Cow Valve Replacement Surgery – Bovine Valves

I will never forget my first interview with a heart surgeon.

My cardiologists – Dr. Wyman and Dr. Chaikin – had already confirmed that my aortic valve was suffering from severe stenosis and regurgitation. As they both told me, I needed a new valve and I needed it soon.

Cow Valve Replacement Option For Patients Interested In Bovine Pericardial Tissue

That first, surgical interview I held was with Dr. Alfredo Trento, the Director of Cardiothoracic Surgery at Cedars-Sinai Medical Hospital in Los Angeles, California.

Dr. Trento’s office was six stories up and looked across the Hollywood Hills. It was quite impressive.

“I’ve looked at your film Adam,” Dr. Trento said as he sat down in his leather chair, “You definitely need a new valve.” He continued, “Now you have some options. You can select a pig valve. You can select a cow valve. You can select an artificial or mechanical valve. Or, you can opt for your own valve using the Ross Procedure.”

I’ll never forget that moment. I gazed over at my mom who was sitting two feet away from me. “A pig valve? A cow valve?” I questioned Dr. Trento, “You mean I could have a cow valve used to replace my diseased aortic valve?”

Dr. Trento went on to explain that cow valves have been used for many years as valve replacements. By some, strange twist of evolutionary coincidence, our valves and cow valves are similar in tissue physiology. That makes them a frequent choice for heart valve replacement.

Although I opted for a different surgical approach – I underwent the Ross Procedure – I was always curious to know more about bovine valves and who manufactures them. It is quite an odd curiosity, I admit, but it exists. Plus, I needed to better research cow valves for my book.

  • First off, you should know that bovine valves are chemically treated for transplantation from the animal to the human patient. The human body typically responds positively to this procedure because of the similarities in tissue composition.
  • Second, unlike a pig valve replacement, a bovine valve uses the tissue of the cow’s heart NOT the actual structure. I better understood this when I visited Edwards Lifesciences for a heart valve manufacturing tour. Essentially, the cow valve results from a sophisticated manufacturing process in which the pericardial sack (the tough tissue sac that surrounds the heart of a cow) is collected and then processed into proper shape. Very, very, very, very interesting, right?

The disadvantage, however, is that the animal valve is not as durable as a human valve (given the lifespan of a cow) and is often more susceptible to calcification on the valve leaflets following a heart valve replacement operation.

Cow Valve Replacement Surgery - Bovine Valve

Reports suggest that the average lifetime of a cow valve replacement is about 10 to 15 years. Although some research suggests that cow valve replacements may last over 20 years. Therefore, younger patients opting to have cow valve replacement surgery may need to have a re-operation at a future time.

I hope this helps better explain cow valve replacement surgery and bovine valve replacement surgery.

Keep on tickin!

Adam Pick
Written by Adam Pick

Adam Pick is a patient, author of The Patient's Guide To Heart Valve Surgery and the founder of

To learn how Adam has helped millions of people with heart valve disease, watch Adam's video, subscribe to his free newsletter, or visit his Facebook, or Twitter pages.

  • Marlene Dodson

    I have had an mechanical artificial heart valve for nine years. I had a saliva stone surgery last week. I have two cracked teeth now. I have been on antibotics for 14 days, Can I have dental work done without taking lovinox shots? I had an epidural for my neck four weeks ago and had to take lovinox and stop the coumadin for four days. It is so expensive and if not necessary I would hope I could have the work done on my teeth without it.I would still be on antibotics. Thanks M. Dodson

  • nelson E Ferris

    I had heart surgery in August 4 bypasses and valve replacement with the bovine–shortly after surgery–started with itching and it is steadily getting worse–I have been eliminating medications as I am also diabetic–I am now on Insulin and will be starting on prednisone 40 mg for 1 wk and then 20 for 1 wk–watching blood sugars very closely to regulate insulin. My question is have you ever heard of someone having a reaction to this valve??

  • Crystal

    Hello! I was so happy to find this site! I am having open heart surgery Nov 2nd, and Im getting a bovine valve. I am terribly worried about the surgery, so was just looking around the internet for ppl who have had this surgery. I am 29 yrs old, and I was born with tetrology of fallot(blue baby syndrome) and was just wondering where to get your book and kinda looking for ppl who have been through this to email about my concerns.

  • Stacey

    My 15 year old daughter had her gortex patch replaced with a cow valve October 2010. She also had a septal occluder placed to close up a small hole in the heart. She’s doing great, not allowed to run yet but has been hitting softballs off a tee and some “light” pitching. Waiting to get approval to train and start playing softball again. No allergic reactions but has shown more signs of eating like a cow, her appetite has definitely increased!

