Who has tissue AV?

[LauraS]

Having surgery on Thursday, July 2nd. It looks like many here have mechanical valves but my surgeon said.......it is my choice of course.......but of all the medical field patients he's operated on, not one has chosen mechanical. Opinions, please? I have 6 days to decide and I'm almost 59 years old.

I'm concerned with the possibility of hearing it click? He said they don't know why that is but it does happen. I think it would drive me crazy.

Thanks all.

 

[Woodbutcher]

The ticking WILL drive you crazy ! Luckily I've always been crazy so I couldn't get any worse ! In truth though, after 6 months sometimes I dont notice it at all, but then again sometimes I just can't get it out of my head. You do get used to it for the most part but there are many times where it drives me nuts and brings me down.
Some people report of never hearing theirs though ?
For me it was the lesser of two evils because I really didn't want to be opened up more than once if I could help it and this shiny On-X they've given me should manage 100,000 clicks a day for a hundred yrs, so it should see me out ?

 

[Megan]

ive had both- a brand new mechanical that replaced a bovine tissue. I never heard the tissue valve but the mechanical valve- its and ats-i can hear when its very quiet- like right before i fall asleep. im praying it gets better with time. i too was terrified of the sound because i couldnt sleep in aroom with a ticking clock but it hasnt been as bad as i expected. At age 59, you have at least a good 18-20 years of possibility of freedom from reop even though there are never any guarantees. if i was you id go tissue. btw, the reason my tissue valve was replaced is because i was only 29 when i had it put in and had two children with it--both young age and kids cause the tissue valve to calcify quicker --doesnt really happen in older patients over the age of 50 for some reason at least in most cases.. hope this helps!

 

[john79t]

I am having surgery on Tuesday June 30. I am 61 and I did not want to deal with the cumidin. I am going to need surgery to replace a hip after the valve surgery and it would be more complictaed and more risk with the blood thinner. I am getting the Caroenter Edwards Paramont Bovine valve. It should be good for 20 or more years.

 

[gerriann]

I am a medical speech pathologist who works with many OHS patients. I am 53 years old and chose a tissue valve in order not to spend the next 40 yrs. managing my coumadin. My surgeon, who is my age, said that he would chose tissue as well. The current generation of biosynthetic valves are currently at 15-17 years without showing signs of failing. Hopefully, by the time we need a replacement, they will be doing it in the cath lab.

 

[COLLEEN S]

I'd try the valve sparing procedure. Then I'd go the tissue route. I have avr mechanical but I had my 2nd ohs at 46, and my aortic valve fell apart in the surgeons hands, so no option there. Please come back after and let us know what you decided. Best wishes.

 

[Johan]

Laura. My AVR is scheduled for 1 July a day before your own and a day after John79t's surgery. Over the last few months I went from mechanical to tissue and back and did a lot of research and spoke to many professionals. I am 66 and finally settled on a tissue valve, the same make and model as John. Freedom from anticoagulation as an older person was a major deciding factor for me. Johan

 

[Marguerite53]

If it's only the clicking you are really concerned with, then you should go tissue. I am virtually certain there is NO clicking EVER with a tissue valve. My bovine (tissue) valve has been in place for over 3 years now (I was 52 when I had my AVR) and it does not tick.

If you are worried about coumadin, it is possible that even with a tissue, you might be a candidate for necessary blood-thinning therapy. It does not happen often with tissue, but it does happen.

This is a somewhat touchy subject here on this forum. You are right in that age zone where there isn't a tried and true choice. If you were in your 30's most of us would have the opinion to go mechanical. If you were in your mid 60's, we'd probably have the opinion to go tissue.

This is a very important decision that you make with your surgeon. Please be sure that you understand the differences in valves (there are different kinds of tissue valves as well, are you thinking bovine or porcine?) as completely as your mind can get around it (it's a lot of information to process!!).

Good luck! We're here for lots of other kinds of questions, too! Ask away!

Welcome, and Best wishes.

Marguerite

 

[OldManEmu]

Silence

Silence

I received a tissue AVR (porcine) at 41 in 2004.
I must say I have no noise or sensation of any thing abnormal with the valve.
I find that there is no abnormal feeling with my heart beat unlike when I had endocarditis and my valve was deteriorating.
Unfortunately you are in the grey area where going tissue may entail a redo; I consider a redo in my late 50's the price of an unencumbered lifestyle in the interim.

 

[dick0236]

It's your call. Personally, I have not, nor has my spouse, heard my valve for many years. Maybe we just got use to it. No other person has remarked that they could here me ticking.

Although I had no choice between mechanical or tissue, I am thankful (in hindsite) that I got a mechanical as a young man. It undeniably has saved me from a number of reops. Warfarin can be a pain in the A..(but it is not the horrow that some make it out to be) and it is a lifelong commitment.

