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Pat

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Aug 18, 2009
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My name is Pat and I'm 53. I'm going in for valve replacement surgery next Thursday. I have not decided which type valve to go with yet. I want to be able to continue to play sports and lead a somewhat normal life. I have heard different stories about taking anticoagulants. Do i go with a tissue valve or mechanical valve. That's the big question. Any suggestions would be great.
Pat
 
Pat, No one on here should tell you which valve to choose or, in my opinion, even try to sway you towards one or the other. All of us have made our decisions based on info. from our Dr.'s and what risks we are willing to live with. Mechanical valvers do have to take coumadin for life. Most of them will tell you that it doesn't keep them from living a very full, active life. Tissue valvers typically avoid coumadin (unless you develop a-fib), but at your age, would most likely be facing another surgery. So, you have to weigh the pros and cons of these two and decide which one fits you and your personality better. Neither choice will be a "wrong" choice.

Good luck to you.

Kim
 
Welcome to VR Pat & I hope that by communicating your questions here, making your choice of what type of valve to choose, easier. Whatever choice you make, tissue or mechanical, will be good so long as you are comfortable with the choice you make. The key is getting as much information on both type valves & disspell any myths you may have on anticoagulants.

I've been on coumadin for 34 years, have had 3 OHS & have had other major surgeries in my life & coumadin was never a big issue. I have also lived as normal & as active a life as perhaps someone who has not had 3 OHS can have. The only restrictions I had were those I placed on myself because I cherish the 2nd, 3rd chances of life the Lord has given me.

So if you're worried about being able to have an active life after OHS & on coumadin, think again my friend. Not a problem!!!

Good luck to you & keep asking questions! :)
 
Pat, I responded to your question in the thread by Mileen 46. Good luck, we've all been there and done that....sort of. Each case is a little different. I never had to choose between mechanical or tissue...... thank GOD.
 
I sure dont want to have another surgery again. Lucky for me i don't have any blocked vessels. I'm leaning towards the mechanical valve. I just had concerns about the coumadin. I have been taking baby asprin for years and that has not bothered me.

Pat
 
Well sword fighting would be out, if you ski, you might want to avoid smacking into a tree, but then, even if not on Coumadin, that might be a little lethal. Anticoagulation is about common sense. Anyone who hits their head could potentially have a fatal bleed whether or not they are on anticoagulants.

The active lifestyles forum is full of both Mechanical and Tissue valvers and they all enjoy doing what they love....LIFE.
 
Pat said:
I sure dont want to have another surgery again. Lucky for me i don't have any blocked vessels.
I'm leaning towards ***the*** mechanical valve.

I just had concerns about the coumadin. I have been taking baby asprin for years and that has not bothered me.

Pat
Click to expand...

Actually, there are 4 (maybe 5) MAJOR Manufacturers of Mechanical Valves in the USA (and some more in Europe).

You can find details of their valves on their respective websites (which have been posted on VR.com or can be found from a GOOGLE Search for the company names).

The manufacturers are ATS, Carbomedics, (Medtronics), On-X, and St. Jude.

St. Jude was the First BiLeaflet Mechanical Valve and has a track record approaching 30 years. see www.sjm.com

Carbomedics was next in line, along with ATS.
BOTH designed by Jack Bokros, Ph.D., who consulted with St. Jude on their leaflet design (he created the material).

On-X is the "Latest and Greatest" design from Jack Bokros based on a lifetime of experience designing Heart Valves. Do a Search (on VR.com) for "Bokros" to find posts detailing his experience. See www.heartvalvechoice.com and www.onxvalves.com for details on the technological improvements incorporated in the On-X valves.

Comparison Data for each of those valves was presented in a Thread entitled: St Jude , probably in the Valve Selection Forum.
 
Hi, Pat, from a fellow new(er) member. I just had AVR surgery in April 2009, and like you, had no vessel blockages. I can relate to the decision you are faced with. I echo all the sentiments already posted about this very personal choice and the things to consider. I will just add that, at age 41, I chose the mechanical simply because I didn't want to sign up for another one of these surgeries in 15 years or whenever!

Getting the Coumadin dosage dialed in has been a bit of a challenge, but not a big deal. Being on Coumadin has not limited me in any way -- I am back to riding motorcycles and bicycles and everything else I was doing before surgery.
 
Seeing as all you have heard from are mechanical valvers, Pat.....

thought you might wish to hear from someone who chose tissue valve at my second OHS.

