Decision to make

[S77Durham]

Hi, I’ve been told I need to have a valve replacement and can’t make my mind up between a mechanical valve and Ross procedure. I’m 46 so if I have the Ross procedure I’ll need to get another replacement in 20 years or so. The mechanical valve looks like it will make my diet complicated , I need to reduce my carbs , can’t have chilli due to allergy and mechanical valve will mean I need to reduce the veg I eat. Any advice ?

[Rhinos67]

Hello, I have a mechanical valve and haven't had to make any changes to my diet at all. I'm on Warfarin, but apart from a finger prick blood test every 4 weeks or so its no issue at all.My surgeon made the decision for me based on my anxiety around hospitals in the hope that I would need another OHS in future. Obviously no guarantees though.

Maybe consider joining our Facebook group, UK Aortic and Heart Defects Pre and Post surgery. Lots of people in the same situation who can guide and support and regular Zoom support sessions

Joanne

😊

[Hanibil]

Hi I had a mechanical aortic valve in 2005 at age 48, this was recommended by GP Cardiologist and Surgeon as none of the other valves are likely to last more than 10 years, then you have all the trauma of going through it all again, not to mention the possibility of tackling scare tissue from the first operation. I have to say it’s been the best decision I have ever made. It’s nearly 20 years now and on recent checkups am told it’s working perfectly. Yes you will have to take warfarin but have never found it to be the slightest problem, don’t believe any of the negative things you will be told about it, you can get a home tester to keep an eye on you INR, cutting your hospital visits to around twice a year. As for how you will be with a mechanical valve am 68 now and still ski and mountain bike.

[Ageingfast]

First, listen to your surgeons advice.

Second, if you go for a non metallic, check that you get a valve with a TAVi option.

Third, I am much older so not hard decision for me, but my Edwards Resilia has been faultless for four years and I don’t even know it’s there.

Fourth, the op is amazing. Gave me my life back. Staff were fabulous.

Best wishes

Sooty

[S77Durham in reply to Ageingfast]

unfortunately they don’t give advice anymore. The surgeons just give you your options and say it’s up to you.

[Rosie1066]

Hi, I had a mechanical valve fifteen years ago and just had it checked and it’s still absolutely fine. I choose the mechanical valve as I didn’t want to go through OHS again, and it has turned out to be the best decision I have made. Yes, slight alterations to diet but that doesn’t bother me and I m on Warfarin which, in my case, does mean very frequent blood tests but I can live with that . Best decision I ever made and I have no regrets.

[Sion52]

Yup, I went with a mechanical valve and self-test @home. I've had no problems with the warfarin and eat what I like. Although, I do not drink. I was 51 when I had the replacement valve and exercise regularly. All the best.

[Traveldreams]

Although I was heading in for mitral valve repair, the surgeon asked me to choose type of valve in case they found it was necessary to replace. He told me that some international advice (unfortunately can’t remember the term) was mechanical under 50 and porcine/bovine over 65. As I was in between it was personal choice. I signed up for mechanical as I found the wait for surgery stressful and didn’t want to face that again in a decade. As it happened they were able to repair..

[Horses68]

Hi there,I had a mechanical valve put on mid Feb this year , I already had 3 heart ops so this valve was the best option for me. Tbh I was worried about the food I eat, but after speaking to the anti coagulation specialists the only things I cant have are grapefruit and cranberry juice. The veggies high in vit k are ok to eat just don't be excessive about it like at a whopping bowl of spinach. . They said if you were eating them before just carry on as normal. The thing is you will have to take warfarin every day and have you blood checked. But I was told the valves don't wear out so that was the Best option for me as it was my final operation. ( I had my 1st one when I was 10 im now 56.) You have to do what's best for you I would take to a cardiac nurse or doctor about this. Whatever you decide you will feel so much better. Good luck and all the best.

[Classof1988 in reply to Horses68]

Glad all is well with you, but intrigued that you can't have grapefruit. I know grapefruit is not advised if on statins but I am not and have been eating half a grapefruit a day for years with my mechanical valve with no problems. The only thing to upset my Warfarin regime was a health drink with glucosamine and chondroitin

[Horses68 in reply to Classof1988]

Sorry for late reply, when I asked about this it was the juices only!!! Maybe because it changes when juiced,?

[Classof1988 in reply to Horses68]

Not sure if it changes. I do drink grapefruit juice as well as the fruit itself (Waitrose or Sainsbury's, never made from concentrate, as I don't think fruit juices made from concentrate are as pure) and have never noticed any difference. It is down to personal choice and taste, on my cardiac rehab course the dietician said that nothing was forbidden but best to only eat the "bad" stuff occasionally. How are you getting on with Warfarin? Do you have flexible phlebotomy services and an anticoagulant clinic where you live?

