Valve replacement...............

Tissue or mechanical valve

by LondonAndy - 2017-04-15 02:58:25

I don't think there is a straight-forward answer to your question, and whatever conclusion you reach I am sure will be right for you.  As you rightly point out, tissue valves have a shorter life than mechanical, and so 2.5 years ago, at age 48 when I was told I needed one, I had no hesitation in going mechanical. Open heart surgery is not something I wanted to keep doing, especially with the increased risks of it when 10 - 15 years older each time, combined with increased risks of cutting the heart and tissue, let alone chest bone, repeatedly.

So what are the down sides of mechanical?  There are two that people normally complain of: the fact that they tick, and the fact that you have to be on Warfarin for the rest of your life, which means bleeding incidents are worse, there are stroke risks if you get the dosing wrong, and for women it complicates pregnancy.  Speaking as someone who doesn't even have mechanical clocks in the house because I find the tick irritating, I have to say I only notice the ticking when I listen for it.  It is just like a watch, and I don't mind it at all.

Warfarin issues are also now greatly reduced by the wider adoption of home-monitoring.  Instead of going off to an anti-coagulation clinic once a month or so for a blood draw, I do a finger-prick test at home using a CoaguCheck XS machine that is similar to those used by diabetics: you have a test strip each time, and insert this into the machine for a reading in about 15 seconds.  Here in the UK our national regulator, NICE, found that this specific machine is reliable and similar quality to lab results, and being able to test weekly means staying in the right range is much easier.  Typically somebody under a clinic is in range no more than 70% of the time, but I have been in range over 98% of the time.  This means a 42% or more reduction in the risk of a stroke.  Plus the convenience of doing this at home whenever you want, compared with going to the clinic.  You can see their full report at https://www.nice.org.uk/guidance/DG14 - it is £300 for the machine, which in most areas the patient has to buy, but thereafter your GP should prescribe the test strips for you - but check as some don't, weirdly.

Having said all that, my cardiologist says that there have been improvements to the design of tissue valves that make choice between them and mechanical less of an issue, and technology such as TAVI can mean extending the life of a tissue valve without OHS by inserting another valve inside.

You can see lots of discussions on the whole mechanical v tissue valve on www.valvereplacement.org.  For me, avoiding repeat surgery was the deciding factor.  Hope this helps.

Hi London Andy........

by Tattoo Man1 - 2017-04-17 16:03:56

.......you have demonstrated that great quality that Pacemaker Club has exhibited for the years that I have been a Member.

At the best, this is a clear and knowlegeable grasp of details of proceedure,..reliable news,..compassionate support and that ..'need to know about info' that is not that free for so many of our Global Community.

Andy, my thanks for your contribution..you, I guess..are not short of good solid information, but do really value well informed facts

Tattoo Man..also a Londoner ...(SW3)