Among the reasons for my choice was the reluctance to take a chance my valve would click loudly. My surgeon told me he could never predict who would have a loud valve and who would not as he never found a firm pattern between large, barrel chested people and tiny, petite, thin little ladies. There isn't necessarily the logical correlation one would expect.

I also did not want to take coumadin for the rest of my life if I could avoid it. Just my personal choice and I know that even with tissue, there is always a small chance of a-fib and the need for anti-coagulation.

I also am a believer that so many reports from a large number of exceedingly credible surgeons that in the near future percutaneous valve replacements will become common and open heart surgery as we know it may not be necessary in many cases. My Mass General Surgeon was of the strong opinion that in the near future, many valves will be replaced by cath.

There are arguments both ways and the only bad choice is to not make a choice.
I am very, very happy I chose tissue valve. For me, that was the right choice.

Best Wishes.
 
To answer (or not answer) your question, you can continue to play sports and lead a relatively normal life with either a tissue or mechanical valve. The major difference seems to be that with tissue valves anticoagulation is generally not required, but a reoperation is generally required somewhere around 15 - 20 years or so. The advantage with mechanical is that it theoretically will last the rest of your life and thus a reoperation is avoided. The disadvantage with mechanical is that anticoagulation is required. So, your choice becomes whether you think you would prefer to have a reoperation, or do you think you would prefer taking anticoagulation medication? Also, as another poster indicated, some folks are concerned about valve noise with mechanicals. There are many, many posts on the same question(s) you have posed, primarily in the archives of the valve selection section. You can perform searches and find a lot of discussion related to your concerns. I would guess that you will need to finalize your choice soon if your operation is next Thursday. Whatever your choice is, good luck.
 
It's a monumental decision all right - one I will be struggling with myself soon. I'd say there is no wrong choice. You weigh the pros and cons and make the leap. There are no guarantees in either choice you make as to whether you would never need warfarin or whether you would never need a reop. My sense from reading a lot of things on here that once someone makes a choice and it is all said and done, they seem to be confident that they made the right one.

Another piece of advice I read in here is to always have a plan B choice in case for some reason plan A won't work.

Rhena
 
Welcome and good luck to you! I am sure the choice you do decide upon, will be the right one for you! Get as much info as you can from your cardio and surgeon, and take it from there.

Please keep us posted!
 
Mechanical or tissue?

Mechanical or tissue?

My mother chose mechanical at age 48 and is going strong with it at age 71. She works out with weights, runs on a treadmill and hikes hills and mountains all over the place. She's very happy with her choice. I chose tissue at age 53 because A) I wanted to avoid anticoag. therapy (although it was no big deal the 3 mths I was on it); B) I was concerned about the ticking noise; and, C) right or wrong, I felt a tissue valve would perform better (hemodynamically, better red blood cell survival) under extreme exercise stress. Most people don't subject themselves to that kind of punishment so that wouldn't be a concern. I know I'll need another AVR. I'm not looking forward to it, but I'm happy with the choice I made given the options and my lifestyle. If I end up having to replace this valve before something minimally invasive becomes relatively "routine", I hope On-x will have proven itself. But who knows what additional choices (perhaps none) may be out there at that point. I know, doesn't make your choise any easier but it's great to read about other people's reasoning, isn't it? I look at it this way: we are incredibly fortunate to have some options and to have such a wonderful forum as this to learn more about them.
 
TXWildflower said:
It's a monumental decision all right - one I will be struggling with myself soon. I'd say there is no wrong choice. You weigh the pros and cons and make the leap. There are no guarantees in either choice you make as to whether you would never need warfarin or whether you would never need a reop. My sense from reading a lot of things on here that once someone makes a choice and it is all said and done, they seem to be confident that they made the right one.

Another piece of advice I read in here is to always have a plan B choice in case for some reason plan A won't work.

Rhena
Click to expand...

Well said, Rhena ! You can develop a-fib with a tissue valve and require anti-coagulation, and there are things that can go wrong with a mechanical that require re-op, but the chances are on your side in both cases.

Also wanted to welcome you to the madhouse that many of us call "home".

BTW, I was 52 and chose mechanical; I do not hear it ticking unless the room is very quiet, or I am in a small tiled bathroom where sound echoes anyway. I live a normal active life . . . anticoagulation is only a small part of my life, and is not a big deal.
 
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