Valve choice--tissue or mechanical?

[Guest]

Hello--
I was diagnosed with both mitral and aortic regurgitation 10 years ago (most likely phen-fen related).

My cardio is now discussing the possibility of surgery. I am fascinated by all the types of valves you are discussing!

I am 65 and had been assuming that probably a tissue valve would be the best choice due to age. What are the factors involved? I know the mechanical valves generally last longer but require coumadin, but don't know what the average life is for a tissue valve.

Thanks.

Pat

 

[geebee]

Some of the newer tissue valves are expected to last up to 20 years or more. I guess it just depends on how long you think you will be on this earth. Of course we never know for sure how much time we have but I am currently planning on being around until at least 100. So, if you were like me (assuming I am successful) and you get 20 years from a tissue valve, you would be looking at another surgery at 85. Just give some thought to that idea, talk to your doctors and I am sure you will come to a decision that makes sense to you and gives you the most comfort.

 

[Bridgette]

I am sure you will do well with whatever valves you choose.
Good luck with everything Pat.

Bridgette

 

[Bina]

I'm sure that some of our tissue valvers will post their experiences soon,
but I've heard that the Bovine valves are lasting quite long in older patients.....15-20 yrs.?

 

[kfay]

I have a tissue valve at 45, so I know, according to my surgeon, that I am looking at another replacement at around 55-58ish and then again around 70ish. I have a very good friend who's mother had a porcine valve for 23 years when she died 3 years ago at 80 from something else. You just have to weigh for yourself whether or not you want to take coumadin for life with a mechanical valve (which by the way, is not the reason I have tissue). I think most people on here with mechanical's will tell you that coumadin is not a big deal at all.

Educate yourself and then decide what is best for you.

Kim

 

[skeptic49]

Ah, the trade off between ACT and re-operation(s) makes this an interesting choice. I used to lean toward the preference for a tissue valve but now I have more of an open mind. I want to talk to some more people especially surgeon(s) about it for more perspectives.

Jim

 

[Mary]

Hello--
I was diagnosed with both mitral and aortic regurgitation 10 years ago (most likely phen-fen related).

My cardio is now discussing the possibility of surgery. I am fascinated by all the types of valves you are discussing!

I am 65 and had been assuming that probably a tissue valve would be the best choice due to age. What are the factors involved? I know the mechanical valves generally last longer but require coumadin, but don't know what the average life is for a tissue valve.

Thanks.

Pat

Pat, you say the cardio is now discussing the possibility of surgery. Hopefully that means you still are a year or two out from a replacement. I would ask the surgeon you consult what his experience has been with tissue longevity.
When I had replacement at the age of 53 with one of the new bovine valves, my surgeon, who performs many replacements each year, stated that he thought I would get 12 years from mine.
You're 65, so I imagine you could reasonably expect 15 years if you had your replacement today.

 

[Cooker]

All technical discussion aside (I don?t know enough to get technical) it will boil down to how you feel in your gut after researching and talking with your doctors and surgeon ? Some would rather face a possible/certain second/third replacement than be on ACT ? some would do anything to avoid a possible second/third replacement ? I truly feel that whatever you choose will be right for you??

I went mechanical with the recommendation of my cardio and surgeon ? based on lifestyle and age I know this was the best choice for me ? I did not want to be put in a position to second guess the medical professionals I trusted ? I can obsess about such things and it was one less thing I needed to be concerned with?.. Good luck!!

 

[neil]

hi like most of the people on herei believe it is a personnel choice,i talked it over with my surgeon and decided on a porcine tissue valve yes i face another op i had a hancock 11 valve fitted, my surgeon said it can last 10 to 15 yrs,maybe longer, who knows,all i know is either valve is better than the one you got,and am sure whichever you choose will be the right one,

 

[escargome]

Hi,
Just adding my vote. I'm 56 and chose a bovine valve.
Reason: Sleeping. I have a hard time with sounds, light (room never dark enough) etc. So even though I am facing the prospect of another surgery, I'm hoping that the less invasive techniques will be old hat by then but will deal with that situation when the time comes up.
Just like all the other opinions, just do a lot of research, ask a lot of questions and the right answer will rise to the top...
Good Luck when they finally give you a surgery time. For me, it sure didn't turn out as bad as I had thought.

