At 38 I think you'd be nuts to consider a tissue valve and I really dont understand why it's ever a consideration except in the case of woman who want to have children and those with no choice for some reason.
I've heard of too many cases now of them needing replacing in around 6 yrs, far short of the 15/20 estimated. It's not like they're live tissue that hook up and work in harmony with your body, they're not, they're just very thin and very dead cusps taken from a farm animal and treated with some magic jollop to maybe make them last a little longer.
When you're reoperated on in maybe 6 years time it'll be harder and more complicated than the first with more chance of needing a pace maker fitted afterwards. I saw a film recently about this and the surgeon pointed out how several bits and pieces on the "inside" had fused together due to the scar tissue from the first operation. This made things pretty tricky to get at.
I had OHS a couple of months ago and it still hurts when I cough or sneeze, as a rude reminder of the severity of the operation and I also have quite nasty side effects from being on the heart lung machine with all those little bubbles wizzing round my brain !
To want to volunteer to put yourself though all that again in a few years you'd need your head examining, never mind your heart !
Can you tell I'm having a bad day ? I am, still in bed because I over did it yesterday and my chest is hurting so much when I move about, so the thought of opting to go through all this again as soon as your tissue time bomb fails really is beyond my comprehension ?
The flip side is mechanical with ACT. The valve should last for up to 100 years, so should see you through and as for Warfarin, it's really not worth worrying about so long as you can simply remember to take a pill a day and have blood tests it's pretty easy stuff really.
Good luck.
Justin