I’m due to have replacement surgery next week, and still somewhat undecided about whether to go biological or mechanical. I’m 55 and quite fit and active, with no outward symptoms.
My surgeon has left the choice to me…my biggest stress is longevity. I’ve been told that if I opt for the biological route, I will need a second surgery at some point to replace again , but can only do this once more. Given that these valve only last 7-10years, this feels v life limiting at 55.
On the flip, the mechanical valve has better long term reliability but comes with other issues, such as warfarin and ticking .
TIA
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LGBE
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Hi , I had heart surgery in 2020 for a congenital heart defect - so different to you. This is an excellent website that should help you in your decision . Even though I had a different issue I still found it very useful.
Try to work out what your surgeon would prefer. He is the one doing the work, so go along with his preferences.
I had the more common atrial valve. Suggested it would last 15 to 20 years. Since my op in 2020 I believe that current valves can have a later TAVi option if the old one wears out.
I was 72 so I went biological and had the Edwards Inspiris Resilia valve. I paid for private surgery (all NHS surgery had stopped during covid). Being private, I had two surgeons to advise me and I could pick which valve to buy..
However, you are so young that it is probable that mechanical is more sensible.
The warfarin and ongoing tests are likely to be a pain, but you have so long to live.
Whichever way you go, please note that the op is very well organized. I have fond memories of the fabulous treatment. Nothing like other ops.
I luckily only needed a valve repair in the end but had to make a choice of valve replacements just in case they found it had to be replaced once they opened me up. At 56 I was persuaded by my surgeon on the eve of my op to go for the mechanical valve due to the longevity. I had gone into hospital thinking about the tissue valve as I didn't want the whole warfarin issue.
Having had open heart surgery (albeit I have recovered well) I don't fancy going through it again if I can help it (bearing in mind how much older I would be for one) so faced with that choice again at our age I would now go for the mechanical.
Hope that helps.
Best wishes for your op. Just take one day at a time - you do feel better every day.
I had Aortic valve replaced and bypass done in 2016, I have a tissue replacement (pigs) went with what the surgeon thought was best for me. I was older than you 68, I’ve just had my 5 year review ( though it’s closer to 6years) everything was ok one of my numbers was up slightly but only in line with what they would expect. My son was here from Australia so he had a conversation about what happens when I need a another valve! I felt like the child as they talked between them selves! The out come was I would have minimal invasive surgery because by the time I need it I would be in my 80s!
If you’re surgeon’s left the decision to you, you must weigh up the options carefully. On the forum there are lots of us that have had replacement valves some with tissue and some with mechanical. There is a new valve that some have had Inspiris Resilia valve maybe look at that. Keep asking until you are happy with what you have decided.
Have my surgery gave me my life back, and every day I am grateful to the medical team that worked so hard to help me. Just remember to follow all the instructions you will be given, post op.
I hope all goes well with your surgery. I am awaiting mitral valve surgery but have already been advised to go down the mechanical valve route. I've done a lot of reading and though there are the ongoing warfarin checks, I am going with the surgeons advice. I am 66 and after a lot of thought just want to feel so much better than I do at the moment. The alternative was explained to me in depth but the surgeon seemed very positive that mechanical would be a better outcome fir me. Can I ask how long you have waited for your surgery? My operation was cancelled the night before due to no ICU bed in November and I am still waiting......over 6 months. I have severe regurgitation....2nd pre op assessment done but they still cannot give me an idea on dates. I wish you a speedy recovery to where you will feel much better and again....all the best. Let us know how you are 😊
Hi,I had an emergency AVR 3 years ago and only had a week, whilst in hospital, to make a decision. Knowing nothing about it I went with the surgeons advice of mechanical as I was only 49. I would not want to go through the op and recovery again although it was not as bad as expected and I am better now than I was before re fitness level despite not know anything was wrong.
The ticking is noticeable at first but these days I don't often hear it. Warfarin is a pain in so far as I must remember to take it every day but my valve only needs INR of 1.5 to 2 so bleeding hasn't yet been a problem and my levels stay pretty constant plus the health centre is only a 5 minute walk for check-ups, currently every 5 weeks.
I'm glad I went with the surgeon's recommendation.
I went with mechanical as advised by the medical team. The risk of orgnic valve failing in future is higher along with highr risk in surgery when older was too much. mechanical will last the rest of your life. long term risks are stroke and infaction but that can be managed by medicines.
Hi I had mitral and aorta valves replaced last April,my consultant did leave it up to me to choose but did say the mechanical would be better as my age,56.Like yourself am pretty healthy so went for mechanical,yes you are on warfarin for the rest of your live and yes you do get ticking but wouldn’t really won’t to go through the procedure again. Hope all goes well .Take Care X
HiI had two valves replaced five years ago, when aged 65. I went along with doctors' recommendations and had mechanical valves. I have no regrets about that choice. Yes, I can hear them ticking away, especially at night (hence my username), but that ceased to bother me long ago: in fact I now find it reassuring! As for warfarin, that has turned out to be much less of a hassle than I thought it would be. It doesn't stop me eating and drinking the things I like, including green vegetables and moderate quantities of beer and wine. I monitor my own INR and email the results my the GP who then gets the receptionist to phone or text my with my dosage. In practice, I vary the GP's dose if I've eaten a lot of something that I know will affect INR.
