Peggy>>That probably depends on the patient though...
In transposition, the pumping roles of the chambers are reversed so the tricuspid valve is essentially taking the load a normal heart's mitral (or is it aortic?) valve would. That's a big part of why I lost my tricuspid valve. They just wear out after a while because they're not designed to take the workload assigned to them by transposition of the great vessels. It's also why, generally speaking, the atrial switch procedure is prefered over the Mustard (what I had.)
EVERY situation is going to be different. For me, the only real option short of repairing my native valve was an artificial one, but I have a complex heart anatomy which made using the mechanical valve which is more durable than tissue the better choice, inspite of the possible increase on clotting risks. On the other side, the St. Jude's valve that was used is very efficient and has a minimal clotting/calcification risk anyways.
I think the big key is how you take care of yourself afterwards. Eating a healthy diet, regular exercise, quitting bad habits like smoking.
It's a relative decision best based on good information and a careful reflection of one's own personal circumstances. Generally, artificial valves have at least the potential to "out-live" the patient. Tissue valves generally don't and may require additional surgery several years down the road. it might be a better choice for someone in the 50's and 60's or older because it probably will last them a lifetime, but if you're in your 20's or so and lead an active lifestyle, artificial might be better.
The options change again if you want to have children or are prone to other conditions that might complicate matters whether you go mechanical or tissue, it's all dependent on your own situation and if you have the "luxury" of choosing, then use it wisely and get all the information you can to make the most informed choice.
