Randy: I agree with you whole-heartedly. When I first found out that I was born with a BAV (October 2012-age 56.5), which caused the standard concurrent issues with my heart I was first terrified. I went many weeks with sleepless nights. It was horrific! I drew great comfort in reading of the experiences of others on this site, both pre and post surgery. Initially, I was thinking tissue valve. But, the prospect of two more surgeries in my lifetime was unacceptable. I learned of the ease of how others have dealt with the need for Coumadin. I credit dick0236 for helping me see this issue clearly. To avoid a mechanical valve solution simply because of the fear of coumadin would have been a dire mistake in my case. Valve choice is a very personal. I am confident in my choice of an ON-X Valve/attached Aortic Graft choice. I feel blessed with an excellent cardiologist and fortunate that he has referred me to a world class surgeon at the Hospital of the University Of Pennsylvania. Dr. Bavaria told me that there is only a 5% chance that he will need to implant a pacemaker. I feel fortunate that my TEE and cath revealed no CAD. My doctors tell me that I will have the heart of a 40 year old when fully recoved from surgery - my ejection fraction will likely improve from 47 to 60.My surgery is March 18th, 2013.