For me the main factor is that I really do not want to undergo that operation again if I don't need to. The NHS was fantastic - I cannot fault the care I got in any way, and I have made a full recovery. But it is invasive surgery and personally, I would want to avoid all that again if at all possible. But that's me - it is an individual decision. I just hope my experience, along with all the others here, helps you make your choice.
Hi LGBE, I've had a mechanical mitral valve for 5 years now, I was 62 when I had to decide and like you I didn't fancy having it all done again in 10 years so opted for the mechanical.
The ticking doesn't bother me and I find it quite reassuring at times although my wife sometimes comments about how loud it is but I don't normally notice it. I am on a lot of medication besides warfarin which I get checked pretty much weekly and it is quite difficult getting it balanced and easy to get out of balance. It is a difficult choice as there are a number of negatives with the mechanical valve but one major positive that it lasts longer.
Sorry this hasn't been very upbeat but hope it helps you make an informed decision. Best of luck.
I had AVR last year aged 53. I went with a mechanical valve, due to my age as didn't want to have to undergo the operation again. I haven't found Warfarin to be too much of a problem once stable. Last interval bet checks of INR was 56 days. I noticed a slight clicking sound initially but straight after the op you are very aware of everything to do with your heart. I rarely notice it now, it's not an issue.
I think you've had some really good responses in terms of solid experience and preferences. I have a mitral valve issue so I do recognize your predicament although I haven't yet had to make the difficult choice with which you have been presented. My contribution is therefore not based on having had the surgery, but on a considered view regarding life experience generally. You might find it useful; you might not. Here goes anyway:Given your young age, I would lean towards a mechanical option. If you were 15 years older, the organic option might gain a few points.My reasoning is that if we have interventions that might last 7-10 years with only one replacement opportunity once we're in our 70s/older, there are many other things that can go awry before the second valve exchange is needed. Thereby, the limited life of an organic option which seems to be more hassle-free in terms of medication management, might be overtaken by various other health issues that tend to crop up as we enter grand old age. So, the older we get the more the hassle-free option looks favourable in relation to life expectancy.
Being on warfarin for decades, or the more modern alternative and easier-to-manage Apixaban, starting at age 55 is not necessarily an undesirable outcome. As far as the intrusive ticking is concerned, if you haven't already, take a look at the BTA tinnitus forum. Just as with tinnitus (some forms of which can be incredibly loud) I strongly suspect that you will habituate to a regular ticking noise and not notice it after a few months. At least you won't have people telling you that it's psychological! I see that other replies confirm this; one can get used to the tick.
Finally, I hope the outcome for you is a complete success and manageable, whichever option you choose!
Hi all,I’m now home about 10 days post op. All gone well, although I overdid the exercise causing AF and resulting in a trip to A&E before being given the all clear. Like many on here, I find myself in a whole new experience. I'm used to being very active so having to manage my expectations and set sensible goals. Priority 1 is to get INR stable and aim for sensible exercise regime.
Anyone who would like to know more about the op, especially the first few days, happy to share.
I opted for mechanical valve - the longevity outweighed everything else. I was given a device for breathing in hospital, clearly I need to doing at home more. The biggest frustration is the limit of what I can do.
HiI would have made the same choice, but luckily I had a repair.
I didn't get any breathing device, sounds good, but I breathe in through the nose and puff out slowly through the mouth. Seems to work. Stick at it.
Give yourself small goals in terms of what you can achieve in walking - say, down to the corner/ end of the road, or whatever, and gradually increase. You will then be able to see what you have achieved, it's very rewarding. I use an app to track my walks (under armour).
It is very frustrating, but you will improve, quicker than you think. I hope you have good support at home? If so, make the most of it.😉
I found sleeping was a problem for a while, I tried sleeping in the armchair, but couldn't. I took myself off to bed after lunch to try to sleep there, had the radio on quietly, but still no good, but at least I was resting. Also found I was soaked in sweat in the mornings, apparently that's because of the reaction in your body to the op.
Hi LGBE, the mechanical option and a good outcome. Excellent news! If you don't already, have a think about trying an exercise regime such as Tai Chi. It's gentle enough to be tolerable for those in recovery/with issues yet comprehensive and effective enough to provide a work out for all the muscle groups as well as improving balance and breathing. Doctors tend to recommend it as well.
Thank you that an interesting suggestion. I’m finding the physical limitations the hardest to get head around. I’d like to hear from others post valve replacement and how they are further down the road.
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