What I don't understand is why we are given a choice of type of aortic valve. All through the procedures and appointments leading up to the TAVI we follow the instructions of the experts.I have my initial pre op appointment with TAVI team in Cardiff on 13th January.
I am 78 in a few weeks.
I would rather they make the decision on type of aortic valve as I would have no idea what to choose.
At present I take furosemide, apixaban, bisoprolol and rampril and simvestatin.
Will any of these be stopped after TAVI?
Written by
Gooner1947
To view profiles and participate in discussions please or .
Hi, possibly they mean a mechanical or a biological valve not the actual one they are going to use. Ref meds I was taken off bisoprolol immediately after the op, Ramipril remains but the others I have never taken. I hope all goes well for you.
Hi, It's horses for courses when it comes to type of valve, in many ways it becomes a lifestyle choice.
Personally, I went for a tissue valve first time around, I was 33 and I'd have been gutted if I'd been told it had to be Mechanical.
Correct me if I'm wrong, but, it's my understanding that with a TAVI op there is no valve choice, the only option is biological. Not everyone fits the criteria for TAVI.
Quite likely it is mostly biological, I was never asked whether that was an issue. I can't imagine the doctor asking a patients opinion on which precise valve to use.
I was given a choice of sorts, but it was strongly recommended that I should opt for a tissue valve. Which, obviously, I did. Had the op exactly four months ago, no problems and recovered quickly.
I was lucky in that I recovered at a good rate of knots. I think it helped that I was otherwise in decent shape, not overweight and didn't smoke or drink alcohol. I'm a positive sort of person as well. I didn't find recovery too difficult, and it surprised me really. I thought I'd struggle when I got home, I live on my own, and I did a bit for the first few days even though my son looked in morning and evening for the first week. But I soon got the hang of it. I think rest is more important than exercise for at least the first three weeks, and then as advised short walks , one lamp post further each day on decent days. My son was looking in most evenings by then, and he encouraged me, which helped. At some time between the fourth and sixth week, I realised I felt like a new man (old music hall joke there!), and everything became easier. The risk then is overdoing it!! Remember to just pace yourself. Overdoing things can lead to set-backs, and luckily I avoided them. Four months now, and I still get some shoulder pains, but nothing a couple of paracetamols can't handle, other that that though I'm feeling pretty good. In some ways, it's like stepping back in time. Good luck with it.
Pre-TAVI, I was on Nebivolol, Ramipril and statins and continued on the last two. Ramipril is for blood pressure, and mine has fluctuated a bit post-TAVI. It averages 143/75 which, I gather, for ME is optimum.
With a TAVI, the replacement valve is threaded along a vein, usually from the groin, sometimes from the neck. If all goes well, one can hope to have to spend only one night in hospital (I spent two).
No, I've never heard of furosemide. On discharge, I stayed with a cousin for five days, so an eye could be kept on my just in case. Did walks of up to two hours. Driving not allowed for four weeks. Saw the surgeon after three weeks, who said it was OK for me to do light gardening and resume sexual activity. It took almost a month for the large blue-black bruise close to my groin to disappear - this was where they'd injected tracker dye so (I think) that the progress of the valve up my vein could be checked. Much less bruising on the other side where the valve had been inserted, and some very minor puffiness.
I was monitored for a few years before having an aortic valve replaced as I got more breathless surgery was planned. I was fine afterwards. I had a tissue valvynearly 10 years ago now aged 57. I also stopped the bisoprolo after my 6 week check with no ill effects
Forgot to ask. How long roughly did the procedure take? Say from time they started to insert in groin to being taken back to ward?Do they offer anything to help remain calm? I opted for that for my coronary angiogram.
I was surprisingly relaxed about the op. I can't recall if I was given anything before being wheeled in to the theatre, but once in it was anaesthetised. I remember a nurse shaving off some pubic hair (think "Mohican" or "Brazilian" for a man - or perhaps not), and the surgeon kneading my groin, then it was lights out until I woke up, still in the theatre, with a nurse saying everything had been straightforward.
I had the TAVI on local anaesthetic and painkillers and was awake throughout, I had to ask for an oxygen mask as I was struggling to breath at some points (but I have asthma and had lung cancer at the time), from going in to theatre to leaving was maybe an hour, there seemed to be a lot of prep work of getting me ready for the op. For me, the worse part was being flat on my back for 6 hours after the operation, and having been nil by mouth for 16 hours before (the nurses got the time wrong) I was nearly 24 hours without food and had to drink through a straw as I was not allowed to sit up or move.
