Thank you for sharing your story and your thoughts on valve choice Michael. I'm sorry that your hospital experience was not a good one. Like Crooser and Keithl, I had a very good experience in the hospital. I had my procedure at UCLA.I wish I had discovered this forum when I had time to consider options. I already had my surgery this past June (2021) but I am posting this only to emphasize how valuable this forum is. It has been interesting reading about experiences and reasons behind choices made.
I have been fortunate to be reasonably healthy and strong. Something serious like open heart surgery was new to me. It all came fast. After about 2 months of symptoms which were not eliminated with normal adjustments I saw a doctor. It was either physical or more disciplinary (lack of proper rest). Symptoms pointed to a heart condition. After an initial echocardiogram I was immediately referred to a cardiologist and told a valve replacement was inevitable and within a couple months.
As the options were described the dangers of Coumadin stood out as the greatest threat. How naive. I had yet to go through open heart surgery but that was not the concern at that time. My biggest concern was being able to arrange and manage everything on my own from beginning to end. Up to the final moments before I was knocked out I never got nervous about the surgery. Getting through the surgery was nothing if I could get that far.
You would think I would opt for the one time shot through the mechanical valve option. Maybe my situation is so unique it is not useful to hear. My big concern was not the surgery itself or even the recovery from it. It was managing everything on my own. At that time I perceived a life on blood thinners as a life ever at risk of stroke so I chose the biological valve and consequently to have at least two open heart surgeries in my lifetime (I was 62 at the time of the surgery). I would accept the surgeries but I was not considering the logistics.
Having experienced the surgery, (more specifically the recovery in the hospital), I would not make the same choice. My experiences in the hospital were some of the worst things I had experienced in my life. It was the people and the environment. The good could not counter the negative. Far from healing it was a toxic environment and my needing to be sparkling clear before I could be released, given my solitary lifestyle, made me an inconvenience to some nurses. The experience was so miserable I would rather live susceptible to a stroke than go through the hospital process again. I look forward to truly minimally invasive advancements.
If you feel comfortable sharing, it would be good to know the name of the clinic and any specifics that you were unhappy about. You might also consider writing a letter to the hospital administrator about your experience. There is no certainty that they will pay attention to your concerns, but without feedback it is unlikely that things will change.
I appreciate you being honest about how you feel about valve choice. At 53, I felt that the mechanical valve was the right choice for me. I still feel that I made the right decision, but at the same time, the thought has crossed my mind that the surgery and recovery went so well that if I had to do this again it would not be that big of a deal. Although, each time they go back in does carry a little more risk due to scar tissue and the fact that one is older.
At 62, the guidelines indicate that either tissue or mechanical valve are reasonable choices. I tend to agree. If I was 62 and it was my first surgery, I can't say for certain, but I very well might have chosen tissue. There are pros and cons of either decision. The best thing to do now is to not look back and just live the best life that you can, enjoying every moment of the precious time we have here.
As others have suggested, I would definitely plan ahead to have my next surgery at a top rated facility. I am fortunate in that I live just 2 hours from one of the top ranked clinics in the nation. It is a big enough deal that it is worth travelling if your local area does not offer top rated institutions.
For now, the best course of action is to live a healthy lifestyle. There was one study which showed that having uncontrolled blood pressure, excessive weight and insulin resistance led to quicker SVD (structural valve deterioration) for prosthetic tissue valves. So, taking steps to stay in the ideal zone in these categories would be one positive step you could take to increase the likelihood that your valve will last longer, which would mean regular exercise and healthy eating- basically the things that keep us in general good health anyway. This will also help you go into your next procedure in the best condition possible. Hopefully that day will be many many years away.