Mechanical Valve

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pellicle

Professional Dingbat
Joined
Nov 4, 2012
Messages
9,101
Location
Queensland, OzTrayLeeYa
I sure hope to have my mechanical valve for a lifetime, but it seems everything regarding this issue is a crapshoot, which is unfortunate
thats true, but its all a matter of understanding what those odds are.
Lets look at Roulette, some bets are nearly 50:50 (like black or red) other bets are much less likely (any particular number).
With a mechanical the chances of needing it replaced if you don't have a possibility of an aneurysm (so, say you are also having it fixed at the same time) are very low. No matter what the time scale.

With a tissue prosthesis the chances of it having SVD move towards a certainty as you approach 20 years.

As you already know, outcomes with a mechanical are determined by how well you manage ACT, outcomes with tissue prosthesis are more stochastic and management is only by surgery (which included TAVI).


1637542200138.png


lastly life itself is a gamble ... play the hand and see where it goes :)
 

Jodie leigh

New member
Joined
Nov 24, 2021
Messages
3
Hello Everyone! Initially I had planned on going with a tissue valve to replace my Bicuspid Aortic Valve, but now I'm seriously leaning toward the Mechanic Valve at the advice of my surgeon. He said, as an athlete and someone hoping to NEVER repeat this surgery it would be the best option. I'm leaning toward the On-X. What is the incidence of failure on a Mechanic Valve? Would you mind sharing your experience? Would you recommend a Mechanic Valve for athletes over a tissue valve?
Tbh with your age if you don’t want to have surgery again (which I’m not going to lie is absolutely traumatic) then I would go for mechanical only downfall is anticoagulation for life and the noise of the valve! Some people like it and it reassures them it’s working me however find it unbearable and my anxiety is awful!!
 

nobog

Well-known member
Joined
Jun 14, 2019
Messages
146
Location
Wisconsin, USA
I've seen way too many tissue valves fail. In 1997, I got my mechanical. It's slowly failing, but I will keep it as long as possible.
How did they determine that it's "slowly failing" ? That's only 24 years - that's nothing for a mechanical valve as far as "wearing out". Maybe something else is going on that you have not been provided specifics on.
 

Redone

Well-known member
Joined
Sep 1, 2021
Messages
53
Location
Boston, Massachusetts
Tbh with your age if you don’t want to have surgery again (which I’m not going to lie is absolutely traumatic) then I would go for mechanical only downfall is anticoagulation for life and the noise of the valve! Some people like it and it reassures them it’s working me however find it unbearable and my anxiety is awful!!
Yes, I've done much research on this procedure. I will not allow this to take me down. It's definitely been a challenging 6 months wrapping my head around the surgery. I am a personal trainer (my work is affected), former bodybuilder, super fit, hike mountains, etc. A lot to lose regarding fitness and activities, but I will not succumb to this.....I will get my life back. You will get yours as well. Faith is the substance of those things hoped for, but not seen 🙏🏻. Prayers you have better outcome in time.
 

Redone

Well-known member
Joined
Sep 1, 2021
Messages
53
Location
Boston, Massachusetts
thats true, but its all a matter of understanding what those odds are.
Lets look at Roulette, some bets are nearly 50:50 (like black or red) other bets are much less likely (any particular number).
With a mechanical the chances of needing it replaced if you don't have a possibility of an aneurysm (so, say you are also having it fixed at the same time) are very low. No matter what the time scale.

With a tissue prosthesis the chances of it having SVD move towards a certainty as you approach 20 years.

As you already know, outcomes with a mechanical are determined by how well you manage ACT, outcomes with tissue prosthesis are more stochastic and management is only by surgery (which included TAVI).