[Leonardo1]

I had a tissue valve 2 years ago - I wanted mechanical but couldn’t as I couldn’t have warfrin . Mines doing great ! My neighbour is 90 and had her tissue valve 25 years ago and she’s super sparky too !! They don’t know exactly how long they will last as they are still going ! Lots of info on the pros snd cons of each out there but essentially they are both life savers so one things for sure you will feel better ! Good luck

[Mitchum]

Why should it make your diet complicated? If you drink cranberry juice now on a regular basis you will still be able to do so and your dosage will be adjusted accordingly. What you can't do is stop drinking it or drink more, or less, than is normal. There are many foods that interact with the warfarin but if your diet is relatively normal your dosage is adjusted till it's stable. I am in my 23rd year of warfarin and it causes me no bother at all apart from not being able to take anti-inflammatory drugs. A vegetarian friend take 14/15 mg per day because her vitamin K intake is massive but, if she suddenly stopped that intake she would have major problems on that dosage and would need to adjust accordingly. Routine diet makes it much easier.

I home test on a CoaguChek machine and have VERY few problems. If you have any specific questions feel free to ask my friend but at your age mechanical is the way forward.

[TriumphLover]

I had to choose 7 months ago and went with a tissue valve ( inspiris resilia ), mainly due to warfarin concerns and a couple of others ( or ticking sound would freak me out personally, some people on here said they could hear it at night !). From what I read the tissue type guidance was 15-25 yrs estimate, however the “ over speed “ tests were also stopped at 25 yrs, added to that the frame stays in and the valve is replaced by TAVi. For me that felt acceptable.

Someone else has commented that the surgeon gives you the choice, which was what I found. That said when I said I wanted tissue, he then said that was his speciality and I felt he was biased that way.

My advice would be to read up on the actual device ( I’m an engineer so I’m wired that way ), but once you feel drawn one way get it out of your head and trust the surgeon!!

Feel free to bounce over other questions.

[Mitchum in reply to TriumphLover]

Can I just say that Warfarin shouldn't be a concern at all and the ticking quickly becomes "non existent". I wasn't given a choice but told that an organic valve would only last 12 to 15 years. As I am in my 23rd year with a mechanical valve I would have needed more open heart surgery by now and possibly on my way to a THIRD! Believe it or not my friend, it soon passes!

[Classof1988]

I just want to agree with Mitchum and others regarding any dietary issues when on Warfarin. A regular diet is helpful but grapefruit and cranberry juice certainly are ok. Valve noise is minimal too. The only additional assurance I can offer is that my experience is probably longer term than most on this forum as I have had my mechanical valve for 36 years and it has never given me any problems.

[Mitchum in reply to Classof1988]

The problem is that the medical fraternity tells us that something is off limits if there is a slight chance of problems because of this action. I can understand to a degree but a sensible approach from the patient should be taken into account instead of a cover all stance. We are sometimes treated like idiots but then again, some of us are!

[Astronomyrules]

Hi,I had a tissue valve 5 years ago. I wasn't given a choice as I already had OHS and with several co morbidities the surgeon didn't want to risk another. I'm so glad I did even though it had to be a trans apical TAVI ( key hole between the ribs and up through the heart) and not a groinal entry ( less invasive again) the recovery is so much quicker. I was told my bovine valve would probably last 15 to 25 years. If I do need a replacement it will be the same procedure, they'll just pop the new one inside the old plus no warfarin .Many have commented on how happy they are with their mechanical valve and if I was younger and fitting had to be OHS then maybe that's what I'd have chosen where I given the choice. I hope this helps. A discussion with your surgeon as to whether a TAVI is an option might help your decision. Good luck.

[Nickibmibile]

I had a mechanical valve fitted in 1984 at the age of 17 and took Warfarin. I had my daughter at age 34. At 36, in 2003, I had to have emergency surgery due to a clot whilst pregnant with my son. I lost him and gained a bovine valve, no warfarin but had to take Aspirin. In August 2023 I had the valve replaced again and I chose a mechanical valve and Warfarin. I've never had to change my diet (actually researched diet and Warfarin and found that some foods made it more effective so you need a lower dose which is useful). I also react to chilli's so I don't generally eat them but I eat everything else and I also drink alcohol. Anything can be a problem if you let it. I expected my first valve to last 40 years, as advised at the time, however mine lasted about 20 years. The second lasted a similar length of time and hopefully so will this one although my last surgeon said that three replacements is a lot and four he hadn't heard of so we will see, I calculate I will be about 76. I hope medical science will have advanced by then. Try not to stress too much about your choice both are good options.