tissue valve vs mechanical -coumadin

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A

amy

My husband, age 46 will have an Aortic Valve Replacement in a few weeks. We are now faced with deciding between mechanical and biological valve. One one hand another operation in 15 years has to be considered. Then again who know what advances will have occured by then. The thought of a lifetime on coumadin is not a wonderful thought either. Please, we are looking for feedback from people who are living with coumadin on a daily basis. What are your experiences with coumadin? If you had to do it again, would you still choose a mechanical valve over biological?
 
Hi Amy,

There are many posts about Coumadin on the Coumadin thread that you posted your message on. I think you will find many answers to your questions if you read through the many postings on this topic.

I have a mechanical valve, and have been on Coumadin for over 2 years now trouble free. I was 49 when I had my valve replaced.

Good luck,
Rob
 
Hi Amy,

My surgery was almost two years ago and I have a mechanical valve. I would choose it again as I hope to NEVER have this surgery again.
Coumadin is not a big deal once it is stable. I do everything I used to do before surgery. The best thing is if he's going with the mechanical to do the hometesting with the Protime and not have to go to the lab all the time.
It is also helpful if he has a doctor who knows how to regulate Coumadin.
As Rob said before me there are many, many posts on Coumadin and you'll learn a lot.
Happy reading.

Christina
Congenital Aortic Stenosis
AVR's 8/7/00 & 8/18/00
St.Jude's Mechanical
 
I was 46 when my surgery was done last fall. I did ask the surgeon about a pig valve, but he directed me to a mechanical valve so that the surgery would not need to be repeated. Although I have learned much since then and wondered many things, I haven't regretted the St. Jude's valve I have. Coumadin is no big deal. I've cut myself many times since the surgery (I am NOT clumsy, lol) without bleeding any more than I did before surgery, which is next to nothing.
But as has often been stated here, whatever decision you make about the kind of valve is the right one.
 
Tissue valve Vs Mechanical

Tissue valve Vs Mechanical

Reply to Amy,

I had my aortic valve replaced with a St. Judes mechanical valve in 1990. Next month I will be starting my 13th year with this valve and have been on coumadin for this period of time. Since the initial establishment of the correct dose I have had no problems being on this medicaton. I purchased a pill box so that I would always be sure to take my medicine and I keep it by my bed and I take it each night at bedtime. The few times I have cut myself I did not have any trouble controling the bleeding. Of course the decision as to which valve to choose is always yours but I can tell you that taking coumadin has not been a problem for me and my valve has done its job. I had my surgery at age 39.
 
Hi Amy

I am 43 years old, and have 2 St. Jude mechanical valves. Like many others, I didn't want to repeat surgery, and had some other issues that steered me very clearly toward the mechanicals. I haven't regretted it at all...I feel so much better!

Coumadin is really no big deal for me. I had a bit of trouble getting a stable INR, but that only lasted about 6 weeks, I've been stable for the last month. It really has not impacted my life at all...other than remembering another pill I have to take.

For me the potential additional surgery was a much bigger factor than the Coumadin...

Again, this is my experience, and there is lots to read here with varying opinions.
 
Hello Amy,

The surgeon who performed my bypass told me he preferred mechanical valves for patients under age 50 and tissue (Bovine Pericardial) for those >60+ The durability numbers for Bovine Pericardial Valves are 90% at 15 years and counting. Porcine valves have shorter lifetimes, typically 7 to 12 years. Of course there are exceptions, in both directions, but it's best to look at the center of the distribution for planning.

My understanding is that the risks for a second surgery are slightly higher (5 to 10%) than for a first. It is the THIRD surgery where scar tissue becomes a much larger risk factor.

I think the final decision comes down to which set of undesirable consequences you feel you can best accept. Every choice has it's advantages and disadvantages. If you feel VERY strongly about your preference, you need to make sure your surgeon understands the depth of your desire.

At age 58, my first choice was for a Bovine Pericardial Valve but after getting inside, my surgeon felt my best chances for a longer life were with a mechanical valve and he installed a St. Jude Mechanical.

'AL'
 
I had my aortic valve replaced with a St. Jude mechanical in August of 1999 at age 30. I was and continue to be very active (running, fishing, working, traveling, etc. My wife and I just had our second child.) Coumadin has never really been an issue. My lifestyle is essentially the same, except that I have had to cut back on my alcohol intake. (No more drinking to excess.) I have not noticed that I bleed or bruise any more now than I did before Coumadin therapy.

I don't believe Coumadin therapy will be an issue for your husband unless he makes it one. In the long run, with a mechanical valve, I believe he will be happier that he does not have to worry as much about possible future surgeries.

I wish you and your family the best.
 
Like 'Al', I too was 58 when my aortic valve was replaced. My Cardio said I was much too 'young'..heehee..to go with the other possible options. I have found taking Coumadin an easy thing to adapt to..especially with home testing available. I did give up horseback riding tho...too many possible risks..I felt. Best of luck in your choice...it's a personal thing and as has been said here, yours will be right for you!

Zipper *~*
 
Hi Amy-

And welcome to this terrific site.

My husband, Joe, has had a mechanical aortic valve for 25 years, and a mechanical mitral for 3 years. He's been on Coumadin for 25 years. The day to day living with Coumadin is no big deal. You go and get tested every couple of weeks, take what they tell you, and then forget about it until the next test. When he was younger, he was a very active man. He's 71 now.