View attachment 888232

lastly life itself is a gamble ... play the hand and see where it goes :)
Thank you! I'm playing the hand tomorrow so we'll see how it all goes! 🙏🏻🙂
 

charlottekaye

Well-known member
Joined
Apr 4, 2012
Messages
76
Location
georgia
How did they determine that it's "slowly failing" ? That's only 24 years - that's nothing for a mechanical valve as far as "wearing out". Maybe something else is going on that you have not been provided specifics on.
My cardiologist explained that tissue or maybe calcification is interfering with SW×× working parts ( leaflets.) I had no idea this could happen.
 

perrybucsdad

Active member
Joined
Sep 5, 2011
Messages
27
Location
Perry Ohio
@Redone , I remember when I had to have my aortic valve replace in 1997, I was all hell bent on having the Ross procedure. I dreaded the thought of having to be on ACT for the rest of my life. I remember waking up in the ICU and my wife was beside me and I remember her breaking the news to me that they had to use a mechanical valve as my aortic root was too dilated, and there were other issues as well. I remember how upset I was and I felt like the world was going to end because now I had this mechanical thing in me and I was going to be forced to take a rx for the rest of my life. Well, guess what? Yes, I have to take warfarin for the rest of my life (and no, it was not the end of the world), but I also had to start taking some other meds for BP, etc, so the fear of having to take a rx was unfounded.

Sure, I had to better understand what being on warfarin meant. I didn't have to stop shaving with a razor, I didn't have to give up having fun (yes, I need to be careful). The biggest relief that I felt in the days after my surgery was the fact that hopefully (assuming I take care of my heart, don't let endocarditis or anything else screw up my valve/heart - which btw I would still have to watch out for with the Ross or other procedure) I will never need to have open heart surgery to replace my valve again. That is such a good feeling now at 52 years of age knowing that.

Bottom line though is trust your doctors. They know what is best and can make an audible when they get in there if they feel something else will be better for you. At the time you may not fully understand the why, but they went through all that schooling and have all those years of experience that none of us really have. You will be in my prayers.
 

le19555

Member
Joined
Jun 23, 2021
Messages
12
Remember yes a tissue valve may only last 10-20 years but your age is a factor. Also the resillia tissue valve which I had put in 3 weeks ago can fairly simply get a tavr so it’s possible to get 30 years without a need for a second ohs. I chose tissue because I am 66 and did not want to hear a ticking sound, be on lifetime blood thinners and worry about the infections that mechanical valves are more susceptible to. I was all in on a mechanical valve until I stopped and weighed the pros and cons for me. If I was 55 or younger it would have been an easy choice to go mechanical. All that being said, it’s a personal choice and there is. I wrong or right option. Be open minded, read up and listen to the doctors.
 

Redone

Well-known member
Joined
Sep 1, 2021
Messages
53
Location
Boston, Massachusetts
If you follow the hands that have been dealt before you all will go well. Be sure to come back here on Tuesday to let us know how it went.😍
Wish I could have come here Tuesday! Definitely the most challenging situation I've faced before! The surgery went well! It took the surgeon 4.5 hours, which is amazing because I had a lot going on. Bicuspid Aortic Valve Replacement, Aortic Aneurysm, and both left and right Coronary Arteries required repositioning. I'm still in the hospital while they provide me with INR #'s. I praying to go home today. I've been at the hospital 6 days. My blood pressure has always been normal, but after the surgery they put me on Metropolol and it lowered it even more. If it weren't for me saying do I need that if it's already low I would likely be taking it much longer although I do think my care was top notch. I was in the ICU Monday, Tuesday and moved on Wednesday. I had/have absolutely no pain in my sternum (I am so grateful). One thing I didn't expect was the 27lb weight gain from all the fluids they pumped in me during the procedure. It might not be a big deal to most, but it's made me so uncomfortable (although honestly no big deal on the grand scale of things) after all I'm alive. Everything looks good for discharge today that's if my INR #'s come back good! I'm praying to go home because even though my care was incredible the hospital is a place to be repaired and home a place to heal. Every time I tried to sleep another tech or nurse was in the room taking vitals so I'm definitely sleep deprived right now. I'm also really looking forward to NOT being a human pin cushion. I have bruising everywhere from a harvested Artery that wasn't used to bruises on my arms from IT'S etc. None of which is a big deal because I am alive and so incredibly grateful for this life 🙏🏻 ❤
 

Unicusp

Well-known member
Joined
Jan 30, 2021
Messages
236
Excellent news. Congrats. So, what valve (size & mft) was implanted? Where was your surgery? Looks like full sternotomy.
Yeah that water weight gain was surprising for me too. Took about a week to get rid of it. And Metropolol, oh boy. Must be an incentive to put every patient on it. Did not like it and stopped it. Much better without. At least for me. Others may be different.
Good luck and get better! It goes quickly.
 
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