It all seems to boil down to what is important to you. The probability of no anti-coagulant or the probability of no future surgery. "Youse has your druthers and youse takes your picks"

 

[Ross]

One thing, don't use Anticoagulation as an excuse in choosing a valve. Should you go with tissue and end up with chronic afib, your going to be on Coumadin anyhow. I'm simply saying don't go tissue to simply avoid Coumadin. Your at the age where you can go either way. Personally, I think I'd shoot for tissue and hope it lasts as long as they say the new ones will.

 

[Bina]

Laura, if I had been almost 59 at time of surgery, I'm sure I would have been leaning towards tissue.

 

[Lotti]

Hi Laura
I had my valve 3 years ago at 37 and went for tissue. Is is doing well despite being faulty and should last me many years.
If I had to do it over I would go mechanical because the surgery was really rough, but if I was 59 I would definately go tissue and hope it lasted 20 years as many are said to these days.

Hope it all goes well for you

Lotti

 

[Superbob]

Laura,

My advice would be to read everything you can on this question (and there is a lot here, plus available to be googled), and make a list of the pros and cons of both tissue and mechanical, and then go with what looks like the best choice for you. Either way is a good choice; the only bad choice would be doing nothing.

For the record, I was 63 at the time of my surgery, and after giving it a lot of thought (and making my own list), and listening to some great advice from folks with various perspectives here, I opted for tissue. The biggest question for me is what if I live to a ripe old age, and this Freestyle of mine lasts right along with me. How would I do with a re-op in my 70s or 80s? (Or could I even get one, depending on what our health care system looks like by then?) But none of us has a crystal ball and I am content with my choice.

 

[tobagotwo]

Be fair, Ross. Anticoagulation is a viable excuse for not choosing a mechanical valve. And reops are a viable excuse for not choosing a tissue valve.

They are the two bugaboos in the business, and always have been. If either of them were eliminated, there would be no controversy, no guessing, no real decision to be made.

But thereby hangs a decision...

Best wishes,

 

[LauraS]

I am a medical speech pathologist who works with many OHS patients. I am 53 years old and chose a tissue valve in order not to spend the next 40 yrs. managing my coumadin. My surgeon, who is my age, said that he would chose tissue as well. The current generation of biosynthetic valves are currently at 15-17 years without showing signs of failing. Hopefully, by the time we need a replacement, they will be doing it in the cath lab.

Thank you all for so much good information. You are truly an amazing support group and I'm so grateful that I found this forum.

The surgeon operating on me this week said exactly the same thing as Gerriann about by the time I may need a new valve, the procedure will be done in a cath lab. He said they will probably just insert a new valve within the deteriorating valve in a simple procedure by then. He is head of Cardiothoracic Surgery at Newark Beth Israel and was formerly at the Cleveland Clinic. I have complete faith in him but as you know, they leave the valve choice up to us.

I am leaning 100% towards tissue and will google porcine vs. bovine now as I don't have a clue as to the difference. My sister is a nurse and she said she would go tissue also.

John 79t and Johan - good luck this week. Hopefully, we can all be online in a week or two breathing a big sigh of relief that this is all behind us. I keep thinking that one week from this moment, I will be 2nd day post op and feeling alive again! Whoever said the anticipation is the worst part of this surgery is so right!

 

[Jkm7]

If the choices were clear and obvious, we wouldn't have the need to struggle with the decision and most of us spend considerable energy learning and choosing.

If it were me, I'd go with the tissue. Actually, I did choose tissue valve and am now so grateful I made that choice. For me, a bovine mitral valve was the right one. It sounds like you have almost made your decision.

Best Wishes to you.

 

[Kathy McCain]

Hi Laura,

I chose a Medtronic Mosaic tissue valve. I was 56 at the time of my surgery. It is supposed to be the latest, and greatest. Lasts up to 20 yrs. I did NOT WANT to hear ticking! I do not have the personality for that. I also did not want to be on coumadin. My surgeon was 60 at the time, and he told me he would definitely choose a tissue. I am happy with my choice. I have talked to several people who know people that have mechanical valves. They all tell me you can hear it when they are in the same room.

Good luck to you! Please keep us posted.

 

[Bridgette]

I have a mechanical valve (On-x). My partner and my kids say that they can hear it sometimes, but not very often really. It's usually when I'm in a very quiet room that I notice it.....I am used to it now and it doesn't bother me anymore.
No-one outside my family has ever mentioned hearing it.

 

[Ross]

Be fair, Ross. Anticoagulation is a viable excuse for not choosing a mechanical valve.

I totally disagree. How many people have we seen in the 8 years I've been here that went tissue to solely avoid Coumadin and ended up on it anyhow? You can find reasons in choosing what you wish, but using anticoagulation as a deciding factor is not the way to look at your choices.

People are forever coming in here and wanting to avoid Coumadin. They've been told all sorts of horror stories, of which most are from the old days when they didn't know any better, so they automatically look at Coumadin as something to be feared and it's not. All I'm asking of anyone is to do the homework on Coumadin just as you are in choosing your valves. Don't rely on hearsay from the friend of the friend who's uncles grandpa was on it and had bad things happen.