glad to be part of this great community , and looking to you all for a bit of guidance. This is my first post, and I know you'll all have been asked many times about the pro's and cons of tissue v mechanical valves, but hopefully you can bear another such query.
My surgeon initially offered me a mecahnical valve . but to be honest I wasn't happy with the ticking I'd heard about, much less a lifetime on warfarin. So after a second consultation, and because I'm nearly 60 he mentioned this (relatively) new Inspris Resilia valve. It sounds like it could be a great option. Do any of you have expeience of this valve. ? Or any general pointers / about either tissue or mecahnical /. Keen to hear if the ticking was a problem and how you're coping with warfarin. I want to go down the right route so I'm calling on all of your experience and expertise.
Many thanks
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SilverSurfer20
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I have the tissue valve, fitted last day of April 2020. All the cardiac hospitals were closed due to covid, so I went private and got Rolls Royce treatment. My surgeons were not certain about the tissue valve. They like to have six years experience, so are always years behind current stuff. I was 72 and the surgeons were concerned that the tissue would not last my lifetime. But during the past three years the life of the tissue valve has been growing. One very relevant improvement is that the Edwards Resilia now has the option to have a TAVi added later. Given that option , the tissue seems more desirable.
At the time, the cost of the valve was discussed in terms of £30,000 but mine was about £6,000.
Now I have three years experience I can confirm that the valve is fabulous. I have no problems at all. Wouldn’t know it was there. My three year cardiac check up is all clear.
I did have possibly the best surgeon in the country ( no names on this site) but I suggest most cardiac surgeons are superb.
By the way, whatever you opt for, the outcome is 99.5% certain to be beyond your wildest dreams. The op is major and the rehab is months, but I just got better and better every two days. I had been given my life back.
But at the end of the day it will be your choice. And if they can’t offer you the Edwards Resilia then pay for it yourself. Then look forward to a good retirement.
Hi I had a mechanical aortic valve in 2005 at age 48, I went for mechanical because tissue valves last around ten years and I didn’t want to have to go through all that trauma again. I have to say I haven’t regretted my decision for one second. Yes I take warfarin but that’s easily managed with a home tester,
I, too have a mechanical valve back in 2008 and chose the mechanical as I didn’t want to go through such a big operation again. Yes, I hear my heart clicking but, since I also suffer from AF, I find it reassuring when I hear my heart beat and can easily tell if I am in AF or not. Warfarin is not really a problem but, unfortunately, my Warfarin levels never stabilise so I do have to have frequent blood tests.
Hi SilverSurfer, The first thing I would say is that I don't personally have the Inspiris Resilia valve, so can only write on my own experience of other valves.
Valve type is an important and difficult decision many of us have to make and not one to be taken lightly. I've had to choose on more than one occasion and of the mind that there's no right or wrong choice.
I've had both Tissue and Mechanical Valves, and each have their pros and cons, so I try and err away from suggesting one over the other, although I do have a preference.
My Aortic Tissue valve was a bog standard type that lasted 19years, way beyond the often mentioned 10years life, but, as I understand it, not unusual. I say that with the caution that I was relatively young at 33 when it was fitted, with my heart otherwise in decent nick. I was pleased with the valve and have no regrets with that choice whatsoever. Maintenance was relatively low, and I was fine in the knowledge that I'd have it redone. Also options were fairly limited at the time, back in 1994.
Obviously, that had to be replaced so second time around, I opted for a Mechanical valve, but due to complications in surgery, I now have both Mech Aortic and Mitral valves. They themselves needed further replacement and repair within four months. My original intention was another Tissue, but circumstances changed that led me to that decision.
I find Mechanical Valves 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, it's exagerated how loud they can be, particularly, once they're bedded in, bearing in mind I have two of them.
Whichever, you choose, be comfortable and live with the decision you make, and it's the right one for you in your circumstances, no one elses, we can only offer our own experiences.
Had the Inspiris Resilia valve been an option for me 10 years ago, it would have given me a lot of food for thought.
