I am waiting for an aortic valve replacement (BAV) and have had a meeting with my surgeon earlier this week (surgery later this year). Left feeling quite confused. Was fully expecting to be offered a mechanical valve (as this is what the first specialist told me would happen when I saw him back in December) but today was told a tissue valve is also a possibility, that both options are equal and that the choice is mine. I think it’s because I fall between the two ages groups where one is recommended over the other. But… I feel completely at a loss as to how I can decide. It feels overwhelming. There are so many pros and cons. So I was wondering if anyone could share their experience with tissue valves and mechanical valves, if anyone had to choose between them and how people found being on Warfarin (if it was easy to get the dose right etc.). Thank you.
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GreenQueen1
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I had OHS end of February, I'm 50 and chose a mechanical valve before the operation, but once operating they decided to do a repair.
I was still put on warfarin whilst recovering and still on them now till the 12 week mark. They managed to get my warfarin levels correct after about 2 weeks and have had no issues with warfarin
Thanks for replying. I am 60. It seems that up to 50, a mechanical valve is usually recommended and a tissue valve for those over 70. I am completely in the middle - a grey area in all ways! It's encouraging to hear you got on ok with warfarin as that is a concern for me. Hope you go from strength to strength.
Aged 78, I had a tissue valve inserted last July (TAVI) and was able to walk around the hospital in stages for 80 minutes the next day. I might have been discharged that same day, but was kept in another night to check that I didn't need a pacemaker fitted.
Such valves have a limited life and I can't say that I was impressed when the surgeon said mine would last five years, but every other source seems to suggest one might reasonably expect 10 years plus. It's possible to have another TAVI, though I think that this may be a bit riskier. One still has to take drugs post-TAVI, and wondering/worrying about perceived side effects features regularly in this Forum.
I'll leave others to comment about mechanical valves, which I gather are more enduring but require more demanding surgery.
One consideration is how many more active years one hopes for and can expect. By the time I'm 88 I think that I shall have had enough of life, especially with the various other infirmities to be expected then.
Thank you for replying. I don't qualify for a TAVI procedure but this is pretty impressive you were up and about so soon after surgery. Hope you go from strength to strength and prove your surgeon wrong!
I had a mechanical aortic valve fitted fifteen years ago and it’s recently been checked and it’s still working perfectly. Yes, I’m on Warfarin but that is no big deal providing you stabilise on it. Unfortunately, mine has never stabilised so it does mean i have to have regular tests. I choose the mechanical valve as I didn’t want to go through OHS again when I was older. I have no regrets.
Thanks for your reply. Glad your valve is still working well. How careful did you need to be with what you eat because of warfarin? This is a concern for me - the list of foods which need to be avoided or treated carefully looks like my weekly shopping list and are my favourites. Can I ask how regularly you need to be tested? Hope this improves for you but good to know you made the right choice.
I am 36 and have just had a Resillia tissue valve fitted. After discussions with my surgeon this new type of valve was most appropriate for my lifestyle and career. It has a reasonable expectancy and is able to allow me to still live a very active life.
It's good you were able to get advice from your surgeon and that there was a clear choice for you. Am still new to this so am unsure why a mechanical valve might not allow a completely active lifestyle but am learning all the time. Hope you recover well and can do everything you'd like to do!
I had the choice, aged 72. I opted for tissue and it’s been trouble free. I don’t know it’s there. 4 years so far.
The valves are improving at a good rate of knots, so the medics can’t be too specific because they need years to prove a particular valve.
Since I got mine, they are now available so that a TAVi could be used when the valve wears out.
I tried to get the surgeon to decide, after all he is the guy fitting the valve.
At the end of the day, the AVR was just fabulous. I had very few weeks to live, was exhausted and the op gave me my life back. Cardiac staff are wonderful. The recovery is long, say 12 weeks, but I just got better and better.
Hello and thank you for replying. It's so encouraging to hear how much better you felt after surgery. Am looking forward to this and for the waiting to be over.
