mechanical or tissue valve

[Natascha Heard]

Hi everybody,

Im a 38 year old female moved to the us 2 years ago and about a year ago I found out i have an biscubic aortic valve and a descending aortic aneurysm 5.1 cm... My surgery for a new valve and a aortic craft ist scheduled for 28/10 and I really dont know what valve to choose..I would like to know you expirience with the different valves ...Thank you so much and excuse my bad english!

 

[Trinalovescats]

Welcome to the forum!

My name is Trina,31.I had Mitral Valve Replacement and Tricuspid Repair on May 3,2016.

I have a mechanical valve and I am very happy with it.I suggest you choose Mechanical because it will last quite a bit.But some people get tissue valves and it's their choice depending on what their doctor recommends.I would suggest you choose Mechanical.
There is a member on here in his 80s who had mechanical when he was 31.That is a testimont to me.Make sure to do your research and ask away.

 

[Natascha Heard]

Thank you Trina:Smile:

 

[Natascha Heard]

im a little concerned about the bloodthinner and the vitamin K intake and also read that not all mechanical valves last and the risk of bleeding and stroke which makes me scared...

 

[dornole]

Most people on here who are actually ON bloodthinners say it is very manageable and you can eat what you want, just don't juice a bale of spinach and drink it or something. At your young age you'd be very lucky to get 15 years out of a tissue valve, and it could only be 7 years . . . or four. Being young and female are both risk factors for your tissue valve to deterioriate quickly. That means multiple open heart surgeries which is dangerous . Not all mechanicals last, but NO tissue valve will last your lifetime. Mechanical is much more durable. I'd rather take the pills and get blood testing than go through a probable 2-3 more surgeries (which might not even be possible) for several tissue valves.

What is your surgeon recommending for you? I think most people would say mechanical for your young age. Unless future pregnancy is something you want.

 

[MethodAir]

Mechanical. Warfarin is a non issue for me. Stable and predictable...the only time I think about it is when I take the evening pill and self test every week or so.

 

[Trinalovescats]

Everything has a risk and yes sometimes it can be scary.I turned blue the night before surgery and was being held over by oxygen.I chose mechanical because I knew it would prolong my life.
If being on Coumadin and 3 other medicines for the rest of my life is a small sacrifice then I will do it.

I like the ticking of my valve!

 

[LondonAndy]

In your bio you mention kids under interests, Natascha, and not sure if this means existing kids or future kids but presumably you know that if considering getting pregnant they advise against mechanical.

There is quite a lot of information on here under the valve selection forum with some strong opinions for both mechanical and tissue. For what it's worth, I am in the mechanical camp, but with the caveat that I think self-testing (or indeed self-managing) for those of us able to manage it (and I would suggest it's a piece of cake for most people) is an important part of that, to ensure you avoid the risks associated with an INR out of therapeutic range.

 

[pellicle]

Hi

im a little concerned about the bloodthinner and the vitamin K intake and also read that not all mechanical valves last and the risk of bleeding and stroke which makes me scared...

mostly the stuff written about "blood thinners" (a term I hate and prefer to use the proper name of Anti Coagulation Therapy) is exactly scare stuff. I believe that it is misrepresntative of the facts and is poorly compiled and poorly studied.

Why?

well noone makes much money out of warfarin as its as cheap as chips to make, so who is going to fund research to identify that in the main the cases against it are from gross incompetence of INR Managers and shaky data from users who may or may not have the slightest grasp on proper research methodology. People report "I ate X and my INR was high/low" ... based on one event.

Seriously its mostly bullshit. I've spent the last 4 years not only on warfarin but studying my own reactions (as well as those of others), reading journals about it and it seems to me that outside the USA this proposition is much less the view. Whole countries are moving towards self management and self testing because it gives better results and costs the community less.

LondonAndy makes a good point are you considering getting pregnant? Being pregnant on warfarin presents complexities which some here have confronted and done well. Its managable but takes comitment. At the end of the day you'll have about 20 weeks of management issues and a valve that in all likelyhood will last your life without redo surgery.

As long as there are no other health issues which you have not shared ...

 

[Eva]

Welcome to the board, Natascha!

Most of us had this dilemma with valve choice before surgery. Some were pretty sure of their choices...lucky they.

In my opinion, I believe your cardio or surgeon will be best to advise you, as they know your health better and know more about you socially, such as if you want to have children or not? Etc. If you do, a valve tissue is much easier to deal with during pregnancy or any other issues if anti-coagulants may not be right for you.

Mechanical valves last for the rest of one's life, but one needs to take anti-coagulants, which is not a big deal once you learn how to handle it!