Hi, my thoughts were the same as you when I was told that I needed AVR last year. I really didn't want to be on Warfarin, or any medication if I could help it.The surgeon guided me towards a mechanical valve though due to my anxiety around hospitals. His hope was that I would not need further OHS.
Unfortunately I went into total heart block after my surgery so had to have a pacemaker fitted. This means that in about 9 years I'll need the battery replacing. At one point I was counting down the months until I'd have to go into hospital for that doing, but I've managed to push it to the back of my mind.
Yes I've had OHS, yes I'm on Warfarin for the rest of my life, but most days I can totally forget what I've been through. The ticking of the valve is nothing to worry about and I just live a normal life again.
I'm a member of UK Aortic and Heart Defects Pre and Post surgery Facebook group and others opted for tissue valves for their own reasons. Maybe join the group and chat with them?
Ok - one big vote here for the Edwards Inspiris Resillia …. !
My surgery was 2.5 years ago and I was a couple of years older than you at the time and although a mechanical valve was mentioned as one of the options for me it didn’t seem a difficult choice as to be honest I didn’t fancy the warfarin for life / possible ticking etc. I haven’t regretted it for a minute and all seems to be going well and am feeling great. (Only on “baby” aspirin and the lowest dose daily of Ramipril now drugs wise too).
It is such a personal choice and I think most people feel happy with whichever choice they decide best for their lifestyle but as I said I am extremely grateful that I was able to have the newest version tissue valve.
I had the Inspiris valve one yr ago. I had 2 separate consultant surgeon opinions, both of which (at my age of 69) suggested the Inspiris valve. The lifestyle advantages of Tissue were a big factor in choice - no warfarin , blood tests, dietary restrictions, worries about bleeding from injuries. If all is well after 3 months, blood thinners & other meds can normally cease. The life of the (still newish) Inspiris valve is still uncertain, but the latest (7yr) trial data suggests good results so far (see Edwards website reports).
Mechanical valves will last longer, but the surgeons also pointed out to me that the Inspiris valve is a good substrate for a future TAVI replacement, if a 2nd OHS valve replacement is considered risky.
I would still recommend that you take the advice of your consultant surgeons, based on your specific circumstances.
Thanks Dino. I note what you say about future TAVI replacement. That's a route I'd be comfotable with. Procedures and new materials (NB the Inspiris valve) are improving and coming to market all the time so even if I go down the Inspiris route a future repalcment may be a much more straightforward proposition
Hi I had a mechanical valve fitted 3 years ago not had any issues with the ticking noise .I am on warferin but have no problems apart from bruising on my arms .
Thanks Clegg. Good to hear the ticking isn't a problem for you. I'm sure I could get used to it (I'd have to !) if I go down that route. Thanks for your reply
I had a Carpentier Edwards Perimount magna ease tissue valve, coated to help prevent future calcification, lifespan 20+ years and any future necessary intervention by TAVI.
I see you already have had a lot of advice which is good. I can only add to those with experience of mechanical valves but perhaps on a longer time scale. I have had mine for 35 years and noise is very much only an occasional awareness. Warfarin has never been an issue either, with a stable INR I can go up to 10 weeks between tests. I have lived a very active life with my mechanical valve, plus now a pacemaker due to an unrelated issue, as yet unknown in cause, leading to total heart block. At the end of the day it is your choice but it is very possible to live a normal life with a mechanical valve.
Sage words Classof1988. And great to hear that you've had 35 years with minimal noise and stable INR with a mech valve. Plenty for me to consider, thanks for taking the time to reply
I have only recently had AVR and my surgeon guided me towards tissue as, in his opinion, it was more suited to my lifestyle which is biased a bit towards the active side for my age. I didn't fancy the warfarin for life, the ticking wasn't an issue in my mind.
Given how easily I am bruising with blood thinners at present (I'm on Ticagrelor for a year) I'm glad I made the choice I did for a tissue valve. Guidance was it should last for up to 20 years (bovine tissue) whereas porcine will only last around 12 years.
