That would be me.
If you were to have a tissue valve implanted, the likelihood is that with a Mosaic porcine type, you would have a reoperation in 15-20 years, with a Carpentier-Edwards Perimount Magna bovine type, 18-23 years. That reoperation would likely be for your final valve either way, as it would last quite long at that age. We stop or slow down calcifying them as we get older.
However, whether that is the thing for you to do depends upon your personality and your perception of risk.
Mechanical valves produce a low, but fairly constant risk between the clotting tendencies of the valve type and the bleeding possibilities from the warfarin AntiCoagulation Therapy (ACT) required to lower the clotting potential. This risk does spike somewhat when the patient is asked to go off of warfarin temporarily for a medical procedure. Often these procedures do not really require abstention, and it can be circumvented or the risk modified by bridging therapy with Lovenox.
The risk from tissue valves is lower on a daily basis, but spikes when the reoperation is required.
The sum of the mortality risks is about equal between the types over time, so one will not lessen your risks over the other (unless you're over 65).
Some people have a relatively easy time with the surgery. If they have chosen a tissue valve, they are usually content with a reoperation down the road. I am one of those, having had a Mosaic implanted at 51. I will likely have another valve implanted before I'm 70 and be done with OHS, Providence allowing. The payoff for knowing a reoperation will be coming is that most people can live in a "normal" life, without anticoagulation concerns.
Some people have a bad time with the surgery, and want never to have to consider going through it again. If they have chosen a mechanical valve, they are usually content to live with what constraints present themselves, knowing they are unlikely to have another OHS for about 30 years or more.
Unfortunately, you won't know what surgery will be like for you until you undergo it, which is about one day too late to make a valve choice.
As far as the Mosaic valve, I'm enjoying the heck out of it. I have no complaints, and no limitations. It functions unnoticed, just like my original valve, which is what it's supposed to do. My echo tech said that it is not discernable from a normal, human valve, and she wouldn't have been able to tell, if she hadn't known ahead of time.
Best wishes,
Thanks Lezlie
