I’ve recently been told I need a valve replacement, have been told a metal valve will last 40 years but will need blood thinners, the alternative, a tissue valve is likely to last 20-25 years. ( I don’t know the name of it yet apparently it’s 7-8 years old.).
I’m 50 now, so assuming i get past 70 I may need to get it changed then if I get tissue. I was looking for input from anyone that had either, pros and cons please?
Hi, I had a mechanical aortic valve replacement fourteen years ago and it’s still going strong. Had no problems with mine and I am very glad I had the mechanical valve as I didn’t want to go through major open heart surgery again. Yes, I’m on Warfarin for the rest of my life but that is no problem either.
Sorry Rosie, Ive asked about this on the other thread! Can I ask what issues the warfarin causes if any?
Warfarin has not caused me any problems. The only problem that I do have is that my INR test readings have never, ever stabilised which mean, in my case, that I have to have very frequent tests but again, it’s not a problem to me really. Most people don’t have the my problem. But if you take Warfarin it will mean you will have regular INR tests.
thanks for that, yes tricky decision!!
hello Triumph
I had a tissue valve three years ago. What is nice is that I don’t have to even think about it.
I was keen to get my surgeons advice as, after all, they are doing the op. I had the Edwards Resilia. What has come available since then is that the latest valve has the capacity to take a TAVi.
But above all, the op is amazing. Deaths door to feeling so well. Fabulous.
Good luck
Sooty
my auntie had three tissue valves as they didn’t last as long as they do now. Her last one she had for eighteen years and had to have it replaced as she was very poorly at the time. Her last one was stainless steel and she had it for a few years before she finally succumbed in her mid eighties. She was a young woman when she got her first one and had no trouble other than the deterioration of the aged valves. Technology is much better these days.
Hi Triumphlover,
It's not an easy decision to make, same operation but fundamentally different post-op in my experience. I've made the decision twice myself, for my third op I wasn't given a choice.
My first replacement Aortic Valve was a bog standard Tissue type in 1994 at age 33, I had it for 19years, which was good at the time. Second time around I decided on Mechanical to avoid my family going through it again, but, in the event I had it redone again four months later, I now have Mechanical Mitral and Aortic Valves.
The Tissue Valve was low maintenance, but, I was young and was happy enough in the knowledge I'd have it done again. No regrets, but, I knew the implications. I find Mechanical Valve require more care and attention in comparison.
Should you decide on the Tissue, you need to be clear in your mind, that its likely to need replacing at some point, but, when is the question. That said, the new generation of of Tissue Valves have moved on significantly and evolved in recent years, so who knows what it will be like in years to come.
Either way, you need to be comfortable and live with the decision you make, and it's the right one for you in your circumstances.
Take Care
Heed
Hi, first question… cars or bikes? 😁 And classic or modern? 🏍️.
Seriously though, my husband had a mechanical aortic valve 5 years ago. He never, ever, ever wanted to have anything remotely medical done again so he chose mechanical over tissue, knowing that he might hear it forever afterwards and will be on warfarin for the rest of his life, with testing and faff if he needed any other procedures. Warfarin is the only anticoagulant licensed for use with mechanical valves, the new ones aren’t.
Fortunately, although he (everyone really) could hear the valve to begin with, as he healed and regained muscle it diminished and it’s not an issue. The warfarin has been fine. He’s stable and self-tests at home with his own machine, just going to the clinic for repeat prescriptions. He had to stop warfarin for a couple of non-heart things but as he has a modern valve he doesn’t need anticoagulant injections to bridge the gap like patients with older valves do.
Most importantly, he still rides his Triumphs. ☺️
Best wishes to you and your loved ones.
hi, thanks for the reply, interesting.
Oh and it’s bikes, new speedmaster!! Although it’s now in the garage as the cardiologist has got twitchy !!