Furosemide is a strong diuretic (water pill) given with Potassium usually as it will lower your potassium level in the blood. I was discharged the next day and my only restriction was needing someone with me for 24 hours and no lifting more than 10 lbs (4.5 kg). Oddly I had no swelling or pain after.
I had no restriction on driving other than the first 24 hours post op. Felt 100 % better when I woke up, able to breathe easily for the first time in almost a year, walk for quite some distance within a week where before could barely make 20 feet without being doubled over trying to breathe and no longer falling asleep frequently.
My mom had her mechanical valve over 30 years ago and is still going even though she as severe emphysema. My dad died a little over 20 years past his but it was his own fault, the valve was still working properly (tissue valve). He refused to take his meds before the end and developed pulmonary edema which killed him..
Thank you for that and glad all worked out ok.I have been taking furosemide for about 5 months or so now. It was when I went to GP about swelling legs and being breathless. It certainly helped. I get now swelling in legs now but not so effective with breathlessness as it was.
Was hoping it would be stopped with the implant of new heart valve.
Furosemide has also made me to lose weight. I still lose weight gradually even now.
I still get swelling in my feet and ankles occasionally but nowhere near as bad as before. The breathlessness for me only comes when that starts or I try to do too much. I lost quite a bit of weight in the beginning but now that most of the water weight is gone I don't lose much. I now only take the furosemide when either SOB starts or I get edema in my feet. Hope things continue to improve for you.
The doctor hasn't changed the prescription but yes. I have been on and off it for about 30 years now so can tell at the beginning when I am starting problems. For the first several months post op I took them religiously then started skipping a day then sliding to eventually as needed. Furosemide is hard on the kidneys and can also cause liver damage though not as often. I prefer to minimize the risk when the drug isn't as necessary.
Oh yes! Between diagnosis and operation, I was very active on some days (but exhausted on others), and a week before the op did a careful six-hour walk that included climbing the steep hill to the earthwork Barbury Castle, but a couple of weeks before that had scampered and panted to get to an appointment on time ; I made it with two minutes to spare - that was barely enough to get my breath back.
I thought that it was meant to be a local anaesthetic, but I was certainly "out". Just as well, as when I've had eye ops only the eye itself has been numbed and I could hear what was being said: "you need to put the needle in a bit more", and there was after my TAVI, though I had to take it easy because of the tiny wounds in my groin. In hospital a doctor told me that my new valve was "good to go", that is, working well already.
I can't remember if there was a pillow during the op. But back in the ward I was put in an adjustable bed that wouldn't adjust, so had to be transferred to another. Many people are discharged after one night, though I was kept in for a second as there was a very small suspicion that I might have needed a pacemaker.
sir, I had one 16 months ago and it made a massive difference. I don’t know the difference between each type. However, I met a 30 year old who had a mechanical one because his life expectancy is so long. But I understand the blood thinner with that means they will have to attend a clinic possibly weekly for ever.
A natural replacement, such as I have (I’m 74 now) has a shorter lifespan. However, as and when it needs replacement they don’t kneed to open your chest but can replace it via your groin. I think if you can, you have extensive explanations and discussions and they should give you guidance.
I had at quad bypass and aortic transplant and it has transformed my life.
One tip I was given. When you have a meeting with the anaesthetist,a day or two before your op. Ask them to prescribe Diazepam. One the night before op. You’ll get a great nights sleep with no worry. And another for the morning of the op. You will approach the op in a carefree state of mind. If you leave it to the nursing staff to arrange, they will be running around trying to get someone to prescribe at the last minute and they arnt always available and the whole thing is stressful. If prescribed, the whole thing is part of their stress free schedule, and is something they have to do.
It made it so easy. Good luck with your op. You will be giving thanks for the difference it makes.
May I just say again my massive thanks to all at LHCH Liverpool who have saved and changed my life.
Can I just respectfully say, you DO NOT need to go to a weekly clinic for warfarin. This is another fallacy that turns patients away from mechanical valves if given a choice. As I have written on this site previously, the myths regarding warfarin use are legendary and mostly rubbish! If you research this site you will find and read many experiences of warfarin use from numerous patients, me included, who have no issues whatsoever with warfarin and in fact look upon it as a wonderdrug. Millions would be dead without it. Good luck sir.
DavidThank you so much for your very encouraging reply.
Thanks for the tip re the diazepam. A question on that please. Were you in hospital overnight before the Op? What would happen if you travelled from home on the day? Taking one before the Op sounds good. Id like that. Did you stay in overnight after the Op?
Can you recall what the early days were like after the Op?
I just hope I will be able to say goodbye to my breathlessness.
