Hi all, hope your evening is going well. I had an ECG on Monday and I was told I had a leaky Mitral valve and it needs replacing. I have an angiogram next Friday. I was shocked and I'm still processing the news. I'm no athlete by any stretch of the imagination, but I have never smoked, do not drink, walk everyday and eat well. There is no history of this issue in my family and they believe it may have been linked to a bout of bronchitis I had in January. My question is about whether to opt for a tissue or metallic valve. At 50 years old all the advice I've read is to go for the metallic one but I'm concerned about taking warfarin for the rest of my life and that the metal one makes a ticking noise. The tissue one from articles I've read, lasts 10 to 15 years so its likely I'll need another operation in my late 60's. Any advice and experiences from the from group would be so much appreciated. Thank you 🙂
Mitral Valve Replacement - Tissue or ... - British Heart Fou...
Mitral Valve Replacement - Tissue or Metal valve?
Hi, Welcome, to a place you wouldn't necessarily expect to arrive at.
Valve type is a difficult decision many of us have to make, your choice is so important for you, I've done it on more than one occasion and of the mind that there's no right or wrong answer. I've had both Tissue and Mechanical Valves, and both have their pros and cons. My Aortic Tissue valve was a bog standard type that lasted 19years, but, I'm currently with Mech Aortic and Mitral valves.
In my experience, the Tissue Valve was low maintenance, but, I was young and was happy enough in the knowledge I'd have it done again. I find Mechanical Valve require more care and attention in comparison. Most people with Mechanical will tell you that Warfarin isn't really a problem once you come to terms with it. As for the noise, in my opinion, its exagerated how loud it can be, particularly, once they're bedded in.
If you do choose to opt for the Tissue, I can't emphasise more that you need to be clear in your mind, that it's likely to need replacing at some point, but, also consider, that the new generation of of Valves have moved on significantly and evolved in recent years, as have surgical techniques. Whichever, you need to be comfortable and live with the decision you make, and it's the right one for you in your circumstances, no one elses. I have my preference, but, it may be completely the wrong one for you.
Take Care
Heed
Hi Heed, many thanks for your reply. It sounds like you have gone through some difficult times and I hope everything is OK at present. The warfarin for life was not high on my list as I don't drink but I'm older than my years these days and do like quiet and peaceful surroundings, sitting in the garden etc, so having a constant ticking would impact my life quality so its interesting what you said on this. It was one of the questions I was going to ask my consultant, ie does the sounds reduce once the valve is embedded in. I've read several other posts about a newer valve called the Edwards valve, these posts were about 4 years old and seemed to oy be available in London hospitals, so another question for my consultant.
Once again many thanks for replying its given me some more knowledge to help me come to a decision.
All the best. 🙂
I had a mechanical aortic valve replacement 13 years ago and just had an ECG and it’s still performing very well. Yes, I’m on Warfarin fir the rest of my life but that’s no real problem. Yes, mine also makes a noise but at least I know my heart is still ticking as I hear every heart beat!
Hi Rosie, thanks for replying. I've heard that from others as well, who say the ticking is very reassuring. Glad to hear that yours is still performing well after 13 years. Take care.
Hi, it comes as quite a shock when you think that you are relatively got and healthy and are then told that you need OHS doesn't it?I had my aortic valve replaced last April and I was 54. I hated the idea of a mechanical valve purely because of the Warfarin.
My surgeon more or less made the decision for me though. I have huge anxiety issues with hospitals and needed 6 months of intense sessions with a Clinical Psychologist to be able to go through with the surgery and manage the hospital stay. He said that I would be counting down the days, months, years until a tissue valve would need replacing and my mental health could not cope with that. No guarantees with the mechanical valve, but pray that I don't need further OHS.
The Warfarin isn't an issue. I go to a local clinic every 2 months now for a finger prick blood test and they review my dose depending on the results. My heartbeat seems extra loud now, but others in the Facebook group that I'm in say the same and some of them have a tissue valve.
