I have personally seen a tissue valve last 6 months - and I have personally seen a tissue valve last 20 years - which one will you get?
Long termers here have seen that too. Tom included.
The chemistry of failure is well described too
That's why I cringe as people younger and younger are opting for tissue valves.
me too, having had a replacement valve at 28 the subject is close to my heart.
However many of the most vociferous opposers of me saying to someone under 50 the actual facts (and delivering a lot of hate my way for daring to go against their chosen saviour) are over 60yo. Pure irony.
For you statisticians out there, it's called +/- 3 standard deviation.
That's normal, but personally if the SD is small enough that's the key, but the SD should be very tight or that's just sloppy manufacturing. To my mind bioprosthetic valves are something like handicrafts or leather working, and while I've had my leather wallet for a long time now I expect it to fail and I'll buy a new one. I've still however got the same ceramic plates we got when I got married (and indeed I have a few from my parents for various reasons).
Leather gloves are comfortable, but they do wear out faster than my wood chopping axe's steel.
Another reason for the difference in durability is that leather is dead (and bioprosthetic valves are a type of leather) but native valves are living tissue, which (when healthy) grows and repairs over time
During every heartbeat, cardiac valves open and close coordinately to control unidirectional flow of blood. In this dynamically challenging environment, resident valve cells actively maintain homeostasis, but the signalling between cells and their microenvironment ...
Accordingly my hands still look the same (few more wrinkles) but I can't tell you how many pairs of leather gloves I've gone through.
Ultimately all the trade-offs are well understood, make your understanding equally well and pick the trade-off you prefer (warfarin or reoperation).