Tissue vs Mechanical

[LoveMyBraveHeart]

My husband was concerned over an anti-coagulation regimen, so chose a tissue valve. The valve failed in less than 6 weeks (that is not a typo, he went back into heart failure in a few short weeks. And no, it wasn't because of surgeon experience as he was operated on by the world class Lars Svensson of the Cleveland Clinic). They attempted a TAVR procedure to repair it. That was unsuccessful. He had OHS 9 months after his first and chose an On-X valve. While I understand the progression that has been made in TAVR and how it is appealing to many (it was a large reason we chose a tissue valve the first time...who wouldn't like the opportunity for their valve to be replaced via TAVR instead of OHS), I am happy to have a husband that is alive and well...his faulty tissue valve nearly killed him. Oh well that he takes Warfarin. No big deal for him. I think while it is important for any one in the "waiting room" for their valve replacement to weight the pros and cons of a mechanical valve, I think it's equally as important to research tissue valves and their pros and cons. Each valve comes with them, even "brands" have pros and cons. So, you may see very little reason to select a mechanical valve, however, my husband's life is a good indicator to me of a strong reason to choose a mechanical valve, and many other's share similar views. Which is not to say that tissue valves can't or aren't a successful option; they absolutely are, but they aren't the right choice for everyone. Just as Mechanical valves may not be the right choice for everyone. He is only 26, by the way, and has 3 OHS and one TAVR, all in less than 9 months. Mechanical was and still is our first choice.

Thank you for the reminder of how far he has come in such a short time...boy am I grateful!

Be well,
Jill

 

[jcgtok17]

That is why this is a great site. Even with "tribes", as noted, all keep an open mind and remain cordial. My AVR procedure was just over 3 years ago in Tokyo. Severe regurgitation from infective endocarditis meant I was effectively at the stage of heard failure upon admittance. As the Japanese tend to be smaller, the Edwards tissue value is more prevalent but they opted for the St. Jude Medical GT tissue valve in my case. Mechanical was given no air time and given both my state and limited Japanese I chose to go with the recommendation of my very learned Doctor. Not as brisk as I'd like, but I ran 205km in April and 227 so far in May. TAVR procedures are covered under universal healthcare in both Japan (current abode) and my home country of Canada. As my existing valve in 27mm I should be a good candidate for this procedure when the current one has run its course. IF this valve were to need replacing before to 10 year anniversary and TAVR was not possible for some reason I would definitely give consideration to the On-X mechanical value (or whatever the "cat's pajamas model of the day is) to ensure I was "one and done" on the do-over. Regards, Caleb

 

[PAN]

So please read thoes posts in the Anti-Coagulation forum before you make a decision.

Glad to hear your valve is serving you well.

I'm 42 and have been reading AC forums here and elsewhere for the last ten years. Right now it is mechanical , 100%

I'm still waiting but getting closer to the op, maybe polymer valves will become the preference in the coming years. I wonder if offered the option to try one of those over mechanical would i take it ?

If we have time to select our preference then I think that is pretty good going. I feel lucky that it is a repairable condition.

best of luck for the future,

P

 

[user 15848]

Back in 2015 iwas 63 and didnt know what to do, the 5 doctors in my family advised me to go "mechanical", my cardiologist advised me tissue; Here in this forum i found different perspectives on the matter, and after reviewing what i found here, and listening to my 2 sisters and cousins, all doctors, i choose mechanical to the outrage of my cardiologist who patronized me telling me he knew better because was a cardiologist, and that was last time i saw that cardiologist Wolf is his last name; for me all came down to the "reality" of the fact that i was born with a defective heart valve, bicuspid, something that 3% of world population encounters, and the fact that life would never be the same after surgery; the only difference was the choice of going "once" for surgery or 2 or 3 times maybe; TAVI?, well, a lot of things happens inside your body when u place a foreing element, something called PANUS, and other body actions against something that was not there before; Arnold the Terminator was supposed to have a TAVI but the doctors could not perform it, so had to go to a 2nd open heart surgery, check it out, So, Tissue = No Warfarin ( at least till you get older ) and 2nd operation is for sure, TAVI is a possibility not a certainty; So, "for me", from "my perspective", planning to go for a second time to a hospital for a second time no thank you, although is free, no thanks. Just a thought

 

[Agian]

The human brain wants us to be part of a tribe. This is built in for survival purposes.

Hey, that's a pearl of wisdom. It makes sense.

 

[pellicle]

So we have to realize this and try to think in non tribal terms.