Both his valves click, but he's used to them and he doesn't even hear them any more.

So those things shouldn't be issues in the choice.

Having another operation should be something you should think about long and hard. The first surgery isn't too bad, the second one, so-so, anything beyond that is a tough surgery and recovery. Joe had a third surgery to close a paravalvular leak in the mitral valve. His recovery was much longer for that. Scar tissue becomes a big issue with each successive surgery. Not just for the heart surgery, but any other surgery that might be necessary in the immediate vicinity.

Do you have a date for the surgery yet?
 
I'd much rather take my Coumadin everyday than go through another surgery. I was 47 at the time of my surgery and would be looking at multiple future surgeries with a non-mechanical valve if I live as long as I plan to.
I haven't had any serious cuts, but I like to work on my car and I'm always busting my knuckles without any major bleeding problems.
My only real lifestyle concessions have been to give up very heavy weight lifting (300 lb bench presses) and limiting my alcohol intake - no more beer, just a glass or two of red wine with dinner.
 
My husband's surgery date is July 19. He just donated the first of two units of his own blood today.
 
hi amy!
welcome to this wonderfully supportive and informative site. the members here have all been such lifesavers to many of us. my husband had his surgery (ross procedure) exactly 9 months ago today. he was and is 49/
although i've read that most coumadin takers are very comfortable taking it and living that way, it is the non-coumadin takers who are usually the ones who fear taking it.
my husband felt very strongly that he did not want to alter his life and opted for the ross procedure instead. there are several "rp's" on this forum. the rp is a longer surgery since it involves replacing the aortic valve with the person's existing pulmonic valve and replacing the pulmonic (pulmonary) valve with either a homograft (what joey has) or some other valve (mara has a cryolife synergraft).
please check out this very thorough posting by peter easton:
http://www.valvereplacement.com/forums/showthread.php?s=&threadid=304&highlight=making+the+choice
many of us have found it to be helpful.
the bottom line though is that this is a very personal thing, but remember, there is no wrong choice.
wishing you all the best, sylvia
 
Amy

Amy

I had mine last year at the tender age of 37. I have no regrets because I am single and do not like having the thought of having surgery again too soon. You must go with what feels right to you and husband. Do what you feel is best. We are with you with whatever you decide. Just hang in there.

Caroline
09-13-01
Aortic valve replacement
St. Jude's valve
 
Hi!

My husband is a double valve patient. Oct. 3rd, 2001 was the date of his surgery. He has two St. Jude mechanical valves. For him, since he is in peresistent a-fib, and must take coumaden for the a-fib anyway, his choice was pretty simple. He has two St. Jude mechanical valves.

He has had a couple of "bleeding episodes". But, if you read all of the posts here, you will find that this is very uncommon. He had gross hematuria (blood in his urine) that necessitated a lot of testing, etc., but they determined it was from the coumaden. He also takes a baby aspirin (due to the arrythmia), so that has an impact as well. Without a question, we are both glad he chose the mechanical valve. Even though in April he was diagnosed with a third, severely leaking valve. (tricuspid) When he has had an episode, truly it hasn;'t been that bad of a problem. Quick call to the Dr., in to see him, and they take care of it pronto. It is better than having a stroke, and since he had two TIA's before going on coumaden prior to surgery, then we are 100% for the drug.

Most, the vast majority, have no problems with it. But, the folks who have biological valves don't either. Like everyone said, it is a personal choice.

Best wishes over the coming weeks, and welcome to this site.

Marybeth
 
Taking Coumanin

Taking Coumanin

Hi Amy..I am just under 3 months post-op on Coumanin..I have stayed in range..2.5- 3.5..all along. My own Protime arrives by UPS today..I will be taught by a nurse from their company over the weekend..and then I will be free to travel in our motorhome again, no more hanging around waiting for an appointment, ect. to have INR done....Also, who knows whatadvances with be made in the future to replace Coumadin...Tell your Hubby good luck...with whatever Valve he chooses. Bonnie
 
This board has been a godsend. Eveyone is so supportive and there is an abundance of information available.
 
Another further development to consider.

Warfarin has been the mainstay of anticoagulation since the 1950s. No other drug has such longevity. We know a lot about it and how to manage it very well.

However, there are several drug compaines racing to market with warfarin's replacement. It may be a few years before there is one approved use with mechanical valves, but I would bet the farm that that warfarin will be replaced before the procine valve would wear out.
 
HOME TESTING

HOME TESTING

HELLO.....I'VE BEEN ON THE LIST READING ABOUT HOME TESTING PT-INR KITS. DOES ANYONE HAVE AN E-SITE ADDRESS OR RECOMMEND ONE UNIT IN PARTICULAR? IT CERTAINLY LOOKS MORE CONVENIENT THAN HAVING TO GO TO THE CARDIO EVERY 2 WEEKS, AND IS DEFINITELY SAFER. THANKS.......EVELYN
 
Evelyn:
At the top of the first screen on this board ValveReplacement.com,
you will see a re/orange strip. At the end of that strip you will see,"Sponsored by Q A Services." Just click on the "Q A Services.
There you will find information of the ProTime system, which many people on this board use.
 
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