aortic valve replacement

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Chuck C

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Dec 5, 2020
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1,501
Welcome to the forum Wigwam.

I was 53 when I had my aortic valve replaced one year ago. I had two surgical consults prior and both informed me that I should expect about 10 years if I choose tissue. This is consistent with what your surgeon has estimated for you. On average, young folks go through tissue valves much faster than older folks. I ended up choosing a mechanical valve because I wanted to be "one and done" with my surgery.

I think a stumbling block is the social side maybe with drinking and some foods,
There is a lot of misinformation about warfarin out there.
The vast majority can drink when on warfarin. There is a very rare genetic condition that will cause a person's INR to go up significantly when drinking. I have had several days in which I drank plenty and my INR is either not changed at all or just a little bit, but not to a point to which it would put me in an unacceptable range.

Regarding not being able to eat "some foods", do you mean grapefruit? With the exception of grapefruit and possibly cranberry, you can eat just about whatever you want. There is a common myth that you can't eat greens or have to limit your greens when on warfarin. I eat two large salads per day, loaded with greens and other vegetables. No issues at all. Others will tell you the same thing. There are several threads about this topic and I suggest that you investigate it further if you have any doubts about it.

It is a big decision. The decision is yours and yours alone. If you choose mechanical, you will be the one who will live on warfarin for the rest of your life. If you choose tissue, you are the one who will face reoperation. It sounds like you are taking the right steps to make sure that your decision is an informed one. Best of luck with your decision and please keep us posted.

The procedure is not a cake walk, but it is probably not nearly as bad as many imagine as well. The success rate is extremely high, especially for people in your age range who get their surgery in a timely manner and it sounds like your team is on top of it.
 
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LondonAndy

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Aug 1, 2015
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London, UK
There are two other issues worth being aware of when going mechanical: the valves tick, and limitations on the use of anti inflammatory medications.

In my case, I have to really listen intently to hear my valve. But some others have posted that it is loud and annoys them. Others will know more than me about the reasons why, but over the years I have read that larger valves seem to be quieter, and how "in line" with the blood flow the surgeon has been able to get the valve affect this. Both of these issues are outside your control, but even if loud it seems people get used to it, even finding it comforting.

I was not aware of the meds restrictions before I had my valve done, and if there is a history of things like arthritis in your family this might be worth looking into more. Thankfully no arthritis in my family.
 

Brinntache

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Mar 25, 2021
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Hamilton, Ontario, Canada
There is a common myth that you can't eat greens or have to limit your greens when on warfarin. I eat two large salads per day, loaded with greens and other vegetables. No issues at all.
That's a big lie. You absolutely, positively, super-100% can't eat Kale, in any form. Like ever. It will instantly kill you with with all it's Vitamin K. Don't let anybody, including your super duper healthy spouse, tell you to try Kale salads, Kale smoothies, Kale chips. Just say "No dear, doctor's orders. You can have my Kale."
 

LondonAndy

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That's a big lie. You absolutely, positively, super-100% can't eat Kale, in any form. Like ever. It will instantly kill you with with all it's Vitamin K. Don't let anybody, including your super duper healthy spouse, tell you to try Kale salads, Kale smoothies, Kale chips. Just say "No dear, doctor's orders. You can have my Kale."
I don't like Kale either! :LOL:

PS Anyone got a medical excuse to decline Quinoa?
.
 

cldlhd

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Apr 9, 2014
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Levittown ,Pa 19054
Hi I'm looking for information, I'm due a valve replacement later this year I'm 47 years old but not sure whether to go for mechanical or tissue.
obviously mechanical will have to take warfarin and lifestyle change potentially last for ever.
the tissue valve not so much of a lifestyle change and no warfarin but question over how long the valve will last at my age, my doctor seems to think 5 to 10 years then will need another op. has anyone else been in similar scenario?
My valve was repaired and I had my aneurysm replaced but my surgery within a similar age. I had just turned 45. I told my surgeon, FWIW, That if the valve needed replacement I absolutely wanted mechanical. I can't imagine being in my mid 40s and choosing something which I assumed would require another surgery in 5 to 10 years? I mean to each his own but I'll pass on that. I would rather take the warfarin, monitor it and whatever minor changes needed to be done deal with them, but that's a personal decision at least you know that if you go with the tissue valve you're signing up for repeated surgery.
 

djman

Active member
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Mar 6, 2022
Messages
28
Welcome.