^^^this^^^

Now speaking generally (not directly addressing vitdoc)

I usually say this isn't like buying a new Stereo or Car ... its a decision which has much deeper ramifications.

However I also usually say flip a coin. If the answer you get is unappealing then explore why. Neither is a bad choice, you just need to understand the factors and how they apply to you. The key here is "understand the factors" ... not just imagine you do.

 

[tom in MO]

Small mistake here?

Yeah, I chose mechanical. I wrote too many words Software won't let you edit after a day or so

have you ever heard of such a manufacturing error / issue with a mech valve?

I researched my own valve. There was one entry in the FDA database which was catastrophic failure where the leaflet came unattached on one end resulting in death

 

[neil]

havnt been on here in awhile so thought id pop in, glad to see a few of the old faces still around, see the old chesnut still around lol, ive had my porky coming up 14 years and still honking away, agree with a lot on here its what make you sleep well on a night, no bad choices just good ones that keep you alive, hope your all keeping well and safe

 

[LondonAndy]

This comment is not aimed at any tribe, and is said more wistfully than anything, and not to be taken in complete seriousness. But are we not all biased? We are alive thanks to whatever decisions we have made. The people who could really add some useful information here are those heart valve recipients who are sadly no longer with us.

Now, time to load the dishwasher!

 

[TomD]

At age 66 it was a no-brainer for me to choose a mechanical valve. I had read enough about bovine valves to realize that they could fail within 10 years and probably for sure within 15. In no way did I want to go through the operation again in my late 70’s or 80’s. Ten years later now I am so glad I don’t wonder when my bovine valve is going to quit.

And the as to Coumadin, having my own tester and managing my own dosage with a simple spreadsheet is very easy.
The constant thumping in one‘s ears, especially when you lay your head on the pillow, is annoying at first but within six months it totally went away and doesn’t bother me at all. However, I do find it interesting that my grandchildren can hear it ticking and I don’t hear a thing.

if I have been 50 years or younger than I might have gone bovine.

 

[Protimenow]

Don't play hide and seek with the grandkids by standing behind a door -- they'll hear you.

When I tried it with my daughter, years ago, she got to the other side of the door and said 'Hi Dad.'

 

[Superman]

Don't play hide and seek with the grandkids by standing behind a door -- they'll hear you.

When I tried it with my daughter, hears ago, she got to the other side of the door and said 'Hi Dad.'

I’ve been fired as the tooth fairy at my house. Kids hear me.

 

[Protimenow]

Yeah. But if you let them know that the best tooth fairy walks around with a loud watch, this may work.

These days, it's not cash that goes under the pillow -- it's debit cards

 

[MaryC]

My brother and sister-in-law both received bovine tissue mitral valves in 2006 and both were overall happy with their choices. The maze procedure was performed on both of them during their heart valve surgeries which was supposed to help with keeping the heart in rhythm. Both ended up having heart rhythm issues that required them to take warfarin. My sister in law died of non-heart related issues but my brother continues to struggle with a-fib and his cardiologist has recommended his heart valve be replaced in the new few months (not because of a-fib). We make the choices we make, I had a mitral valve repair, and we are lucky to be able to have treatment choices that allow us to continue to live a full life. I just wanted to point out you can't assume not choosing a mechanical valve means no warfarin.

 

[tom in MO]

Seven years ago I read that in patients >70yo, about 25% of tissue valve recipients wind up on warfarin for a non-valve related reason. But that was probably before eliquis came out.

 

[angiedavis]

I had a tissue valve 3 years ago because I didn't want to be tied to the Warfarin for the rest of my life. My body rejected the tissue valve and I had to have the valve replacement again and have to take Warfarin for the rest of my life anyway. I cannot give any advice other than it depends on the age of the patient and whether they want to go through the procedure again. I am having a much harder time recovering this time than the last time because of scar tissue.

 

[ninjasam17]

I personally did tissue a few years ago and it was fine for me. Really depends on your specific situation since there are pros and cons to each. Some people's body would reject a tissue when and at time it does come down to luck. Therefore choosing the right valve is very important.

 

[stephenismycopilot]

I was 37 and went with tissue (Inspiris Resilia) at the very strong suggestion of my surgeon and cardiologists. The three months I was on warfarin, we never really got it stabilized. I'm now seven months out and all is going well. It's a very personal decision, and as you'll see on this forum, there are passionate defenders in both camps. But really you know yourself and your lifestyle better than anyone else. And remember: there are no wrong decisions.