Hi Silver Surfer - I have a tissue valve - was not offered a choice, possibly due to age (64). I have a Medtronic Avalus which seems a lot like the Edwards valves in that they facilitate later trans catheter ( i e non invasive ) valve-in-valve replacement if necessary. There doesn't seem to be much comparative data available to laypeople about the valves themselves, but Edwards certainly has a far more active PR department. Much will also depend on the training your surgeon has had; at the end of the day it is their speciality and they know far more about it than we do, so I at least was happy to let them get on with it.
Thanks Dasy. And wise words about the surgeon. I will ultimately be guided by them, but everyone's replies on here have been very very helpful. Thankyou for yours
Hi - I have this tissue valve and my 92 year old neighbour had too ! She’s had her 16 years snd I’ve had mine 2 . They really don’t know the longevity of them but she’s still very fit and active !
I wasn’t suitable for a metal valve and although I had concerns about tissue being a life long veggie - it’s worked beautifully and I always say a big thank you to any livestock I see !
Listen to your consultant and your surgeons they are real life super hero’s and this is their day job , they do this everyday and they will fo what’s best .
All the best focus on your recovery and the fit healthy future that awaits you .
I went for the IR tissue valve last year, at 51, through OHS. My thinking was that I didn't want to be a patient any longer (I had been for six months, for the first time in my life, and was keen to get back to normality... so without Warfarin). I'm also a runner & cyclist so my decision was tissue would help with that too (even though the valve will burn out slightly quicker through sport). I didn't fancy the ticking but I know I would have got used to it quickly. I'm expecting a 15 to 18 years lifespan for the valve and then hopefully TAVI for the second op (to be honest I'm kinda counting on medical science to have evolved beyond TAVI by 2037!!).
Did I make the right decision? Yes. Would I have made the right decision if I had gone with the mechanical? Also yes because it has to be correct after it's been done so justifying it would be easy.
Will I still be happy with my decision for tissue now when it comes to the second op? That's the important thing I will need to remember then. I made the right choice at the time. Rehab & recovery has been a breeze (maybe it would have been with mechanical, maybe it wouldn't - I'll never know). And that's my main advice to you now. The choice now is tough and thankless BUT don't ever regret making it. When you've made it, that's it - that's your choice. Don't be thinking "what if..." in fifteen years time. Good luck!
Hi silver surfer I was diagnosed with a bicuspid heart valve at 57 expecting to be operated on within a year but am now 62 and still have not quite reached the point when I need to be operated on. But have been thinking about the choice now for 5 years. There are loads of past posts you can find and the vast majority of posters are happy with their decision whether mechanical or tissue. At 57 I was advised to go mechanical, and advised that under the uk NICe guidance generally if you are under 60 mechanical is a reasonable decision and over 65 tissue . Between 60 and 65 either is reasonable. I was told there is a trade off between issues associated with mechanical and warfarin management stroke and bleed risk and the fact that you are more likely to be reoperated on if you choose tissue. Mechanical should last longer on average but some of the tissue ones can now last much longer than previously like the Edward inspires one you mentioned. Tissue have lifestyle advantages as you do not have to manage the warfarin and you should not really drink with warfarin (or not very much) and eating certain vegetables such as Brussels sprouts and spinach can interfere with warfarin levels and also the mechanical ones can click. But tissue can wear out quicker if younger and fitter. Some people take the engineering view why put something inside you which may last.. others can’t face the thought of having a second operation. Others are worried about managing the warfarin levels. Others decide for lifestyle reasons. With tissue it may be possible as other posters have mentioned to have a TAVI as a second operation. My cardiologist says I would be suitable for a TAVI abut not everyone is but still is currently recommending a mechanical valve as I do quite a lot of exercise and he thinks this might wear out the valve more quickly. If I make it to 65 without having to be operated on I will choose tissue but am not sure at the moment. I hate broccoli and am a bit deaf so mechanical is not a disadvantage but am worried about managing the warfarin and would still like to drink I have concluded from the other posts that the decision is very much a personal decision which should best be made in discussion with your cardiologist having regard to your personal circumstances. There is no one size fits all answer Hope this helps a little. , best wishes
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