiris in November 2018 (aged 55) I was guided to this choice by my surgeon who said it can be tweaked by TAVI at least three times further down the line. Whatever choice you make the whole thing is a complete head fu@k, so please ask any questions you may have, but be reassured that this bit before your operation is the worst. I am doing well, off all medication now and went back to skiing (well my interpretation of skiing, I only started when I was 50!) in December 2019, last years was cancelled due to COVID but hope to do it again this winter (fingers crossed). Lots of advice if you need it....my best purchases pre op....Recliner chair....Shower stool....Raised loo seat 
Hi DenHump, thank you for your comments. I haven't been told about the Edwards Inspiris by my surgeon, he is leaning towards the mechanical valve for me, because it lasts a life time. I'll have to ask. I'm not keen on the blood thinners and ticking sounds. When did you give your final decision, during the pre-op??? But, as you say, this is the worst part, trying to decide. Appreciate your thoughts. Cheers, Monty.
My surgeon discussed the options at my one and only appointment with him prior to surgery and prior to the angiogram, the pre op assessment was not done with the surgeon. I must admit it was the lifelong medication that put me off the mechanical one, but yes there is the uncertainty of knowing how long my Edwards Inspiris will last but Im doing everything I can to keep myself healthy and put it to the back of my mind as much as I can. Any questions you may have please don't hesitate to contact me, as I am sure your head will be all over the place right now. Make lists, keep yourself busy, ask questions
Thank you.
Hi, I had an Inspiris Resilia fitted in January this year age 52. No issues so far although it’s early days, and hoping it lasts as long as they predict. Spoke to 2 surgeons beforehand and neither seemed keen on lifelong warfarin… neither was I. I wasn’t on any meds before. Blood thinners and beta blocker for 3 months but now back to no meds. It’s a personal and difficult decision weighing up the pros and cons. Hope you choose the best for you 😀
Hi Samgeorge, thank you for your response. I too am very concerned about taking meds, as right now I don't take any. I guess I will have to decide soon. Cheers, Monty.
Most sizes of the Inspiris Resilia take a TAVI if needed in future. So another thing to add in to the pot. Take care and best wishes. Sam
Hi there following this thread as am in same position as Monty. Can I ask you where you had yours done and whether it was NHS or private ? If like the Inspiris but have no insurance so either have to wait for a very long time it remortgage I fear !Penny
Hi Bookworm60, I had mine done privately at the Alexandra hospital Cheadle Hulme as it was during lockdown and I was lucky enough to have medical insurance through work that covered it. I believe they fit them regularly at the Manchester Royal Infirmary NHS and you can choose which NHS hospital you go to. Hope this helps.
Best of luck in your quest
Sam x
Hi Penny, I have not yet had my surgery, but based on my research, the Inspiris Resilia is not covered by the NHS. Monty
Hi Monty it does seem to be at some hospitals but not at Bristol ( where I am also waiting for surgery). I am considering going private but I have no insurance and am not wealthy so it would be a huge decision. I don't know about you but I seem to have to be making lots of really difficult decisions at a time when I least feel able to ! Hang in there.
Hi Bookworm60, choosing a AV is a very difficult decision. Nice to have this forum to discuss with others. Monty.
Hi Monty. Had my Resilia valve fitted early January this year for same reasons you gave, no warfarin, no ticking etc. Am delighted with my valve. Back running and training and feeling great. Resilia has potential for valve in valve replacement with a coating that has potential to last up to 20 yrs or more.
That's good news Templar889! Monty.
Hi Monty ,
Maybe I was lucky, maybe not, it depends on how you look at it, but my bog standard NHS Tissue AV went on and on for the best part of nineteen years before it was replaced.
Screwed my plans up somewhat😃.
Being serious, I never had problems with it, but, I do appreciate that it lasted longer than what they tell you.
Two more ops down the line, I have mech AV/MVs, neither of which really bother me from either a Warfarin or Ticking perspective.
Best regards
Heed
Hi Heed, that's good information. Yes, I have heard that Tissue AVs can last longer than the average 10-15 years. Really nice to hear that yous lasted for 19 years. Monty.
Hi all. Hi Monty. I am 45 years old and will have surgery at the start of January. Still try to decide between mechanical and Inspiris Resilia. My main concern is not being on meds for the rest of my life but the danger of bleeding and getting some type of internal bleeding. I have problems with both bleeding nose and still bleeding from my previous hemorrhoids surgery. The surgeon just checked me a week ago and said it is all good but it is not coz I am still bleeding even if it is minimal. So I am afraid about bleeding. From your experience, guys/gals, how bad and strong bleeding can get? Thanks a lot and Happy Holidays to all!
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