Tissue valves need a replacement, unpredictable when, but you don't need to take anti-coagulant (99.9%)! Good news: (1) TECHNOLOGY FOR REPLACEMENT IS ADVANCING VERY FAST and replacement maybe done via catheter in the near future for all! Also, (2) some new mechanical valves are in the offings which may require little or no coagulants!

I, personally, chose after a long debate mechanical valves. I had two bad valves...I was 57 then and that was the best choice for me at that time!

Again, I encourage you to ask you cardio or surgeon in addition to our opinions!

Good luck. Any choice you make will be the right choice.

 

[neil]

hi nat, at 38 I would lean towards a mech, but the choice is yours, also have a good chat with your cardio and surgeon, good luck

 

[Agian]

Unfortunately, this issue causes a lot of anxiety for people Nat. Do your research and ask questions.
At 48, I went mechanical. Testing your INR is a minor nuisance.

 

[ForeverThankful]

Hi Natascha!

I was 55 when I had my surgery last year and I did my homework looking into mechanical and tissue valves, I went with Mechanical. Personally, if I were 38 I would definitely go with mechanical.

I have a home testing meter which is very convenient for testing my INR and managing my Warfarin dose.

 

[Trinalovescats]

I'm 31 and glad I went with mechanical.Taking Coumadin is just a small sacrifice.You will be happy in the end.

 

[Cynthia_58]

Hi Natascha

My surgeon recommended me to have a mechanical valve, he said it will last longer than a tissue valve. Doing the surgery again is so scary . Taking warfarin for the rest of the life what they said is not an issue, again it depends on your doctor what is best for you.

 

[AnnaK]

I think I will/ would chose tissue to eliminate the need for a blood thinner. I take eliquis now & I've not had a problem with it but I haven't gone mountain biking since I started out of fear & it was a favorite activity, same will hold for skiing in another couple months. And progress will probably continue to be made for non invasive surgery so it will hopefully be a pretty easy replacement down the road.

 

[Natascha Heard]

Thank you all so much...Im not having no more kids and my surgeon recomment a mechanical valve for me but he also said that also said that in the future they will be able to replace a valve without surgery its a hard dessision since you never know what the future holds for you i always have have menstruel bleeding what would be havier but he said yeah you just take hormones we can manage it...its so good to hear that everybody doing so good with the mechanical valves.my surgeon told me to go and read in forums and see how i feel about it.His assistant said it is a hard dessision and she wouldnt know what to do...I will keep reading and im so thankful that all of you took the time to comment on my post!!

 

[dornole]

If you are done having children, you can get an endometrial ablation and greatly reduce or eliminate your menstrual bleeding while still keeping your natural cycle and hormones intact. It is an easy 30-min procedure that an OB-GYN can do in their office, basically they just deactivate the blood-producing lining of your uterus. One of the best things I ever did for quality of life. My cycle became very heavy when I went on aspirin for my heart. So if this is an issue talk to an OB-GYN for your options. I'd have it done before going on coumadin if you're concerned. Heck I'd have it done just to have a nicer life. : )

You're right it's tough not knowing the future - but the future of non-surgical valve replacement isn't here yet except for old, frail patients because it is too dangerous still to use on otherwise healthy people - and not sure if it's even possible to redo that way. There's tons to read on here about valve choice. When do you have to decide?

 

[Natascha Heard]

Thank you I will check on my gyn my surgery is scheduled on October 28th...

 

[pellicle]

Hi

Thank you all so much...Im not having no more kids

LOL ... well with that impediment out of the way ;-)

and my surgeon recomment a mechanical valve for me but he also said that also said that in the future they will be able to replace a valve without surgery its a hard dessision since

there is no doubt that TAVI is improving and increasing. Deciding if it will work best for you is indeed a difficult question, mostly because there is not sufficient experience or evidence to help you decide. Just because new tools come along does not mean old tools are obsolete. We still walk even though we have cars ... some would even say that walking can be better for you.

Let me give you a metaphor: My house was built in 1951 from (what we in Australia call) Hard Wood Timber (which is usually eucalypt tree). The wood essentially lasts forever as long as its protected from termites and kept from being damp all the time. The tradesmen who come here hate it because they can't use "nail guns" on it and have to pre-drill before they put in a screw. This slows them down in their work. The modern "spec" homes are all built with Pine frames, and within 10 years are showing signs of movement, sag, decay. By 20 years they're looking crummy.

In contrast when I recently refitted my bathroom (and did most of the work myself) I took my time, pre-drilled the screw holes and nailed by hand. I found that well over 50 years later there was no movement in the walls and the timbers were still stronger than the modern stuff is new. It took me weeks to do the work (weekends and evenings) but now that its fitted out the bathroom is fantastic and will probably last another 50 years.