Mitral Valve Replacement-Tissue Or Mechanical

[romarnh]

I am a 66 year old female who will be undergoing valve surgery for the 2nd time in four years. My 1st surgery was a repair which was not successful. I am facing surgery on September 21st and would like to have input on valve choices that people have made and how they feel about their choices. I am tending toward a mechanical valve, however, I have heard that these valves are loud. I believe if I can hear it clicking, it will drive me crazy. I'm also not keen on taking coumadin for the rest of my life, however the thought of a future surgery is not very appealing to me either. I look forward to responses from individuals who have been faced with a similar situation. It is very difficult for me to come to a decision on this matter. I really do need help...

Thank you.

romarnh

 

[901]

I needed a lot of work and I told the surgeon that I only wanted him poking around in my chest once. He recommended mechanical saying it would last longer than I will. So far, so good! The rat poison is not a big deal and after awhile the clicking isn't noticable unless I listen for it. It would be very disturbing if I listened for it and couldn't hear it!

 

[romarnh]

Reply to Doug

Reply to Doug

Thanks for the response Doug. How old were you when you had the surgery?
Was the clicking very annoying at first?

 

[Karlynn]

Welcome! Valve choice is always a tough one. At 66 a tissue valve could last you the rest of your life, but if it needs replacing, you would be at an age where surgery (or however they are replacing tissue when the time comes) could be risky.

Getting a mechanical doesn't guarantee you that you won't have another surgery. But at 66, if everything goes normally, you most likely would not have to have another one.

I've had my St. Jude mechanical for almost 15 years. I was 32 at the time it was put in. I only hear the clicking at night sometimes, or if I'm in a small tiled bathroom. As 901 says - I'd be bothered if I didn't hear it!!! Taking Coumadin is not the nightmare life that some would lead you to think. You eat what you want, drink what you want, pretty much do what you want, and let your dose be adjust to that. We have, in my opinion, the world's best resource for Coumadin information in our member Al Lodwick. I would recommend going to his site and doing some reading. www.warfarinfo.com

I would have to say that if I were 66, and it was my first surgery, that I would lean towards choosing a tissue valve. With a second surgery, I would be as confused as you are.

This is just a suggestion - after doing some research here and on Al's site, I would pick a valve and then talk with the surgeon about a game plan. If you are leaning towards tissue, I would ask the surgeon to assess the scar tissue and other factors once he gets "in there" and make a professional judgement based on what he felt would be present for another surgery in, say, 20 years. If he's already seeing lots of scar tissue from your surgery 4 years ago, I'd (personally) choose mechanical. If he's not seeing much scar tissue and (other than a failed repair) an otherwise overall healthy heart and overall total health, I'd choose tissue. But these are just my thoughts based on what I know now.

You have options - the only wrong decision is to not have anything done.

Best wishes!

 

[Georgia]

Check out this information - one of our members has written some terrific posts on this topic: http://www.valvereplacement.com/forums/showthread.php?t=14330

 

[Liz]

Welcome to VR.com, so glad you found your way here. I can't address your question based on my own experience, but I've seen a ton of threads here discussing the pros and cons of mechanical vs. tissue valves. So in addition to the responses you get on this thread I'd encourage you to poke around more and go back to old threads, maybe someone could suggest a good search word for you to use. Good luck with your decision and your surgery, and looking forward to hearing more from you as you feel like posting.

Take care,
Liz

 

[ALCapshaw2]

Welcome romarnh

Your question is one of our most popular. There is an entire Forum devoted to Valve Selection which I highly recommend that you read.

I believe the Bovine Pericardial Tissue Valve has the greatest longevity in the Tissue Valve arena, especially when implanted in patients over 60 years of age. Durability data is running around 90% as recipients approach 20 years of service (for older recipients).

FWIW, the Bovine Pericardial was my first choice but due to extenuating circumstances, my surgeon felt a (St. Jude) mechanical was my best option after opening me up. I can *sometimes* hear my valve as a 'soft reassuring tick'. It is NOT loud and most of the time I am completely unaware of it.

Living with Coumadin is NOT difficult on a day to day basis. It does complicate having other invasive procedures. Most of us opt to use 'Bridging Therapy' with Lovenox Injections (at home) or a Heparin Drip (one week in the hospital) when undergoing invasive tests or surgeries.

There is an EXCELLENT website about living with Coumadin at www.warfarinfo.com, written by AL Lodwick, a certified anticoagulation provider and active member of the AC Forum on VR.com

There has been considerable discussion of all of these topics which can be found by doing a SEARCH for the appropriate key words. Click on SEARCH at the top of the page.

'AL Capshaw'

 

[susieq14]

Welcome to VR! So sorry to hear that you need to have a second surgery so soon. I can't offer any helpful advice about valve choices since I'm a novice at this and still in the "waiting room" but I did want to wish you all the best as you do your research and prepare for September 21.

Good Luck!
Sue

 

[Janea]

If I were 66 I would definately get a mechanicle valve because having another surgery to replace a tissue valve when you are 76 or 80 something is a lot riskier than when you are younger. I have a tissue valve and probably will someday go mechanicle and I am worried about the ticking too. I am sure it is something you will get used to eventually. Good luck!