You could talk to your surgeon about doing a Warfarin trial before surgery. That is what I did. It was the final straw that convinced me to go mechanical. During the trial you will have to give blood quite often. Also your surgeon will probably want you to stop the trial a couple of weeks before the surgery.
 

pellicle

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Nov 4, 2012
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9,891
Location
Queensland, OzTrayLeeYa
You absolutely, positively, super-100% can't eat Kale, in any form. Like ever. It will instantly kill you with with all it's Vitamin K. Don't let anybody, including your super duper healthy spouse, tell you to try Kale salads, Kale smoothies, Kale chips. Just say "No dear, doctor's orders. You can have my Kale."
I was thinking about trying it, but even seeing it in the supermarket I broke into a mild bleeding rash...
 

wigwam

New member
Joined
Mar 24, 2022
Messages
3
Thank you all for your feedbacks and you a have all been very helpful. Its always difficult to believe what you read on the internet as everything is so negative, that's why I came on here to get info from people who have experienced it.
I have since had meeting with surgeon and also got a lot of answers from him too.
Thank you all again
 

Warrick

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Dec 27, 2015
Messages
761
Location
New Zealand
Hi wigwam,
my 2 cents worth..
My father had a St Jude bileaflet mechanical valve for 36 yrs until his passing at age 79 last year unrelated to his valve.
So mechanical valves do exactly what it says on the tin... last your lifetime.

Warfarin for me certainly caused me some anxiety early on but once I started self testing and management that quickly faded and I’ve been 100% looking after my own dosing for the last 6 yrs now. The fact my father was on it for the majority of my life warfarin was never something I factored in, in fact I never entertained the idea of anything but a mechanical valve.

So mechanicals are a one and done option unless you have something like an aortic aneurysm, if your native valve has failed due to being bicuspid then theres a high chance aneurysm will be a factor at some point. I had a bicuspid valve with artery dilation under the replacement threshhold so expect another go at some point, I only became aware of this after replacement so wether I would have gone mech with prior knowledge I don’t know.
The only draw back with mechanical valves for me is the noise from the valve, alot of people don’t hear their mech valves and theres even been a few posters on here who hear their tissue noticibly,,so its luck of the draw it seems. The sound is not something that should be a deal breaker but be aware of it, I was told it would become quieter over time as things healed but that never happened, you just tune it out after a while.
 

johninsd

Active member
Joined
Jul 27, 2014
Messages
30
Location
San diego CA
I was 67 when I had OHS in 2014. The surgeon put in a tissue valve and replaced the part of my aorta that was bulging - it was right at the root so the original valve could not close correctly and I was having a lot of regurgitation. After the surgery I had several episodes of Afib and Atrial flutter so was put on warfarin, supposedly until the rhythm was regular. Every time I went off the warfarin I had an arrhythmia of one type or the other soon thereafter. So now I'm on warfarin even though I have a tissue valve. Not so bad really - my diet and drinking habits haven't changed much and any changes are more due to aging than medication (I'm 75 now). I see my cardio once a year, will see her in July. I get my INR tested at a lab that's about a mile from home and it stays pretty consistent so I only have to test every 6 weeks as a rule - not a big deal. Exercise capacity has diminished - but I'm 75. Still riding bicycles, swimming, hiking and kayaking. Not doing triathlons any longer, I was always more of a participant than a competitor anyway. Running is out now as well since I had a partial knee replacement in September 2021 after a few years of limping due to severe osteoarthritis. Didn't mean to turn this post into a book - main point is that going tissue does not necessarily mean no warfarin but that if you do need to go on it it's not a big deal. And one more thing - it's my understanding that being on warfarin might be helpful if one contracts Covid 19. So far I've avoided that at least - and yes I did get the vaccine and the booster.
 

WandaW

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Apr 9, 2011
Messages
78
Location
Minneapolis MN
11 years ago at age 52 I discovered I had an AAA and a bicuspid Aortic valve. I had a possible episode of light A flutter and my blood pressure increased which was never a problem for me. My surgeon was recommended by the Cardiologist who diagnosed me in the ER and I am forever grateful. He said that a mechanical valve would last for the rest of my life and I wanted my heart to be OK forever. I have had an easy go with the mechanical valve, the Coumadin is not a big deal. They dose you based on your chosen diet. I have had no problems whatsoever. I have worked full time as an Occupational Therapist, had 2 knee replacements and all is good. Any heart problem is very scary to me and now I live the life I want without more worry.
 

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