I think we are given choices because the doctors don't know everything about our lifestyles. I had open heart surgery not TAVI. I was told the pros and cons of each type and given a choice and opted for tissue rather than mechanical because I didn't want the hassle of warfarin or other blood thinners ( I was 67 when I had the op) . The surgeon had indicated that for me he was inclined to go for tissue.
Hi. Mine was an emergency op so was not in a state to be asked what I wanted. However I was 66 nearly 67 when I had the open heart surgery, and was given a tissue valve. I thought if you're younger they prefer to give the mechanical valve as it lasts longer - you have to take warfarin for life if given that one, I've also read from people with that valve that you can hear it clicking, not sure how bad that is. I was told my tissue valve lasts 10-15 years before needing replacing. It's then replaced via the groin so not needing opening the chest up again. I think there are different types of tissue valve so maybe discuss that with the surgeons team. Hope that all helps.Denise
My daughter had 2 valves replaced aged 18. Tissue in both cases. Aged 34 they are still going strong even after the added strain of having a child. I think for young women they have to consider the potential complications of blood thinners cos of childbirth. Given she had an emergency caesarian I am glad . It is a complicated balance for each person .
I was put on a variety of meds post op, three have stopped but, 18 months on, I still take Aspirin, Carvedilol, Rosuvastatin, Ezetimibe, Felodipine, Losartan and Lansoprazole. It looks as if I’ll be on these for life.
I had a valve replacement in July last year. I was given a choice of valve (mechanical or biological) by my surgeon who explained the pros and cons of each. There’s no right or wrong decision as it’s up to you how you see the advantages and disadvantages of each.
At your age, a biological valve may have fewer downsides than a mechanical valve. You should discuss this with your cardiologist and/or surgeon.
I’m a fellow Gooner and I’d be very happy to continue this conversation with you. But I can’t fix Bukayo’s hamstring!
I had full-on open heart surgery replacing my valve & root as well as cutting out part of my ascending aorta and replacing it with some fabric (really!) which was grafted onto the rest of my ascending aorta.
From what you’d said earlier here, you’re going to have the TAVI procedure which is not open heart surgery. So I can’t say what the days are like after TAVI. If you end up having open heart surgery, I can tell you I was physically wiped out by the operation. I could hardly move in the early few days but each day I was a little bit stronger than the previous day. It took me about three weeks before I could walk 100 yards without pausing for a rest. I am much much stronger now six months later.
On the football front, I’m not too concerned about tomorrow night. We have to avoid falling between two stools. That happened when we played SC Lisbon a couple of years back when injuries picked up by Saliba and Tomiyasu probably cost us the Premier League trophy.
I live in N5. Keep in touch and come to a game after your surgery when you feel fit to travel to London. I’ll find you a ticket.
My husband is now 82 and had his aortic valve replaced 4 years ago by TAVI. The undiagnosed stenosis had led to stretching of the ventricle and he was told that this cannot be reversed so he still has a diagnosis of 'heart failure' but enjoys a much better quality of life than before the op.
As far as I am aware, the different valves were discussed with him but he was not given a choice. The info was so that he would understand after the op what had been implanted.
He continues to take , Ramipril, Bisoprolol, Furosemide and soluble aspirin daily.
My husband, who had never in his life been treated by the hospital for anything other than a vasectomy, found it all much less stressful than he had expected.
The only problem he had was when he needed to self catheterise due to his enlarged prostate. As he was told he must remain virtually flat following the op, he found the catheterisation very difficult to manage and, even with the help of a kindly, but inexperienced, nurse he ended up making the bed wet twice which he found very embarrassing.
He had raised the issue of self catheterising in several pre-op discussions but was told that it would be 'managed'. He was expecting to be fitted with an indwelling catheter overnight. On the day, there was no one on the ward who knew anything at all about catheters and he was left to get on with it as best he could! Poor man!
The TAVI procedure went well and has given him extra years of life which he is able to enjoy much more than he could before the op. He was given a life expectancy of two years before having the procedure.
I wish you all the best for a trouble free procedure and a good recovery.
I'm hoping once it's all over my wife and I will be able to fly out to stay at our cottage by the sea in The Philippines. It's normally at this time of year that we go. But health comes first.
I didn’t get a choice of valve with TAVI . I believe there isn’t a choice because of how they insert it into your heart . I was sedated to keep me calm and ‘op ‘lasted about 2 hours so not everyone same . It was ok just a little uncomfortable . I had a pillow under my head to keep me comfortable.
TAVi as opposed to open heart surgery, is a quick op with a fast recovery.
I too had to opt for OHS or TAVi and i opted for OHS. TAVi can sometimes fail. Also the surgeons may find that the TAVi cant be completed so they would do OHS anyway.
I dont think you can have a metal valve by TAVi but I am not certain about that.
