A 'New' Aortic valve. But which one?

[bocco]

I went with the mechanical valve for my surgery about 3 months ago. Had all of the same concernes. Especially about Coumadin. Yes my valve ticks when it's very quite but I can't hear it right now at work.

So far the worst thing about Coumadin is listening to all of the idiots that think they experts giving you the speech about the does and don'ts. Apply some common sense an Coumadin isn't to bad. You just take your pill and go on about your day.

 

[neil]

bocco which idiots?

 

[yotphix]

I also heard that when you are lying in bed at night, trying to sleep, you can hear the mechanical valve clicking. I’m a bit worried it might bother me. What do you think?

If you live in a very quiet home, especially out of the city, which doesn't have a forced air HVAC system, you might hear it pretty well. If you are the sort of person who is driven mad by dripping taps or mice building nests, you might not do so well with it. If, like most people, you find that the noises of daily life fade into the background, you'll likely not be bothered.
I have a mechanical watch which I can only hear when I'm in a quiet room. Sometimes I'm not sure whether I'm hearing my watch or my valve, but neither keeps me up at night.
Warfarin for me, has turned out to be no big deal at all. I'd think it might be even less of a big deal for someone who already takes daily meds. I take a fair beating at work and play and while I seem to bleed a little more, and bruise more readily, it's not dramatic. I do try not to hit my head as much as I used to! (That doesn't stop me from running, bicycling, motorcycling, rollerblading, camping, swimming, sailing etc., etc.).
Years ago, I had a dentist advise me that my wisdom teeth, which were having trouble finding space, should stay in because researchers were on the verge of perfecting a method to transplant wisdoms into the place of molars. I would have a mouth full of spares, he said. One of those wisdoms became massively infected because it always remained partly under a flap of skin. When it was being pulled, the new dentist asked why it hadn't been taken out ten years earlier. I told him about the transplant idea and he said "yeah, that never really worked out".
The point of my story is that medical advances, even when they seem quite likely, are never guaranteed. In my case, there is a very good chance that the massive oral infection helped along the degradation of my aortic valve too!
I would never recommend choosing mechanical because you expect warfarin to be succeeded soon as the anti-coagulant of choice, nor recommend tissue (which we should always remember is not a 'natural' tissue valve in any way, it just uses biological materials in it's manufacture) on the promise of easy future replacement. I would always recommend basing your decisions on what you know is safe and available today.
They are each good, and you're probably leaning one way or the other. Your choice will be right for you.

 

[bocco]

bocco which idiots?

Sorry. I didn't mean on this site. I just seam to come across a lot of people that need to give advice on the subject because they know somebody that had problems.

 

[neil]

ok bocco, :thumbup:

 

[enkaynj]

I was 51 when I got my valve last year. I wanted tissue, my cardio said mechanical, my surgeon said tissue. 2-1 so I went with tissue. Happy as a clam. Very active - spinning, tennis, elliptical etc and so far so good. Also no need to watch diet or take regular medication. I actually am OK to have another surgery when I need it down the road. Do a table with pros and cons, assign a weight to each and decide logically.
Good Luck.

 

[neil]

glad you are a happy bunny

 

[Forrest]

Patrickh,

After painstaking consideration I chose a tissue valve. I know that I’ll eventually need to have a second OHS to replace this valve down the road, but hopefully not for a long while. Originally my cardiologist didn’t mention that I had a choice of valve type. And when I asked he said since I was under age 60 I’d probably be best served by a mechanical valve. Once I informed him of my choice he began to support me, and said that the new tissue valves are having improved outcomes. My surgeon was very supportive of my choice, but many surgeons would be supportive of either valve type for someone my age, with the concept that “it’s my body”. Of course there are no guarantees at all, and I like how folks on the forum say it’s what makes you feel safe and that there is usually no wrong choice. I don’t know anything about what having other health issues would do to such a decision, so it’s probably good that you’re researching how diabetes etc. may or may not affect your decision.

Before my surgery I read that choice of valve type is often the biggest decision, and due to the circumstances many coin the decision as the “dilemma”, it’s not like choosing a car, you have to live with the choice and both seem to have their downsides. But a decision must be made, hence the appearance of a dilemma. But really it’s a life saving choice, 60 years ago few had any choices when it came to valve disease, you basically went home to live out your life until your valve failed. It’s a good thing to have a choice, in many ways there is no dilemma, although it is unfortunate having to be in a situation where you have to choose from the least scary of two options. Ultimately, to me it seems whatever choice you make you’ve made a choice of saving your life.

I had made a huge list of pros and cons when making my decision. I had heard of the times when something can go wrong, although both valve types have good records, but when you’re researching the “cons” do tend to catch your attention. For example, I heard that a few who chose a tissue valve to avoid a lifetime of Coumadin came out of surgery needing to be on Coumadin anyways due to a new issue (I think the example was a new diagnosis of arrhythmia). I also heard of tissue valves wearing out prematurely (although I’m not sure how often that potential outcome occurs). I also heard some similar but different stories about mechanical valves and anticoagulation (but this forum is full of people who are doing very well with that choice, and many of those who chose tissue valves also report being satisfied). You know, my list seemed to go no where for a while, until I found my self seeming to purposely search for examples to support my gut reaction of which valve would be best for me. It’s probably not the smartest way to make a decision, but even my own idiosyncrasies played a part, after all I would be the one to have to live with my decision. Of course, I did do a lot of hard core analysis on the internet (not full proof), reading a book about valve replacement and I paid attention to the research I did that pertained to how I tended to feel about things, including my personal life history up to then. I knew what my feelings were about certain risks, including re-op surgery. Like others, I do believe it’s a personal decision. It helps to research things as impartially as you can, gathering information about each valve choice, your health history, and listening to your cardiologist and surgeon’s recommendations. Let my choice be of no importance to your choice. I’m doing fine, almost 3 years out, so who knows maybe I made the right decision for me, maybe not, but I’m comfortable with it and I hope you arrive at whatever decision you and your doctors feel is right for you. Hope all goes well for you, sounds like you’ll do fine.