Welcome to the forum Jack!
My surgeon says that a biological valve is better for me, an he says that there is long duration valves that can made 20+ years, but I havent find no mention of this anywhere in internet.
When I was 52 and approaching my time for surgery, I had consults with two of the top heart valve surgeons in the US. They both told me the same thing. At the young age of 52, I should expect a tissue valve to last me about 10 years. The younger a person is the quicker that they go through tissue valves. At one point this was believed to be due to young people being more active. There is now a shift in thinking that it might also have a lot to do with the fact that a younger person has a stronger immune response and attacks the foreign tissue more aggressively.
The valve that your surgeon is probably referring to is the Inspiris Resilia. There is hope that this valve will do a little better than previous generations, at delaying SVD (structural valve degeneration), which will eventually happen with a tissue valve. It's unfortunate that your surgeon is giving you hope that this valve will last you 20+ years. To say that this is optimistic, for a person who is 36, is beyond optimistic. Is it possible? Sure. Then again, I might win the lottery tomorrow. It's possible. As mentioned earlier, I spoke with two top surgeons in the US, specifically about this valve and both said expect 10 years. One of the surgeons was even involved in the design of the Inspiris Resilia, so he is really hoping this valve will do well. But, when he gives expectations, he follows the evidence.
Every guideline in every country in the world recommends that a person at age 36 should get a mechanical valve. These valves are designed to last longer than we are. This was the choice I made at the young age of 53. Yes, 53 is young in the heart valve world. And if 53 is young, at age 36 you are very very young in the valve world. If you take the time to read many of the threads here on the forum, and I hope you do, you will find the stories of several members who received a tissue valve at a young age only to regret it when they had to get operation #2 or operation #3. You will also find a couple of members who defied the odds and have not yet had to get their reoperations, even though they received their tissue valvesat a young age. Some people do win the lottery. The question is whether the casino is a good choice to try to grow one's financial well being. .
Having said all that, if you do follow your surgeon's lead, which is totally understandable, I would suggest the Inspriris Resilia is a very good choice. I am almost certain this is the valve he is referring to. Although I chose mechanical, if I had gone tissue, this is the valve that I would have gone with. But, if you get other surgical consultations, you will probably find that your surgeon is not in line with other surgeons and I expect, given your young age of 36, most will tell you to go with a mechanical valve, which follows the guidelines for someone your age. I do hope that your medical coverage in Brazil allows you to get second opinions. I would suggest getting at least one more opinion and even better if you get 2+ more opinions.
Im also diabetic, controlled now, and high blood pression - that no so controlled.
It is super important to control both of these. Having uncontrolled high blood pressure is correlated with faster SVD, so I do hope that you get this under control. And, I hope that you are making serious lifestyle changes to control your diabetes, with diet and exercise. Diabetes was once thought to be irreversible, but studies have shown that with lifestyle changes it can be reversed. We usually prefer to say that it can be put into remission, because if you drop the lifestyle changes it will come back. When you say it is controlled, I'm not sure if you are controlling it with medications or lifestyle changes, but let me know if you want more info on lifestyle changes that can be made to control diabetes. Even if you're controlling it with medications, I would strongly encourage lifestyle changes to control it in addition to the meds. You are young to have diabetes. As with almost all medical conditions, diabetes makes for drastically worse outcomes if it is not controlled, so this is really important.
As is often said, there is no perfect valve. With one valve, mechanical, you will be on anti-coagulation for a lifetime. With the other valve, you will have future procedures needed. At 36, this would equate to several future procedures. But, you are the one who has the live with the consequences of your choice- not your surgeon and not us on the forum. So, the choice is yours and yours alone to make. We are here to support you regardless of which valve that you choose.