  • Sandra S. Kaplan

    When a bovine aortic valve replacement becomes infected (visible vegetation radiographically and positive blood cultures) is it curable with intravenous antibiotics or does cure require valve removal and replacement as would be likely with a biomaterial graft.

  • R. Doukhan

    Do you or any one out there know if an intolerance to hot weather or dehydration are possible side effects of a bovine valve replacement? My elderly mother is dealing with both after 5 years. Never did prior to the surgery.

  • Steven Ryan

    Which is better, cow or pig?

  • R. Clement

    I had my aortic valve, root & part of the aorta replaced 2 months ago and since then it feels like my heart is going to beat right out of my chest. You can really feel it and at night or whenever you are quiet you can actually hear it beat in your head. Has anyone else had this and will it get better? It is driving me crazy.

  • Hi R Clement,

    You raise a great question. Here is a link with over 90 responses from former patients about heart pounding sensations after valve surgery.

    As you will read, you are not alone…

    Keep on tickin!

  • R. Deston

    I had an aortic valve replacement using bovine tissue, in 2005. I have never had an ache, pain or felt my heart beat since that time. Two days ago I had a complete cardiology examination and was given a good health report. At 80 years of age now, I am given to expect a number of more years with the same replacement. My sole medication is one 75mg dipyridamole tab taken twice daily.

  • k.smith

    I was born with tetrology of fallot. I have had 3 open heart operations. 2 when I was a child and pulmanary valve replacement in 2004. I walk 3 miles a day at a steady pace. I still work full time and feel good most of the time. However I can only move at a steady pace, I can’t step it up a notch if I do i get very short of breath is this normal? I also have a bovine valve and wonder how long will it last, do I have to worry. I am not sure I would want to go through the ordeal of having it replaced again. Anyone have any thoughts?

  • ron lake

    At age 60, I Had my aortic valve replaced with a bovine valve 12 years ago at Yale NH hospital and I have never had a problem. Still going strong.




  • Keith

    On April 27 2012 i’m going in for a aortic heart valve replacement. I’m 62 years old. The doctor suggested the bovine valve. I’m leaning that way. I’m hearing the valve lasts 10 to 15 years. I’m active out doors and on the tennis courts. I would like some feed back from people who have had this done and their reaction, pros and cons to this procedure.
    Thank you, Keith

  • Rev Ron lake


    I had a bovine valve in 1999 and have had no problem. I bike, reffed varsity basketball and hike. I am 74 and went yesterday for my yearly checkup and the dr. remarked how well the valve is doing He also told me he has patients at 25 plus years with the valve still working fine. Make sure you have a very experienced surgeon with lots of surgery behind him or her
    Good luck. You are in my prayers

    Reborn lake

  • Mike Kelly

    On August 23 2011, at 58 years old, I had a bovine aortic valve replacement, and a Dacron graft replacing my ascending aorta at the Cleveland Clinic in Ohio. It was a 6 hour drive and believe me it was worth it. So far everything is going great.No problems and I am as strong os ever. My surgeon was Dr. Eric Roselli. He also instructs the procedure to learning Doctors. I along with my entire family highly recommend the Cleveland Clinic. They have Hospitals in Florida also.

  • Ron Dennis

    June 21 2011 at the age 64 years old I had a bovine aortic valve replacement, and I’m doing great. I didn’t have any fear what so ever.

  • alice underwood

    i had an anulrysm on my aortic and i had it fixed and a bovine valve put in on april 29 2009 …i have done realy great so far …never had any problems with my heart but lost the sight in my right eye …that is when they relized they needed to check my heart …they said i was a lucky person by loseing my eye or they would have never knew i had the anulrysm …i have centreal retnia exclusion august 26 2006 was when i lost my eye sight ..oh ! by the way i am 70 years old …….the only problem i have is i smoke ……..i am so stupid

  • Ron

    I’m 66 & need aortic valve replaced quickly. No other health issues. One surgeon recommended bovine, another pig and the 3rd, mechanical. I’m confused! Good to see comments about the bovine. Please let me know if any of you have any suggestions. Thanks, Ron

  • Karen Klosterbuer

    I was born with “the funkiest mitrol valve ever” per my heart surgeon as he was replacing my valve in 2005. I had the bovine tissue valve and it has worked wonderfully. My cardiologist recently said there was no reason it shouldn’t last my full lifetime (I was 54 when I had the replacement). Since my heart had never delivered blood very well throughout my body, my improvement was immediate. I remember waking up one night thinking I was hearing bombs exploding on the army post firing range….turns out I was hearing my own heart beat for the first time ever…LOVED IT!!! I have always liked cows; now I really like cows. My husband does say I seem to “graze” all the time since the surgery….better than wallowing in the mud is my thought. I can only tell those who are anticipating a replacement is to relax and enjoy the improvement.

