Hi, I’m writing this post on behalf of my brother who is 56 and is otherwise fit and healthy! He found out at the beginning of this year that he needs his aortic valve replaced, mitral valve repaired and possibly a by pass (they won’t know for sure about that until the operation).
He has his date for the op, which is next Tuesday. He still hasn’t made the decision about whether to have a mechanical valve or a bovine valve. His surgeon and cardiologist have said they can’t guide him and have just given him the options. How do you make that decision without guidance from the surgeon?
We are familiar with a mechanical valve because our Mum had one and she really struggled with keeping her INR levels consistent. She unfortunately passed away 11 years ago, partly due to her taking warfarin.
The thought that if he opts for a bovine valve he might need another operation is a worry, or could he possibly have that procedure by TAVI.
I know ultimately it’s his decision, but I wondered if anyone had experiences of either of these options - good or bad! Thank you.
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Fastlane2007
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Hi I had a mechanical valve at age 48 in 2005 under the recommendation of my cardiologist and surgeon, as they said a bovine valve would only last around ten years where as a mechanical valve would last a lifetime. Who would want to go through that traumas again after ten years I don’t know.I believe having the mechanical valve was to best decision I have ever made. Almost twenty years now and at a recent check up I was told the valve is working perfectly. I do have to take warfarin each day but it presents no problem whatsoever don’t believe any of the stories you may hear. You can buy a self testing machine you use at home. Cutting hospital visits to two a year. As for activity with a mechanical valve I mountain bike and ski.
That’s really helpful thank you. I think the thing that is making it a harder decision is that the bovine valves are now lasting a lot longer than maybe 20 years ago, but there is no guarantee that this will definitely be the case!
Hi, having been through O.H.S last year to replace my mitral valve with a mechanical valve aged 49, like Hanibil , there’s no way I would be signing up to potentially repeat the process again with a tissue valve any time soon! I wasn’t even offered a tissue valve because of my age.
Like your poor Mum, I have had real trouble regulating my I.N.R. It’s supposed to be between 2.5 - 3.5 but recently fluctuated between 4.1 down to 1.7 in just 5 days. Fortunately, I invested in my own Coaguchek machine, so I can test at home and then advise the Anti-coagulation Nurses of the result. They then dose accordingly. It is a nuisance, but not insurmountable.
I think your Brother wld need to ask his Cardiac Team re the possibility of having a T.A.V.I procedure in the future, if a tissue valve were used this time around. Would he be even be a suitable candidate in a few years time? There are just so many unknowns, until he’s in theatre. My Surgeon advised I would be having a repair. I woke up 12 hrs later to the news I’d had a replacement and wld be on Warfarin for the rest of my life. Apparently, the repair wouldn’t withstand my blood pressure (which is low at the best of times).
At the time, I felt a bit cheated - because that wasn’t what I’d signed up for. But looking back now - having read my post op notes re quite how badly damaged my own valve was and the damage it has caused to my heart, I’m grateful that a mechanical valve was used. If I hadn’t had the op when I did, I may not even be here now.
I hope you get a few more answers and then your Brother can discuss with his Surgeons. Wishing him a speedy recovery from his surgery, whichever option he decides.
Thank you for your reply. Really interesting insight. Unfortunately his surgeon and cardiologist seem very reluctant to offer any guidance which is slightly frustrating! It’s good to know that you can now check your INR at home!
Hello - I had OHS in April 22 to replace my Aortic Valve and root. My surgeon did make the decision for me based in my anxiety around hospitals and went with mechanical in the hope that it won't ever need replacing. Of course there are no guarantees and he said that if I'd insisted on a tissue valve he would have gone along with my decision.I'm sorry to hear about your mum.
I was really against Warfarin, but I'm coping fine with it. My valve is an ON_X and my INR range is 1.5 - 2. It took a little while to stabilise, but now it's absolutely fine. I walk around 5 miles most days and go to the gym regularly. I had to have a pacemaker fitted due to going into heart block as a result of the surgery but all OK and I'm very grateful that my heart defect was picked up and treated in time.
May I also recommend a Facebook group for you and or your brother to join.
UK Aortic and Heart Defects Pre and Post surgery. I got so much support and reassurance up to and after my surgery
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