The Facebook group is UK Aortic and Heart Defects Pre and Post surgery if you feel that you need any more support.
Best wishes
Joanne
Hi Joanne, many thanks for replying. I get the comment about your surgeon saying you'll be counting down the days with a tissue valve and another OHS. Thanks again.
hello JDayt
Good responses from others.
I would add that I Listened intently to what my surgeons advised. After all, they will be the ones fitting your new valve. I was 72 so perhaps a leaning to tissue made a lot more sense. That was three years ago. I believe the new tissue valves have a longer life expectation and that they now carry an option to renew by TAVi. Things are evolving fast so the consultants haven’t got the years of experience that they normally desire.
In my case I have had three years trouble free. So my Edwards Resilia has been brilliant. Also the operation was fantastic. Cardio staff were fabulous so I would not be concerned if I need a replacement.
Finally, I note a suggestion that you refer to Facebook. If I make an inappropriate comment on this site then my post will be eliminated. But Facebook might not do that. I would stick to just this site plus NHS site. You then get only advice intended to benefit you. Not the author.
Sooty
Hi Sooty, thanks for the advice. You are spot on in saying the technology is always advancing so I will be asking my consultant about this as well. I will be listening intently to my consultant when I have my appointment. Thanks again.
I went mechanical Aorta valve at 55 yrs old for the longevity.After the recovery of OHS I don't want to do that again......
Warfarin is no biggy, I am now at 10 weeks or so for my inr check.
The ticking just reminds me I am now part robot. I only hear it when it's quiet.
Good luck with YOUR choice 😀
Hi there, thanks for replying. The warfarin is not as big an issue for me compared to the noise but so many people have said over time you stop hearing it as much. Still so much to consider. Thanks again.
A couple of days after my op, I heard the ticking noise, at first I thought I was imaging it as it was never discussed. Anyway I asked the surgeon on his next ward round what it was, as he walked away chuckling he said "it's the new valve, you get use to it" haha 😁I use to worry when I couldn't hear it .... but then realised I am still here so it must be working 😉
hi. I had my second mechanical valve fitted 18 months ago. I’m 52. The ticking seems to have got quieter and as , Hedoo61, mentioned I think it is now bedding in.
Hi Anon2023, thanks for replying. Good to hear you are doing well and the ticking has got quieter.🙂
Hi JDAYT. I had a mechanical mitral valve fitted in 2017. I have no problems with warfarin, eat what I like and self-test. My decision to have a mechanical valve was age (51), still being active and not wanting a re-op. All the best.
Hi Sion52, thanks for replying. Sounds like all has gone well for you🙂. I agree, the thought of having another op in 10 to 15 years is a big factor. Thanks again.
Hi Jdayt,Four years now for me post surgery. I too was 50...well, 49 when diagnosed, 50 just after the op. In fact, I was in hospital on my 50th, lucky me.
I only have experience of the mechanical valve, and as such just come from my perspective. The warfarin did concern me too, but I home test, like a lot of people, and also go to the doctors every couple of months, just to check. The appointment is about 5 mins, a finger prick, and then results.
The ticking I can hear, but only at night when all is quiet. It did bother me at first, now it doesn't and is rather soothing. My wife doesn't hear it at all now.
Good luck with your decision
Pete
Hi Pete, thanks for the reply. Wow, having your 50th in hospital, something you are not going to forget🙂. I've heard a lot of people having a home testing machine which sounds really good. Good to hear the doctors appointments are quick. Thanks for sharing your experience with the noise of the valve. Thanks again.
hi, I’m in exactly the same position as you! I’ve found the replies to the same question useful on here. I’m leaning towards tissue, my initial research on the Inspiris Resilia valve are positive, the surgeon told me it’s looking at 20-25 years ( accelerated beat tests ). The studies I read confirmed that along with the 5 year real time tests being positive.