  • John Hayden

    I had a Bovine Aortic replacement at 64, 22 months ago.. No other non age related, health issues. I still work full time and life is great. No side effects, no problems and in general improved health. I can run up stairs. How lucky I am to find this valve problem, and solution within this decade, it would have been a different story, years earlier.

  • donald smith

    I was born with tetrology of fallot and had a Blaylock shunt at age 2 and corrective surgery at age 11, in 2004 I had a pulminarry valve replaced and have done well since. I have the same questions as most of you , How long will this valve last, can it be replaced again? I am now a diabetic, will this affect The valve. I am blessed by god and at age 56 am stilll working full time so if anyone is about to go through this procedure all i can suggest is to pray and never give up.

  • wm. franks

    i was 21 when i had tricuspid valve replacement w/ a pig valve. within 6 weeks, after coming off iv antibiotics i was sick, very sick. come to learn the valve was infected and i needed a second surgery. this time they went w/bovine (cow) valve. its now been 12 years and the only complications i’ve had thus far are a leak around the ring of the valve. although my surgeon did say i would need a surgery every 8-10 yrs. to replace said valve, im still kicking, somewhat. they want me to prepare mentally for a 3rd surgery but im sorta blocking it out by just living everyday to its fullest..

  • Bill Corley

    My father had a (Bovine)heart valve replacement in March of 2013. He developed CJD first noticed problems in June of 2013. CJD was confirmed August 2nd and he died August 4th of 2013.Is there a possibility of CJD contaminated Bovine heart tissue finding its way into his valve replacement?

  • wm jones




  • Yuri

    Had a mitral valve replaced with bovine a year ago and now I have developed all over rush/hives for which I find no cause, tried eliminating foods and now I wonder if it is possible I have an allergic reaction to the valve ??? By the way I am 71 and filling fantastic with my otherwise friendly cow.

  • Gary Hansen

    I had a mitral valve repair for a broken cord on my mitral valve, and a bovine aortic valve replacement on January 30th ( just a little over 5 weeks ago.) They also found a small hole in my heart that they sewed up while in they were in the area ! This was done by Dr Damiano at Barnes BJC hospital in St Louis. I can’t say enough good things about the skill and professionalism of Dr Damianom and his entire team. He saved my life, and actually made the entire process rather easy. Because 2 valves needed attention, I did have the full sternum incision, but even that was very manageable. I got home in only 4 days, and am doing great. I feel better than I have in many years. At 62 years old, I am looking forward to a long life, and many active years with my wife, children and grandchildren. .

  • Carol Smith

    ,My boss had heart surgery several years ago, his aortic valve was replaced with a
    cow valve. Since his surgery his heart rate very rarely gets ant higher than 49 and
    sometimes it is in the 30’s. Is this common or unusual ? Please reply, both he and
    his wife are aware that I was going to check on the internet to see if this heart rate
    is normal following his surgery.

  • B Ashley

    October 21, 2013 I had my aortic valve replaced with a bovine valve. I can actually feel my heart beat for the first time in many years. I had rheumatic fever as a child that caused my aortic valve to regurgitate. Within 6 months after surgery, I was walking 30 minutes twice a day at 2 miles per hour on my treadmill. I will be 60 years old soon and my best years are yet to come.

  • steven a husted

    i have never heard my heart beat and find it hard to find my pulse because i have a hard thick skin and fatty tissue and i am hard of hearing in one ear and deaf in the other will i be able to hear my heart after my aortic heart valve surgery

  • Bill Wright

    If the average life of a Bovine Aortic Valve is 15-17 years, what can a young patient
    expect to be done when this valve begins to fail after 15-17 years?

  • Hi Bill, If the valve fails, then you can have re-operation to get a new valve — kind of like a plumbing valve — out with the old, in with the new. Or, you may even be able to get a Valve in Valve procedure using the new TAVR devices (at some point).

  • Bill Wright

    Thanks, Adam. If BAV installed via chestwall, would later valve replacement need to be done via chestwall again or through the groin artery? How many times could
    this valve be replaced?

  • Connie Belmonte

    My husband had his mitral valve replaced 9 months ago with a bovine valve. Everything is good. Now he’s been on coumadin for afib and would like to take xarelto instead is that possible?

  • Mick

    My husband is flying in March and I wondered if he should with a cow valve replacement.