 

[Lisa in Katy]

I was 36 so went with a mechanical for longevity. Frankly, at the time, I didn't even realize that tissue was an option for someone my age! If I have to have to have my mechanical replaced, I hope to be at least your age, preferably much older, and will consider a tissue valve, especially if they are really lasting 15-20 years. Really there are advantages and disadvantages for either, so it's a personal choice.

 

[Bina]

Hi,
Just adding my vote. I'm 56 and chose a bovine valve.
Reason: Sleeping. I have a hard time with sounds, light (room never dark enough) etc. So even though I am facing the prospect of another surgery, I'm hoping that the less invasive techniques will be old hat by then but will deal with that situation when the time comes up.
Just like all the other opinions, just do a lot of research, ask a lot of questions and the right answer will rise to the top...
Good Luck when they finally give you a surgery time. For me, it sure didn't turn out as bad as I had thought.

I hope people don't avoid a mechanical valve because of ticking.....I am a VERY light sleeper and my Regent does not "tick" or bother me in the least when I am falling asleep.

 

[Freddie]

Pat, as suggested talk to your surgeon and see how he feels about putting in either one.
It's important for you feel confident in your surgeon that he will do a good job in replacing your valve.
As for myself, I wasn't really given a choice in the matter. It was either repair or replace with a mechanical valve. "Cause I don't think you want to do this again" was my surgeons words.
Its been just over a year and I don't hear the ticking as much - only in the shower its really loud and its quieter than my alarm clock - when I use it
In regards of taking warfarin - its like recovery, it takes time to get stable in your proper range. You don't have to change in what you eat, just have to be a little more consistent with what you eat - but that too comes with time and that's why we are here.

This is a personal choice (when you have the choice) and I wish you the best of luck in making the right choice that's good for you.
Take Care

 

[Roger Frank]

My On-X is totally quiet and no reopens for me please! The last experience was quite enough for one lifetime...not to mention the expense.

 

[skeptic49]

If you are hearing challenged (like me) I assume that you have less of a possibility or wouldn't hear your own mechianical valve. Is that right?

Jim

 

[escargome]

I hope people don't avoid a mechanical valve because of ticking.....I am a VERY light sleeper and my Regent does not "tick" or bother me in the least when I am falling asleep.

patw, please understand that in actuality I wasn't promoting either type of valve. I told you what I was comfortable with and why. I hope that you can come to an informed decision that you personally will be comfortable with. I don't know about other people, but I did considerable research plus my cardiac surgeon was very truthful about both types of valves and his experience in the operating room. Truth be told, my cardiologist didn't even express an opinion since he said "this isn't my heart, nor am I doing the surgery". Again Good Luck to you.

 

[ChouDoufu]

there's a link to a roundtable discussion about valve replacement on the edwards site.
(from memory) the moderator asked the group of surgeons if they had to decide, how
many would want a mechanical. noone was brave enough to raise their hand.

 

[zipper2]

Hi Pat and welcome,

I know whatever you and your surgeon decide will be right

for you and all the best to you in your decision and surgery.

Looking forward to all your posts........Take care,don't worry

it well all turn out for you


zipper2 (DEB)

 

[Bryan B]

Pat,

Are you looking at getting both the mitral valve and aortic valve replaced? I'm not going to make a recommendation, but I will say that if I was trying to decide between a tissue or mechanical valve, having both valves replaced versus just one replaced would play a factor in my decision. If you do need both valves replaced it would be a good idea to ask your surgeon's opinion on how your choice of valves might make a difference versus if you only needed one of the valves replaced.

 

[tobagotwo]

I might point out that the estimates given above for tissue valve life are lower than the actual results. You are 65. That puts you in the premium group for longevity of a tissue valve. The majority - including patients of all ages - of one major brand of tissue valves is already lasting over twenty years. As valve ancticalcification treatments and nondamaging preservation techniques weren't even developed when those 20+ year old valves were made, the entire cycle should be improving as we watch. Being in the premium group, you can expect the highest yield on tissue valve life.

That's not to say you should have a tissue valve, but to balance the longevity expectations toward what is really happening with them, rather than the old numbers.

Best wishes,