Nice. Cardiologists seem twitchy about motorbikes generally in our experience, especially with Warfarin but they haven't said “don't ride” so my husband’s maintaining his sanity. 🤣😎
Nothing to do with the hearts or cardiologists. But our nephew-in-law, a Californian lawyer, has a mom and pop, who are both senior surgeons and educators in emergency medicine. Their experiences persuaded our nephew never to ride a motorbike. Fair does, what he told me was scary. For my part I learnt to ride one in London about 40 years ago. . I loved the freedom.
I guess that's the dilemma of biking! (What I've noticed in my friends that still ride in their 60s is how much armour they use. To paraphrase Frank Spencer, "There are old bikers. There are bold bikers. But there are no old, bold bikers.")
Sanity is worth a fortune ... but stay safe. 😉
Definitely into all the good gear. Its no guarantee of safety but it helps. 😁
Definitely. I was never a tearaway, but I did practice what some people call defensive driving. TBH that's just following the same sort of principles preached by IAM Roadsmart or Roadcraft - the police drivers manual, i.e. safety and mindfulness of other drivers. My only spill was when an idiot shot out from a junction across oncoming traffic near Clapham Junction to turn in front of me. I braked sharply on a wet autumnal day (plenty of leaves) and took a spill. Luckily a police car was behind me ... so I didn't get run over. Other road users are the real bane for motorcyclists. 
I had a mechanical aorta valve fitted 2 years ago at 55 years old.I was told the valve should take me till I die based on the life expectancy for a male in the UK.
I take warfarin in addition to other heart meds. Its no problem, I have my inr checked every 10 weeks or so and the dosage is changed if needed. It did take a little while for the level to settle which meant more frequent testing.
I hear the valve 'ticking' when it's quiet but you get use to that.
I for one wouldn't want to go through the recovery again it's not very pleasant.........
Good luck with your choice.
Hello Triumph Lover. OMG such a decision to make where there is no right or wrong. I am at this minute in hospital on day 4 recovering from Aortic valve replacement and Mitral repair. I am 61 and up till i actually went into hospital for op i was still undecided. Now I spoke to my heart consultant who was part of the team who was to operate on me. He did give me some stats that around 80% of people that had an Aortic tissue valve replacement valve replacement had to have it replaced within 10 -15 years some earlier wheras 80 % of people having an Aortic mechanical valve replacement lasted the individuals lifetime over 40 years. Obviously this doesnt take into account a specific make/type of valve and is a general statistic. I asked about the Edwards resilia new valve which he did say was still experimental as hasnt been around very long. Personally for me i would not like to be opened up again and go through this op again as he said reopening of the scar tissue has other complications apart from all the drains in the body and post op processes that im still going through. So i choose the mechanical valve which for me i am so glad. Even though i have to take warferin the rest of my life its a small price to pay. I have not heard any clicking at all yet but maybe that will come (hospitals are noisy) After all that no valve replacement is time garenteed and is a choice. Just feel happy with the choice you make and then you can get on with your life. Good Luck and many happy bike rides. I hear the distant sound of my hospital breakfast coming. Take care. Stuart
Hi i had to get a new mitral valve a few year ago,i remember being confused about the metal valve or tissue valve so in the end i decided to go for the metal valve and i can safely say i made the right choice i have no issues with it at all ,feel like a diff woman am 50yr now and i got the op in 2019 if you have any questions just ask im only to happy to reply X
Hi, I needed an AVR aged 52. Surgeon suggested mechanical valve due to my age. I have no regrets in having this. Initially I had a bit of clicking noise (only when reading in bed when it was quiet). This is no longer evident. Warfarin hasn't proved to be a major issue. Once my INR level had settled, I usually only need a test about every 56 days. I didn't want to have to go through OHS again if at all possible. It was the right decision for me.
At age 65 I chose, with my surgeon in agreement, a tissue valve as when I had previously taken warfarin I could not maintain a stable INR and was visiting the INR clinic 3 times a week. The valve I now have has an anticipated lifespan of 20+ years and if future intervention is required it can be done by TAVI (by cathetar) Best wishes
Hi
It’s a tricky one - I had tissue and I struggled being a life long veggie it seemed to go against things - however I don’t tolerate aspirin so warfrin was a no go apparently .