I had a mechanical valve back in 2005 at age 48 it’s been brilliant and in recent tests it’s been shown to be working perfectly. I take warfarin and that has presented absolutely no problems whatsoever, don’t believe any of the scare stories you may hear.you can get a home testing gadget so you will only need to visit the hospital around twice a year. As for activity I ski and mountain bike even now with absolutely no problems. Had a gone for a tissue valve I would have more than likely of had at least one operation to replace it by now and possibly be looking at having another in the not to distant future
Very encouraging to hear warfarin has worked so well for you and that you're able to be so active. Were you given an idea of how long the mechanical valve would last? I'll definitely look into the home testing kit. Good to know.
I had a Edwards respira tissue valve fitted last year via TAVI It should last 15 to 20 years and can be replaced via another TAVI if needed I am 75 Your age is important in your choice TAVi as stated in a previous reply is a faster recovery time
That's the make that I have too. The company was very helpful when I contacted it recently in Germany, with a doctor speaking to me on the phone for 17 minutes and sending me links to four technical articles. (The issue was not with the valve itself, but the effect that it can have on one's body.) I very tentatively and diplomatically forwarded one link to the NHS haematologist I'm due to see on May 31.
I had a mechanical valve gutted at the age of 54. The surgeon made the decision for me based on my mental health and anxieties around hospitals, in the hope that I won't have to have it replaced. I'm on 6mg of Warfarin a day, and eat and drink what I want. I go to the gym and exercise classes and walk around 5 miles a day at work, so all good 😊
Thanks for your reply. Sounds like a good decision for you. And great to hear you get ok with warfarin. Do you have to pay attention to green vegetables etc? So encouraging to hear how active you are!
That's what I'm concerned about. I might be overthinking it all, but hard to know how much is "limited" and how to be consistent (which is what I've been told).
Maybe overthinking it a little, but that's perfectly normal, its a huge deal. If you aren't a member of UK Aortic and Heart Defects Pre and Post surgery Facebook group then consider joining. We have all been or are on the same journey.The Warfarin clinics are excellent too x
Apologies to Rhinos67 for replying to your question to them, but recommended foods relate more to the medications you need to take post-op than the type of valve. With my tissue valve, I'm on Clopidogrel anti-coagulant (and Ramipril). The post-op guidance from my hospital was very skimpy and I ended up doing a lot of my own research. IN MY CASE I concluded that Omega 3 supplements were not a good idea (and certainly should be taken in moderation) and I need to be careful not to overdo vitamin K (found in leafy greens). Inevitably Dr Google leads to differing advice about how much to consume - or not.
Received wisdom in this Forum is to consult one's GP or pharmacist, though with caution one can find AUTHORITATIVE websites.
(One activity that I learned to be unwise, courtesy of this Forum, is to avoid deep massage - this after I had had several!)
So this is news to me. My consultant said only a mechanical valve would need warfarin and not a tissue valve. That’s why I’ve equated mechanical with warfarin and tissue with nothing. Good to know about massage too.
I am 67 and have a tissue valve after OHS last year. I take a baby aspirin daily. Warfarin was never considered. I was steered fairly firmly towards a tissue valve and I really did not want to be on Warfarin. A year on I am doing well I was told that I could not have a TAVI. It’s not recommended in th UK or Europe for people under 70. I was also told that O HS would lower the risk of me needing a pacemaker. I have not needed a pacemaker I was told the valve should last 10 to 15 years and if it needed replacement a TAVI procedure would be possible. I think the choice is mechanical valve, probably will last a lifetime, but you will need warfarin. Tissue valve, will only last a limited time, but they can’t say how long and you won’t need Warfarin. What I have learned since is that you do still get a cocktail of medicines, Bisoprolol Amlodipine, aspirin, but you don’t have to watch your diet or worry about bleeding. There is no perfect answer!
I have congenital heart disease and recently had my third valve replacement (Aortic)
I have had tissue valves throughout and been very lucky with the first valve lasting twenty four years, that was a pig valve. I then had a cow valve ten years ago and now had another tissue valve.
I think a-lot of it all depends on your body and how it deals with the replacement. I have had three open heart surgeries and one keyhole.
I have made a good recovery and hoping for this valve to last me at least ten years. Good luck with everything I am sure you will be fine.
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