Mechanical valves or the biological ones

[darenso]

I am going to have an operation for a aortic and mitral valve replacement I am 73, and my dilemma is do I have the mechanical valves or the biological ones which might last for about 14 years or less

What options would there be when the biological valves wear out, can you have another operation

and would I be fit enough in my mid eighties to have one. Might TAVI be an option to replace

both valves

Would very much welcome advice

Many thanks

[Hanibil]

Hi darenso I had a mechanical aortic valve fitted at age 48 back in 2005, my surgeon said it was the best option because I would hopefully never have to go through the trauma again . Whereas with a biological one I would definitely have too.

I am very glad I agreed with him. I certainly wouldn’t want to go through it again and definitely not in my eighties. I wish you the very best of luck.

[Blackcatsooty]

Dear Darenso

I am just turned 75 and I had a biological valve two years ago. I suggest you listen to the advice of your surgeon. He is the one fitting your valves so he is the one to advise.

Doctors do have a problem…….they like to have plenty of precedents, but the valve improvements are so frequent and fast they can’t really know what the latest valves can do.

Since I had a biological valve, I hear that the latest valves can accommodate a TAVi at a later date, if needed.

My Edwards Resilia biological valve has been fine and there are no monthly checks nor any warfarin to take.

I found the choice easy to make, but if I was just 60 years old things would be different.

Best wishes

Sooty

[DinoCat]

Hello Darenso,

I would echo the view to be strongly guided by your Consultant Surgeon, who will know your particular case circumstances best. For what it's worth I'm awaiting a replacement aortic valve surgery (age 69), so had a similar dilemma to you about tissue v mechanical. I've had 2 separate Consultant Surgeon assessments and both suggested a Tissue valve for me - here's the verbatim comments of one of them, which I found convincing:

"I would definitely recommend an Edwards Resilia valve, since the valve performs very well and is a perfect substrate for a future TAVI valve-in-valve procedure, if required".

It can still only be proven in the yrs to come, but the latest generation of "Resilia" Tissue valves may well have a 15 to 20 yr lifespan. With regular checks the gradual wearing out of the new valve can be closely monitored and managed on a timely basis. And who knows what further medical advances there might be in 15 yrs!

Finally, the lifestyle advantages of not having to be on warfarine for life is a significant factor in favour of Tissue valves in my personal opinion.

I wish you well in your choice and surgery

[Hidden]

Hi darenso, The decision of a lifetime in some ways, both Mech and Tissue valves have there pros and cons, with risks either way. I would certainly concur with others and aim for a frank discussion with your Cardiologist/Surgeon over what they consider is best for you.

You may have more options than you realise, and also take into account future-proofing with potential updated surgical procedures as you've mentioned with the option of TAVI.

I've had both Tissue and Mechanical valves and I can honestly say that there is a fundamental difference between the two. For what it's worth my bog standard Tissue AV lasted for nigh on 19 years before it needed replacing. I had always planned for further surgeries, but, that was my choice. Two further surgeries down the line, I now have Mech Aortic and Mitral Valves.

Whichever type you choose, stick with that decision and don't look back wondering 'what if' I'd gone that way instead.

Best Wishes