I opted for biological rather than metal valve. Being in my 70s made that decision easier.
Surgeons like to have several years of trials but the valves are improving so fast that they cant have their desired several years. So us as patients need to confirm the decisions.
Four years on and I am delighted with my biological valve. A wonderful op by amazing medics. And no need for warfarin. I get an annual scan at the local hospital which confirms that, so far, so good.
Hi,In some way I wish we could go back to being told we need some procedure and when it would be done, instead of being asked if we agree or being given alternative treatments and asked to decide which we think will be right for us. I don't like being told how a procedure will be done either, I'm a bit of a wimp and it stresses me out.
Most of us aren't cardiologists. They're the experts. Our lives can depend on these decisions and they should be the ones make a plan.
I know it's all in the name of transparency and probably to save them being sued if things go wrong, but they wouldn't ask an astronaut to advise on building the rocket that will keep him/her safe do they?
I only wished that I could have qualified for the TAVI procedure rather than the openheart surgery which was the only option for me since I needed triple by-pass as well as the replacement valve. TAVI is, by all accounts, far less traumatic to one's body. As someone else has said, I believe that tissue valve is then the only option available by TAVI, and I assume that it might well be your choice anyway, given your age (still quite a bit younger than me, though) and the likelihood that in view of your travel plans you would prefer not to have to worry about checking blood thinner levels regularly while in Philippines. My understanding is that warfarin (a blood thinner) is required for life with a mechanical valve, and you must then check fairly often at the hospital or with a home self-check machine, to make sure that the dosage is correct and does not need adjustment. The downside to TAVI/tissue valve seems to be that it is not a lifetime "fix" and I understand previous versions of the valve would only have an expected lifetime of maybe 10 years. However, I opted for the Edwards Inspiris Resilia valve, a fairly recent type which the maker claims to have special non-calcification treatment which can be expected to have a lifetime of 20-25 years, which should see me through. Admittedly it has only been approved since around 2016, so all that can be definitely said is that it seems pretty reliable for at least 9 years, but it has another feature in that if anything does go wrong another valve can be inserted on top of the old one, again via TAVI process. From other posts on this site, that valve type seems to be the one usually now used in UK too.
As to whether your breathlessness will go away, I did not have that symptom to any great extent, but mine was shoulder pain which could be bad enough that I would have to stop my activity and take a rest. So far at least, no problem with that in the 3 plus years since my operation. Nor was I required to lie flat in bed, either in hospital or after I was discharged.
Good luck with the procedure. I am certain that, as many others have said, you will find the apprehension is worse than the actuality, especially with TAVI. Maybe one day we can meet up on Mindanao and swap war stories.
Hi, I don’t know alot about TAVI but did have open heart to replace my Mitral and Tricuspid valves in 2023. I’m in Australia and my Surgeon told me before surgery that I couldn’t have a mechanical valve on the tricuspid as it’s on the right side of the heart so pigs valve would be best. He explained he would do what was best when he operated, I had severe regurgitation. He did Annunoplasty on both valves and said your heart didn’t like the valve. It was a 6 hour operation so I assume a lot is decided when they get in there and see the condition of your valves. I am 71 and take apixiban and 1/2 spirinolactin every second day. Good luck.
Gooner: just one observation that I don't think has been made in this particular thread: good dental hygiene is essential before and after valve replacement, as bad teeth can affect hearts, even healthy ones. Before the op, my private dentist was happy to bring forward my six-month check-up and hygiene treatment. Anything that might lead to bleeding in the six months post-TAVI is probably best deferred. Occasionally we get questions about whether anti-coagulants and the like should be paused prior to an extraction, say. It was once advised that it should be, but current thinking has it that it should not.
And poor teeth can lead to bacteria affecting the new valve, it is said. The other day I read an article advising everyone (not just heart patients) to clean their teeth before lunch, as well as in the morning and before going to bed. My hygienist noticed I was using a strong mouth-wash and advised against it.
As ever, all the above is For What It's Worth and based on my own experiences.
You're given a choice depending on age. Mechanical ones are offered to younger people as they last longer, where as bio ones have a shorter life span. These will probably be pig valves or some other animal.
When the surgeon asked me my preference of valve type, I replied that my choice was what ever he recommended. I guess many people have various reasons for a preference maybe ethical, cultural considerations but I agree I wanted their medical expertise to be the decider.
Content on HealthUnlocked does not replace the relationship between you and doctors or other healthcare professionals nor the advice you receive from them.
Never delay seeking advice or dialling emergency services because of something that you have read on HealthUnlocked.
Aortic valve surgery 
Aortic valve replacement 
aortic leaky heart valve
Aortic valve replacment