I guess depending on the angiogram he has told me he will attempt the surgery using keyhole ( TAVi ) and only open if he can’t do a 100% job, ( other stuff to sort in there also!) A lot of my replies mention that a renewal is usually TAVi also and my thinking is that if I make it to 70 then there will also be advancements.
I’m not there mentally myself yet by no means but this site has helped, I also joined UK AORTIC & HEART DEFECTS PRE SURGERY AND POST SURGERY which has helped get my head round things. Although blacksootycats comment makes sense and I will be bearing that in mind.
Good luck, if you come across any good articles please let me know.
Hi there, thanks for the reply. Interesting about your research on the tissue valve, this is something I'll be asking my consultant. I hope everything works out for you and thanks for the suggestion of the other group to join. All the best. 🙂
I had AVR aged 52 with a mechanical valve. This was suggested due to my age - I didn't want the thought of having to go through OHS again. Once my INR had settled, I usually have it checked about 2 monthly - so not a major hassle. The 'clicking' sound, initially I could only hear when in bed at night reading. However, my husband couldn't really hear it. I can no longer hear this so it must have gone quiet once embedded. Initially I felt my heart beat sounded louder, however I think part of that was a heightened awareness off my heart after the operation. As others have said, after the initial apprehension, I became reassured that it confirmed my heart was beating well! Again, this is something I'm no longer aware of. There is no right or wrong decision - it is your decision that you will make to fit your situation. Either way, the new valve will hopefully improve your health. Wishing you all the best.
Hi there, good to hear you are now well and you have mentioned several things that I'm concerned and anxious about and these have helped, so thank you🙂. Thanks again for replying.
Hello there. Im 61 and have had a mechanical aortic valve replacement and mechanicl Mitral repair due to a very leaky valve (bicuspid from birth) At first i decided for a tissue valve. My surgeon said a mechanic valve will and should last at least double that of a tissue valve and explained that around 80% of people having a tissue valve replacement would have to have another surgery 10-15yrs down the line. That sort of scared me as id be 70 something and didnt want to go through the op again, so i went for the Mechanical one and am very glad i did. That was only 7 days ago and i am home recovering. The operation was very succesful with a well seated Mavr and the TEE showed really good funcionality of that valve. I was worried after as i couldnt hear any ticking whatsoever (maybe my ears need cleaning) so i held my phone to my heart and recorded and yes i could hear a faint tick tick so reassured me that all is ok. Im now getting my INR sorted between 2 and 3.currently is 4.1. I think taking warferin the rest of my life is a small price to pay. Im very lucky to not have a loud audiable ticking sound as some people really struggle with it and others seldom hear anything. Its a choice after all what you choose but whatever choice you make be haappy as it will give you a new lease of life. Good luck take care and keep on ticking. Stuart x
Hi Stuart, glad to hear that you are now at home recovering. Thanks for the advice and all the best with your recovery. Cheers.
hi. I’m 52 and I’ve had two mechanical mitral valves fitted. My surgeon encouraged me to have a mechanical valve because of longevity. The first one lasted 4 months due to endocarditis but the second one is still going strong 18 months later. Both valves are susceptible to infection although it’s rare. I nearly went for a tissue valve last time but was put off by the thought of needing it changed sooner. The new tissue valves are lasting longer and if you go for that option you need to check which ones your surgeon/hospital offers. I had no choice about the type of mechanical valve I had but I don’t suppose it really matters with the mechanical ones. The ticking is much quieter now and warfarin is a nuisance but it’s definitely manageable. Minimally invasive surgery is certainly a bonus but be aware that if your surgeon encounters any problems they will likely revert to ohs anyway. My surgeon said he preferred ohs because it means that if any problems arise he’s in a position to sort it out then and there. It’s a very personal decision and both valves have positives and negatives . It’s a case of weighing up what’s best for you x
Hi there, thanks for your reply. Sorry to hear the first one had issues but glad to hear the second is good. I've heard several people say that about surgeons preferring ohs as they can check and fix any issues during the op. Thanks again. All the best.
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