  • bethmoore

    Thanks for your post, I’ll be 60 in march and got a cow valve for avr, you gave me real hopem

  • steven a husted

    well after my surgery i can now hear my heart and feel my pulse i am glad i had the surgery and i am glad i chose a bovine valve and would choose it again because of my fear of a bleed out j bleed internally several times a year from kidney stones i am 9 months out and doing fine i have started cardio rehab phase 3 it is very helpful your heart brother steve (popeye)

  • Debbie

    I had aortic valve replacement in 1998 using a pig valve. I chose this option so I didn’t have to worry about taking blood thinners. I am coming up on year 17 and still ticking right along. At 61 years old, I am praying it will last me my lifetime, but my cardiologists thinks I will need to have it done again in the future. However, great strides are being made in methods. I sm hoping if I do need another relacement, it can be done with stint surgery where they balloon the valve in. Have to say I am so grateful to that pig for its good valve! I would go the same route again. Best of luck!

  • Niketana

    I will be having mitral valve repair or replacement surgery in a week. But the big concern of the cardiologist and surgeon is the enlarged heart. Can such an enlarged heart regain its shape and smaller, healthier size?

  • JonUsingDisqus

    I have Bovine Aortic Heart Valve since April 2008 and today is June 3,2015., I am 74 and valve works great. At issue is : my Cardio Doc has me always taking 4 pills of 500 MG Amoxicillin (thats 2000MG) one hour prior to Dental procedures. Late last month (May 2015) the Amoxicillin destroyed the good bacteria in my gut and i have diarrhea on and off for two weeks ,so the Gastro Doc placed me on Medicine “Flagyl “for a C.Diff infection in my gut. I also take 5Mg of warfarin daily since 2013 because of a suspected AFIB , I say suspected because I had poor vision in right eye lasting 15 minutes that occurred in year 2013.The Cardio Doc said it may have been from a brief lasting clot that may have been formed from a suspected AFIB. By the way I have no recorded incident of AFIB since my new valve was installed in May of 2008.
    I am not comfortable with this Cardio Doc but don’t know where to turn.. I say that because i have been to hospital emergency room 5 times in past 24 months because of bleeding from Xarelto and Warfarin. And also i must say this cardio doc had me first on xarelto for suspected AFIB until my medical RX plan would not refill, because the FDA has not approved the newer drugs like Xarelto for individuals with Aortic Tissue Valves.. My current medical RX plan found several meds that are not compatable with warfarin and caused me to pass blood.

  • JonUsingDisqus

    thats a good question … i have the same exact question as you Connie,except my bovine was the Aortic

  • JonUsingDisqus

    Bovine Aortic Help question:

    Must I always take 4 pills of 500 MG each of Amoxicillin prior to All Dental Visits?

    Because I always bleed the next day

    I also take 5 MG Warfarin daily

  • Shelley Eiteman

    Hi everyone. I have a question. I had aortic valve replaced almost 2 years ago, with a bovine valve. The valve area is now at 0.78 cm again. Is this normal? Anybody have this happen? Thanks, Shelley

  • Courtney Sandow

    Where do they get the valves.Kill the cow or somehow preserved?

  • Helga Wetzold

    Adam can you please tell me if you know anything about TAVR valve in valve replacement. My husband received a bovine aortic valve which does not open properly the walls thickened after2 1/2 years.
    Suggested procedure is valve in valve replacement. Scary because we don’t know enough about this procedure.

  • Brian Coghlan

    Getting a mitral valve repaired, possibly a valve replacement as the leaflet is severely torn, lean towards a mechanical valve as I plan on living past 80, I am now 68. My surgeon leans towards a bovine valve I have read good things about the St. Jude and On-X mechanical valves, but taking blood thinners are my concern are they that hard on you? ANY input is appreciated.

  • Kenny S

    This is a great site. I am scheduled for surgery on Sept 29th to address an ascending aortic anureysm and a leaky aortic valve. Surgeon said I need to tell him what kind of valve I want IF he cannot repair it. After reading the comments here, I will go with the bovine valve. I don’t want to have to deal with blood thinners the rest of my life. I’m 58 and relatively active but hopefully I can get many years out of the bovine valve. Having my surgery done at NY Presbyterian by Dr. Leonard Girardi. Best of health to all of you!!!!


    Hi Adam, I am a 37 years old Male and I need my bicuspid arotic valve stenosis /regurgitation to be replaced, which is better for me -Pig or a cow tissue? I do understand that I will reop ! But which is better if the human tissue is not available which would be my first choice !!! And what’s the difference between stent and stentless? Thanks

  • Marlon V. Garcia

    Hi bill. I’m with a medical facility here In California and we are investigating another case of CJD and its regarding the use of imported bovine pericardium from New Zealand.We suspect that the tissue used might possibly have been infected with the prion.The surgery was performed around the same time period as your father’s. If you don’t mind, is there any way we can get in contact with you? We have a team of doctors and we would like to find out if ur dad’s CJD is related to our patient’s CJD. Please let me know.

  • Vicki Hood

    Is this tissue from a calf or cow raised strictly for the tissue or is it a by- product of a meat cow from the slaughterhouse? I am vegetarian and have bad feelings about this.

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