Seventeen years ago today, my husband received a mechanical valve. We were told it would last well over 100 years - that it had never failed in laboratory testing. That sounded wonderful.
In 2001, there was an opportunity to replace that valve when his chest was opened to remove his ascending aortic aneurysm. The valve looked good at 11 years old, so it stayed in place.
On Novemeber 30, 2005, fine, hair-like strands of tissue on the intake side of the valve broke off and went to my husbands brain. He had the equivalent of 4 or more strokes all at once. The mechanical valve kept opening and closing. But it was the source of very major harm to my husband after 15.5 years.
The human body is very different than experiments in a laboratory. There they can simulate mechanical exercising of a valve that is the equivalent of 100 plus years of opening and closing. But they cannot simulate all the conditions inside the human heart. The pathology report on his old mechanical valve showed pannus (tissue) overgrowth around the valve, and also fraying of the fabric sewing ring. The tiny hair-like strands were too small for the pathologist to see.
The actual proven time for valves inside the human body still has a fairly young history - the first aortic valve was replaced by Dr. Harken with a mechanical in 1960. The first complete replacement of a mitral valve was done that same year.
It is extremely important that they do all the engineering tests. They are vital. There must not be any physical failure, so these devices need to be vigorously exercised. (The Bjork-Shiley strut failures were in our local newspapers seventeen years ago, just as he went in for valve surgery.)But we have learned that mechanical failure is not the only source of problems, and in every possible way, the valve should be followed.
Last year, my husband received a new tissue valve. This time we were told something more realistic - words in agreement with the 2006 Guidelines for Valve patients. Every prosthetic valve, whether tissue, mechanical, or self donation/homograft (Ross procedure) needs to be followed.
Despite what has happened to him, I encourage my husband to enjoy each precious day. We don't want it spoiled by worrying about his valve or his aorta. But we will always be sure to have a follow up plan in place for him.
Best wishes,
Arlyss