So I’ve had to have a tissue valve so no decision and no problems at all since then . I’m on blood thinners but again no issues . My neighbour had her valve 15 years ago and she’s still going strong at 96 - apparently they don’t say how long the tissues will last because they simply don’t know - we are a work in progress !!
Be guided by your surgeons snd consultant they are the experts and this is their day job .
What I will say is this operation is a game changer - within 3 weeks I felt so well at 6 weeks I was super perky and feeling so well and at 18 months I’ve just danced at my sons wedding until the early hours full of beans !
Look to your future whatever valve you choose they give you a whole new life !
Good luck
CH
thanks for that, appreciated.
So here's my take on this. I had my operation last year at 60 after being diagnosed with bicuspid heart valve that was only picked up when I was about 57. I looked long and hard into this and when I finally met surgeon I explained why I wanted tissue replacement. He fully supported my decision also. I didn't want to take warfarin for the rest of my life. I think that's still the choice as for me too much restrictions on what you could eat and drink, visits to warfarin clinics etc plus the risks that come with taking warfarin. I personally just wanted to get back to normal, recover and get my fitness back and take as little medication as possible. I hope this helps but my quality of life is good and I feel strong and healthy. In say 15 or 20 years who knows what I will be like or even if I'll still be around. I hope I am but i hope you find your choice and I wish you all the best in your recovery 🙏
hi. I’ve had two mechanical mitral valves fitted. I was 51 when the first one went in but it only lasted 4 months due to endocarditis. From what I understand both types of valves are susceptible to endocarditis although it’s rare. The 2nd one is going well 18 months after it was fitted. My surgeon was keen for me to have the mechanical valve rather than tissue due to my age. After 2 open heart surgeries I’m really not in a hurry to have it done again and I’m hoping the second valve will last until I expire. Warfarin is a nuisance but manageable. It’s a very personal choice and if I’d been younger I would have opted for tissue but I’m ok with having a mechanical valve at 52. Good luck. X
Maybe be guided by your surgeon? My husband had replacement aortic and mitral valves 3 years ago. It was emergency surgery and to be honest we didn't even ask what type of valves they were until afterwards. We were just grateful that he had survived.
I had the same conundrum - 50 and either tissue or mechanical. I went with tissue as I am pretty sporty but clumsy. I didn’t want Warfarin interfering with my activity and I also didn't want to fear bruising. Also, I'm counting on medical advances over the next 15/20 years to ensure my next operation is not Open Heart. It's not an easy choice with no 'right' answer but the important advice is "when you make the decision nans have the op - don't wish you had gone for the other option". You need to be able to tell yourself you went for the best option at the time.
Hi,
my father-in-law had tissue valves about 18 years ago when he was 69. The main benefit was no warfarin and no INR tests. By about a year ago, he needed a 'redo' and wasn't considered strong enough to have his chest cracked open. Instead, he had a TAVI procedure, which is like putting an umbrella via a catheter to support the leaky aortic valve. They reckon this will give him maybe a decade of good service, which will make him 97/98. He was happy to proceed on that basis.
If I had to make the same choice now (as a 64 yo with a CABG×4 17 years ago - i.e. I've already had a sternotomy) I'd probably go for tissue valves to obviate the need for warfarin (as I've had bleed problems in the past). If I was fit enough at 80 to have a 'redo' I'd probably go for tissue again, or ask about a TAVI. But there again who wants 3 sternotomies?
What does the surgeon say?
that’s really helpful thanks. Surgeon was careful to stay neutral, but when I said was leaning towards tissue I felt he agreed. He would initially attempt with keyhole which is good.
Hi If you have a tissue valve this time it means that if it needs replacing in 15 years or more you han have a TAVI replacement which is simple to do and a faster recovery time and in 15 years time things will, have advanced even further
Hi there, I had an AVR 3 years ago when I was 56. I went for a mechanical option as the thought of going through the op again in around 15 years was unbearable.It has been a massive success and having to take warfarin is a small price to pay as I'm lucky that my INR has mostly been very stable.
Good luck whatever you decide, it's a total game changer.
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